title: Active peripheral inflammation is associated with pro-atherogenic lipid profile in psoriatic arthritis.
abstract: The association between psoriatic arthritis (PsA) disease activity and lipid profiles has not been explored. We studied the association between active peripheral arthritis and/or enthesitis/daclylitis with lipid measurements in PsA.
  
  
  
  We conducted a cross-sectional study of PsA patients enrolled in the Consortium of Rheumatology Researchers of North American (CORRONA) registry. Low activity was defined as Clinical Disease Activity Index (CDAI) ≤ 10 without enthesitis or dactylitis. Moderate-to-high peripheral disease activity was defined as CDAI > 10 and/or the presence of enthesitis/dactylitis.
  
  
  
  Of the 4672 patients with PsA enrolled in the CORRONA registry from June 2008 to October 2012, 725 (15.5%) had complete data on CDAI and lipid measurements. Of them, 284 (39%) patients had CDAI > 10 and/or enthesitis/dactylitis. Moderate-to-high group included more women and more current smokers. Patients with moderate-to-high disease activity had shorter duration of disease, and were more likely to be on prednisone, but less likely to use tumor necrosis factor (TNF) inhibitors. Moderate-to-high peripheral disease activity was associated with abnormal total cholesterol (TC) (>200mg/dl), odds ratio (OR) = 1.58; 95% CI: (1.11, 2.24); p = 0.01, and abnormal triglycerides (TG) (>150mg/dl), OR = 1.64; 95% CI: (1.16, 2.32); p = 0.005, after adjusting for gender, duration of PsA, smoking, body mass index, diabetes, modified Heath Assessment Questionnaire scores, as well as the following medications: methotrexate, other non-biologic disease modifying anti-rheumatic drugs, prednisone, TNF inhibitors, cholesterol lowering medications, and fish oil. The presence of enthesitis and/or dactylitis, irrespective of CDAI scores, was associated with abnormal TC, OR = 1.64; 95% CI: (1.08, 2.48); p = 0.02.
  
  
  
  Our findings suggest an association between peripheral joint inflammation and lipid dysregulation in PsA. Further studies are needed to determine if treating PsA improves lipid profiles and cardiovascular mortality.
authors.affiliation: Division of Rheumatology, Montefiore Health Systems, Albert Einstein College of Medicine, Forchheimer Building, Room 103N, 1300 Morris Park Ave, Bronx, NY 10461.
authors.forename: Asha
authors.initials: A
authors.lastname: Shrestha
authors.affiliation: Division of Rheumatology, Montefiore Health Systems, Albert Einstein College of Medicine, Forchheimer Building, Room 103N, 1300 Morris Park Ave, Bronx, NY 10461.
authors.forename: Asena
authors.initials: A
authors.lastname: Bahce-Altuntas
authors.affiliation: Division of Rheumatology, Montefiore Health Systems, Albert Einstein College of Medicine, Forchheimer Building, Room 103N, 1300 Morris Park Ave, Bronx, NY 10461.
authors.forename: Wenzhu
authors.initials: W
authors.lastname: Mowrey
authors.affiliation: Division of Rheumatology, Montefiore Health Systems, Albert Einstein College of Medicine, Forchheimer Building, Room 103N, 1300 Morris Park Ave, Bronx, NY 10461. Electronic address: abroder@montefiore.org.
authors.forename: Anna
authors.initials: A
authors.lastname: Broder
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D007249:Inflammation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D014280:Triglycerides / Q000097:blood*
chemical_list: D000924:Anticholesteremic Agents; D018501:Antirheumatic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol
keywords: Cardiovascular risks; Disease activity; Lipids; Psoriatic arthritis