title: Gastrointestinal comorbidities in patients with psoriatic arthritis.
abstract: Comorbidities associated with psoriatic arthritis (PsA) include cardiovascular diseases, diabetes mellitus, and obesity. This study evaluated the association between PsA and common gastrointestinal (GI) diseases. A retrospective study was performed in Israel's largest health care provider database between 2002 and 2013. 3161 PsA patients were matched for age and sex with 31610 randomly selected patients. We searched these patients' records for the presence of peptic ulcer disease (PUD), reflux esophagitis, Crohn's disease, ulcerative colitis, irritable bowel syndrome (IBS) and celiac disease. T-test was used to compare continuous variables and a Chi-square test was used for categorical variables. Multivariate logistic regression models were used to assess the association between PsA and GI comorbidities. PsA was associated with Crohn's disease (OR 2.4, 95 %CI: 1.75-3.32, p < 0.0001), ulcerative colitis (OR 2.1, 95 %CI: 1.33-3.26, p = 0.001), reflux esophagitis (OR 1.6, 95 %CI: 1.44-1.78, p < 0.0001), PUD (OR 1.5, 95 %CI: 1.31-1.63, p < 0.0001) and IBS (OR 1.4, 95 %CI: 1.01-1.86, p = 0.045). After controlling for known risk factors, the association remained significant between PsA and Crohn's disease (OR 2.2, 95 %CI: 1.59-3.03, p < 0.0001), ulcerative colitis (OR 1.9, 95 %CI: 1.21-3.00, p = 0.005), reflux esophagitis (OR 1.5, 95 %CI: 1.31-1.63, p < 0.0001), and PUD (OR 1.3, 95 %CI: 1.12-1.47, p < 0.0001). No significant association was found between PsA and celiac disease. In the current study PsA was associated with gastrointestinal morbidities including Crohn's disease, ulcerative colitis, PUD and IBS. Physicians treating patients with PsA should be aware of these associations.
authors.affiliation: The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Zohar
authors.affiliation: Central Headquarters, Clalit Health Services, Tel Aviv, Israel.|Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.
authors.forename: Arnon Dov
authors.initials: AD
authors.lastname: Cohen
authors.affiliation: The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.|Central Headquarters, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Bitterman
authors.affiliation: Central Headquarters, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Feldhamer
authors.affiliation: Central Headquarters, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Sari
authors.initials: S
authors.lastname: Greenberg-Dotan
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel.
authors.forename: Idit
authors.initials: I
authors.lastname: Lavi
authors.affiliation: Central Headquarters, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Comanesther
authors.affiliation: Central Headquarters, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Erez
authors.initials: E
authors.lastname: Batat
authors.affiliation: The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. devyzisman@gmail.com.|Department of Rheumatology, Carmel Medical Center, 7 Michal Street, 34362, Haifa, Israel. devyzisman@gmail.com.
authors.forename: Devy
authors.initials: D
authors.lastname: Zisman
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000453:epidemiology*; D002446:Celiac Disease / Q000453:epidemiology*; D003093:Colitis, Ulcerative / Q000453:epidemiology*; D015897:Comorbidity; D003424:Crohn Disease / Q000453:epidemiology*; D016208:Databases, Factual; D004941:Esophagitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence
keywords: Gastrointestinal diseases; Psoriatic arthritis.; Spondyloarthritis