The Risk of Developing Diabetes Mellitus in Patients with Psoriatic Arthritis: A Cohort Study.
To estimate the prevalence of diabetes mellitus (DM) in patients with psoriatic arthritis (PsA) in comparison with the general population and to assess whether the level of disease activity over time predicts the development of DM in these patients.



A cohort analysis was conducted in patients followed in a large PsA clinic from 1978 to 2014. The prevalence of DM in the patients was compared with the general population of Ontario, Canada, and the age-standardized prevalence ratio (SPR) was calculated. For the assessment of risk factors for DM, time-weighted arithmetic mean (AM) levels of PsA-related disease activity measures were assessed as predictors for the development of DM. Multivariable Cox proportional hazards models were used to compute HR for incident DM after controlling for potential confounders.



A total of 1305 patients were included in the analysis. The SPR of DM in PsA compared with the general population in Ontario was 1.43 (p = 0.002). Of the 1065 patients who were included in the time-to-event analysis, 73 patients were observed to develop DM. Based on multivariable analyses, AM tender joint count (HR 1.53, 95% CI 1.08-2.18, p = 0.02) and AM erythrocyte sedimentation rate (HR 1.21, 95% CI 1.03-1.41, p = 0.02) predicted the development of DM.



The prevalence of DM is higher in patients with PsA compared with the general population. Patients with elevated levels of disease activity are at higher risk of developing DM.
From the Women's College Research Institute, Women's College Hospital; Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada. lihi.eder@wchospital.ca.|L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network; R. Cook, PhD, Department of Statistics and Actuarial Science, University of Waterloo; D.D. Gladman, MD, PhD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network. lihi.eder@wchospital.ca.
Lihi
L
Eder
From the Women's College Research Institute, Women's College Hospital; Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.|L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network; R. Cook, PhD, Department of Statistics and Actuarial Science, University of Waterloo; D.D. Gladman, MD, PhD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network.
Vinod
V
Chandran
From the Women's College Research Institute, Women's College Hospital; Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.|L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network; R. Cook, PhD, Department of Statistics and Actuarial Science, University of Waterloo; D.D. Gladman, MD, PhD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network.
Richard
R
Cook
From the Women's College Research Institute, Women's College Hospital; Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.|L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, and Department of Laboratory Medicine and Pathobiology, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network; R. Cook, PhD, Department of Statistics and Actuarial Science, University of Waterloo; D.D. Gladman, MD, PhD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network.
Dafna D
DD
Gladman
D000328:Adult; D015535:Arthritis, Psoriatic / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012306:Risk
DIABETES MELLITUS; EPIDEMIOLOGY; INFLAMMATION; PSORIATIC ARTHRITIS