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Endocrine Comorbidities in Patients with Psoriatic Arthritis: A Population-based Case-controlled Study.
Amir Haddad1,2, Ron Ilan Ashkenazi1,2, Haim Bitterman1,2
1From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.
Psoriatic arthritis (PsA) is linked to increased risks of hypothyroidism, osteoporosis, diabetes mellitus (DM), and Cushing disease. Early detection of these endocrine comorbidities is crucial for managing PsA patients effectively.
Area of Science:
- Endocrinology
- Rheumatology
- Public Health
Background:
- Psoriatic arthritis (PsA) is a chronic inflammatory disease with potential systemic manifestations.
- Endocrine comorbidities are increasingly recognized as significant factors influencing patient outcomes in chronic inflammatory conditions.
Purpose of the Study:
- To investigate the prevalence and association of various endocrine comorbidities in patients diagnosed with psoriatic arthritis (PsA).
Main Methods:
- A retrospective, cross-sectional study utilizing data from Clalit Health Services (2002-2014).
- PsA patients were identified and matched with healthy controls by age and sex.
- Analysis included hypothyroidism, hyperthyroidism, hypo/hyperparathyroidism, hyperprolactinemia, Cushing disease, Addison disease, diabetes insipidus, diabetes mellitus (DM), pituitary adenoma, acromegaly, and osteoporosis.
Main Results:
- The PsA cohort (3161 patients) showed significantly higher rates of hypothyroidism (12.7% vs 8.6%), Cushing disease (0.3% vs 0.1%), osteoporosis (13.2% vs 9.1%), and DM (27.9% vs 20.7%) compared to controls (31,610 patients).
- Multivariable analysis confirmed increased odds for hypothyroidism (OR 1.61), DM (OR 1.35), Cushing disease (OR 3.96), and osteoporosis (OR 1.56) in PsA patients.
Conclusions:
- Psoriatic arthritis is associated with a notable frequency of endocrine disorders, including hypothyroidism, osteoporosis, diabetes mellitus, and Cushing disease.
- Increased physician awareness of these associated endocrine comorbidities is vital for optimizing patient care and management strategies.