Better control of metabolic factors could significantly reduce the risk of psoriatic arthritis in patients with psoriasis, according to a new retrospective study. Researchers analyzed data from a large U.S. electronic health record network to examine whether routinely measured metabolic markers influence progression from psoriasis to psoriatic arthritis.
Metabolic Factors and Psoriatic Arthritis Risk
Adults with psoriasis were grouped based on control of key metabolic measures. Poor metabolic control was defined as having at least three readings showing any of the following: low high-density lipoprotein (HDL) cholesterol at or below 40 mg/dL, triglycerides at or above 150 mg/dL, glycated hemoglobin above 7%, low-density lipoprotein (LDL) cholesterol at or above 130 mg/dL, or uric acid above 6 mg/dL. Researchers then compared psoriatic arthritis incidence between patients with poor versus adequate metabolic control.
The study found that low HDL cholesterol, high triglycerides, and elevated glycated hemoglobin were each linked to a higher risk of developing psoriatic arthritis. Specifically:
HDL ≤40 mg/dL was associated with a hazard ratio (HR) of 1.34 (95% CI, 1.02–1.76).
Triglycerides ≥150 mg/dL carried an HR of 1.47 (95% CI, 1.12–1.93).
Glycated hemoglobin >7% was linked to an HR of 1.14 (95% CI, 1.01–1.29).
In contrast, elevated LDL cholesterol and uric acid did not significantly affect psoriatic arthritis risk.
Implications for Patient Care
The findings underscore the importance of managing metabolic health in patients with psoriasis. Optimizing HDL cholesterol, triglycerides, and blood sugar levels may help reduce the risk of musculoskeletal complications.
For clinicians, the results highlight the need to address cardiometabolic risk during routine psoriasis care—not only to prevent cardiovascular disease but also to potentially lower the likelihood of psoriatic arthritis. The study’s authors suggest that proactive management of metabolic factors should be integrated into comprehensive psoriatic disease care.
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