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The Connection Between Psoriatic Arthritis, Metabolic Syndrome and Insulin Resistance

By

Marijke Vroomen Durning, RN

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Psoriatic arthritis is a type of arthritis that affects mostly people with the skin disorder psoriasis; it causes symptoms like joint pain, stiffness and swelling. But the effects of this condition spread beyond just your joints—it can affect other parts of your body, too, and put you at higher risk for serious health issues. Significant research has shown that people with psoriatic arthritis have a much higher chance of developing insulin resistance and metabolic syndrome, two conditions that can have severe consequences if not treated appropriately.

What is insulin resistance?

Insulin resistance is a condition that can trigger type 2 diabetes. Ordinarily, your body produces as much insulin as you need and you use as much insulin as your body produces. In some cases, while your pancreas produces enough insulin for your needs, your body can’t respond to it or the cells in your body become resistant to it. As a result, your blood glucose levels remain high, which can lead to prediabetes and type 2 diabetes.

Today, we’ve seen many advances in treating the damage and pain of psoriatic arthritis. Watch as experts share the advice they give patients for managing the condition.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Apr 29, 2017

2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

What is metabolic syndrome?

Metabolic syndrome is a term for a collection of medical problems conditions that tend to co-exist. They’re grouped together because they’re all risk factors for heart disease and diabetes. Millions of people in the U.S. have one or two of these conditions, but to be diagnosed with metabolic syndrome, you must have at least three of these five conditions:

  • High blood pressure

  • High blood glucose (sugar), which could be a result of prediabetes or insulin resistance

  • Abnormal cholesterol levels in your blood

  • Abnormal triglyceride levels in your blood

  • Excess fat found around your waist

Experts aren’t sure why these conditions are linked.

It’s easy to see the connection between insulin resistance and metabolic syndrome, but where does psoriatic arthritis fit in? All of them are considered inflammatory conditions, but unfortunately, researchers don’t yet completely understand the relationship between the three. Experts do know that up to 58% of people with psoriatic arthritis also have metabolic syndrome. Many more have just one or two conditions related to metabolic syndrome or insulin resistance alone. In one study, researchers found that 74% of patients with psoriatic arthritis had high blood pressure, 56% had excess fat around the waist, and 43.5% had elevated triglyceride levels.

People with psoriatic arthritis may also have higher levels of inflammatory cardiovascular markers (enzymes, hormones and proteins). Cardiovascular markers help measure your heart function; the more cardiovascular markers a person has, the higher the risk of heart disease or heart attack. This, combined with metabolic syndrome, also has an effect on heart attack or heart disease risk.

You can reduce your risk of these conditions.

Although researchers are still trying to determine why people with psoriatic arthritis are more likely to develop metabolic syndrome and insulin resistance, it’s important that patients stay vigilant about lowering this risk. Some risk factors for metabolic syndrome and insulin resistance can be avoided or prevented. These risk factors include:

  • Being overweight or obese

  • Being physically inactive

  • Smoking

  • Difficulty sleeping

  • Taking certain types of medications

  • Having a history or family history of diabetes

  • Having Mexican-American ancestry

While there’s nothing you can do about your family history, there are things you can change. If you’re overweight or obese, start by adapting your diet to one recommended by the ChooseMyPlate initiative from the United States Department of Agriculture (USDA). The initiative recommends that half of your plate contain fruit and vegetables and the other half grains, proteins, and small amounts of dairy. If you need to lose weight, speak with a healthcare professional to learn the best approach for you. Other lifestyle changes include increasing your exercise level, stopping smoking, and trying to improve your sleep habits. 

Sometimes, lifestyle changes aren’t enough to reduce the risk. If necessary, your rheumatologist may refer you to a cardiologist or prescribe medications to help regulate your blood pressure and blood glucose levels. Follow your treatment plan and go for regular check-ups to stay as healthy as possible.

Living with a chronic condition means you must take extra care of your body. By being aware of the risks associated with psoriatic arthritis, you have the power to make positive changes and stay in good health.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Mar 2, 2017

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. How Is Metabolic Syndrome Treated? National Heart, Lung, and Blood Institute. Part of the National Institutes of Health. https://www.nhlbi.nih.gov/health/health-topics/topics/ms/treatment
  2. Prediabetes & Insulin Resistance. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
  3. Psoriatic Arthritis. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis
  4. Haroon M, Gallagher P, Heffernan E, FitzGerald O. High prevalence of metabolic syndrome and of insulin resistance in psoriatic arthritis is associated with the severity of underlying disease. J Rheumatol. 2014 Jul;41(7):1357-65. doi: 10.3899/jrheum.140021. Epub 2014 Jun 15. https://www.ncbi.nlm.nih.gov/pubmed/24931949
  5. Raychaudhuri SK, Chatterjee S, Nguyen C, Kaur M, Jialal I, Raychaudhuri SP. Increased Prevalence of the Metabolic Syndrome in Patients with Psoriatic Arthritis. Metab Syndr Relat Disord. 2010 Aug; 8(4): 331–334. doi:  10.1089/met.2009.0124 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3129701/
  6. Dallmeier D, Larson MG, Vasan RS, Keaney JF, Fontes JD, Meigs JB, et al. Metabolic syndrome and inflammatory biomarkers: a community-based cross-sectional study at the Framingham Heart Study. Diabetology & Metabolic Syndrome. 2012 4(28) doi: 10.1186/1758-5996-4-28 https://dmsjournal.biomedcentral.com/articles/10.1186/1758-5996-4-28
  7. How Inflammation Affects Insulin Resistance. Diabetes Forecast. March 2011. American Diabetes Association. http://www.diabetesforecast.org/2011/mar/how-inflammation-affects-insulin-resistance.html?referrer=https://www.google.ca/
  8. Cardio Biomarkers (Blood). University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=cardiac_biomarkers
  9. Lee S, Mendelsohn A, Sarnes E. The Burden of Psoriatic Arthritis: A Literature Review from a Global Health Systems Perspective. Pharmacy and Therapeutics. 2010;35(12):680-689. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008384/

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