Influence of Metabolic Factor Control on Psoriatic Arthritis Risk in Psoriasis Patients: A Retrospective Cohort Study Using TriNetX Database

Mayo Clin Proc. 2025 Dec 4:S0025-6196(25)00516-6. doi: 10.1016/j.mayocp.2025.08.024. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore the influence of the control of metabolic factors, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TGs), hemoglobin A_1c (HbA_1c), and uric acid (UA), on psoriatic arthritis (PsA) risk in patients with psoriasis (PsO).

PATIENTS AND METHODS: This retrospective cohort study used data from the TriNetX research network. Data were retrieved from the TriNetX US Collaborative Network in May 2025; the analysis included patient records up to December 31, 2022. Eligible participants were individuals given a diagnosis of PsO. Patients were divided based on the control of metabolic factors. Poor control was defined as having LDL ≥130 mg/dL, HDL ≤40 mg/dL, TG ≥150 mg/dL, HbA_1c >7%, or UA >6 mg/dL at least three instances. The HR was used to compare the rate of PsA occurrence between the poorly controlled and adequately controlled groups.

RESULTS: Patients in the HDL ≤40 mg/dL, the TG ≥150 mg/dL, and the HbA_1c >7% group were associated with a significantly increased PsA risk, with an HR of 1.339 (95% CI, 1.022 to 1.755), 1.469 (95% CI, 1.119 to 1.928), and 1.144 (95% CI, 1.012 to 1.294), respectively. However, no significant increase was observed in PsA risk in the patients in the LDL ≥130 mg/dL (HR, 0.983; 95% CI, 0.775 to 1.245), or UA >6 mg/dL (HR, 1.168; 95% CI, 0.863 to 1.581) group compared with their respective lower-level counterparts.

CONCLUSION: Managing metabolic factors including HDL and TG levels may reduce PsA risk in patients with PsO.

PMID:41348069 | DOI:10.1016/j.mayocp.2025.08.024