Clinical and pathogenetic features of psoriatic arthritis associated with metabolic syndrome

Novikova L.A., Dontsova E.V., Kuranosov A.Yu., Ivanova I.I., Borzunova L.N., Bakhmetyev A.A., Voronkova N.A., Potapenko A.O.

1) Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; 2) Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Moscow, Russia

Background: The role of metabolic syndrome (MS) in potentiating the mechanisms underlying the development of psoriatic arthritis (PsA) remains poorly understood.
Objective: Evaluation of the impact of MS on the clinical features and underlying pathogenetic mechanisms underlying the development of PsA. 
Materials and methods: In 320 patients with PsA, 230 of whom had signs of MS and 90 of whom did not, arthritis activity was assessed using the DAS28 index, ESR, and blood C-reactive protein (CRP) levels. Enzyme-linked immunosorbent assay was used to determine blood levels of pro- and anti-inflammatory cytokines, leptin, β-endorphin, oxidative stress and antioxidant system parameters, ACTH, and cortisol. Anxiety and depression levels were assessed using the Zung scale, and quality of life (QOL) was assessed using the DIQOL questionnaire. 
Results: Patients with MS had statistically significantly higher waist circumference, number of painful and swollen joints, CRP and ESR, levels of proinflammatory interleukins (IL)-1β, -2, -6, -8, -13, -17, -18, -23, tumor necrosis factor alpha and interferon-gamma, total oxidative capacity of the blood, leptin, oxidized lipoproteins, anxiety and depression (p<0.001) than individuals without MS. Levels of anti-inflammatory IL-4 and -10, total antioxidant activity of the blood, superoxide dismutase, ACTH, cortisol, β-endorphin, and quality of life were lower (p<0.001). 
Conclusion: Metabolic disturbances associated with PsA and MS potentiate the development of oxidative stress, the production of proinflammatory cytokines, and the suppression of anti-inflammatory cytokine synthesis. They contribute to the development of an imbalance in the pituitary-adrenal axis, which is accompanied by increased joint inflammation and a worsening of arthritis. A decrease in β-endorphin production associated with MS potentiates the development of anxiety-depressive disorders and a decrease in patients’ quality of life. The identified metabolic, immune, oxidative, and psychoneurohormonal disturbances suggest that they represent a specific pathogenetic feature of the comorbidity of PsA and MS.

For citations: Novikova L.A., Dontsova E.V., Kuranosov A.Yu., Ivanova I.I., Borzunova L.N., Bakhmetyev A.A., Voronkova N.A., Potapenko A.O. Clinical and pathogenetic features of psoriatic arthritis associated with metabolic syndrome. Pharmateca. 2026;33(5):97-103. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.5.97-103

Authors’ contribution: L.A. Novikova – study concept and design. E.V. Dontsova, I.I. Ivanova – literature review, A.Yu. Kuranosov – collection of material. L.N. Borzunova, A.A. Bakhmetyev, N.A. Voronkova – data analysis, A.O. Potapenko – writing the text.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Ethical Approval: Extract from Protocol No. 3 of the Ethics Committee of the Voronezh State Medical University named after N.N. Burdenko of the Ministry of Health of the Russian Federation dated March 24, 2026.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.

Keywords

About the Authors

Lyubov A. Novikova, Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenereology and Cosmetology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; novla17@inbox.ru, ORCID: https://orcid.org/0000-0003-3465-8348, eLibrary SPIN: 5445-2961
Elena V. Dontsova, Dr. Sci. (Med.), Professor, Professor of the Department of Dermatovenereology and Cosmetology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; ledn89@mail.ru, ORCID: https://orcid.org/0000-0001-6119-2120, Scopus Author ID: 57170222700, eLibrary SPIN: 5227-3284 (corresponding author)
Andrey Yu. Kuranosov, Cand. Sci. (Med.), Assistant Professor, Department of Faculty Therapy, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; bigis1301@mail.ru, ORCID: https://orcid.org/0009-0008-1394-6731, eLibrary SPIN: 6064-0800
Irina I. Ivanova, Dr. Sci. (Med.), Professor, Professor at the Department of Physical and Rehabilitation Medicine with the Course of Clinical Psychology and Pedagogy, Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Moscow, Russia; i.ivanova@mail.ru, ORCID: https://orcid.org/0000-0002-8943-9321
Larisa N. Borzunova, Cand. Sci. (Med.), Associate Professor, Department of Dermatovenereology and Cosmetology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; lnborzunova@mail.ru, ORCID: https://orcid.org/0000-0001-8606-9006, eLibrary SPIN: 8779-5108
Andrey A. Bakhmetyev, Cand. Sci. (Med.), Associate Professor, Department of Dermatovenereology and Cosmetology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; adrbmv@yandex.ru, ORCID: https://orcid.org/0009-0001-0548-8944, eLibrary SPIN: 4593-5954
Natalya A. Voronkova, Cand. Sci. (Med.), Associate Professor, Department of Dermatovenereology and Cosmetology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; shurinova-nata@mail.ru, ORCID: https://orcid.org/0000-0003-3716-233X
Alina O. Potapenko, Teaching Assistant, Department of Dermatovenereology and Cosmetology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; potapenkoal1na@ya ndex.ru, ORCID: https://orcid.org/0009-0008-5257-3843

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