Central obesity in psoriatic arthritis: associations with disease activity, function, and quality of life in a real-world cohort

Objective: This study aimed to explore the association between central obesity and disease-specific activity, functional impairment, and patient-reported outcomes (PROMs) in a real-world cohort of individuals with psoriatic arthritis (PsA). Methods: We conducted a cross-sectional observational study at a tertiary rheumatology outpatient clinic. Adult patients with PsA, diagnosed according to the CASPAR criteria, underwent a multidimensional assessment by a multidisciplinary team. Clinical and pharmacological data, anthropometric measures, disease activity indices (DAPSA and CRP), and PROMs (FACIT-F, PHQ-9, HAQ, PsAID) were collected. Central obesity was defined by waist circumference (≥88 cm in women, ≥102 cm in men). Multivariable regression analyses were performed to investigate associations between central obesity and clinical outcomes, adjusting for age, sex, disease duration, and antirheumatic therapies. Results: Among 158 patients (54.4% female; median age 55.4 years), central obesity was present in 70.2% of the group. Patients with central obesity had significantly higher inflammatory markers (CRP), increased disease activity (DAPSA), and worse scores across all PROMs compared to those without. In multivariable models, central obesity remained independently linked to disease activity and worse physical and psychosocial outcomes, including fatigue, depression, disability, and disease impact. Conclusion: Central obesity is a significant and independent predictor of disease severity and patient-reported disability in individuals with Psa. These findings highlight the clinical importance of routinely measuring waist circumference in PsA management and suggest that targeted interventions addressing visceral adiposity could enhance both inflammatory and quality-of-life outcomes.