Central Obesity in Psoriatic Arthritis: Associations with Disease Activity, Function, and Quality of Life in a Real-World Cohort

Salvatore Corrao^1,2*Salvatore Scibetta^2,3Luigi Calvo²Marika Lo Monaco¹Raffaella Mallaci Bocchio²Giuseppe Natoli²Antonella Montalbano²Ignazio Cangemi²Christiano Argano²

• ¹University of Palermo, Palermo, Italy
• ²Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Civico Di Cristina Benfratelli, Palermo, Italy
• ³Istituto per la Ricerca e l'Innovazione Biomedica Consiglio Nazionale delle Ricerche, Palermo, Italy

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. Conclusions 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.