Research Article

Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis

Volume: 17 Number: July, August, September 2026 September 9, 2026

Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis

Abstract

Purpose:Obesity and vitamin D deficiency are common comorbidities in psoriatic arthritis (PsA) and have been associated with increased disease activity. However, the independent contribution of vitamin D deficiency beyond obesity remains unclear. We evaluated the associations of obesity and vitamin D deficiency status with disease activity in PsA. Methods: This retrospective study included adults fulfilling the Classification Criteria for Psoriatic Arthritis (CASPAR). Patients were categorized by obesity (body mass index ≥30 vs. <30 kg/m²) and vitamin D deficiency status [25(OH)D<20 vs. ≥20 ng/mL]. Four groups were defined according to the coexistence of obesity and vitamin D deficiency. Disease activity was assessed using the Disease Activity Index for Psoriatic Arthritis (DAPSA). Multivariable linear and logistic regression analyses identified factors independently associated with DAPSA score and high disease activity (DAPSA >28). Additional sensitivity analyses were performed using serum 25(OH)D levels as a continuous variable. Results: Ninety-nine patients were included. Disease activity differed among the four groups (p=0.008), with the lowest DAPSA scores in non-obese patients without vitamin D deficiency and the highest in obese patients with vitamin D deficiency. High disease activity also differed across groups (p=0.001). Obesity was independently associated with higher DAPSA scores (β=8.66, 95% CI 1.91–15.40, p=0.012) and high disease activity (OR=4.85, 95% CI 1.18–19.87, p=0.028). Vitamin D deficiency was not independently associated with either outcome. Sensitivity analyses using serum 25(OH) D levels as a continuous variable yielded similar results and did not demonstrate an independent association between vitamin D status and disease activity. Conclusion: Obesity was independently associated with higher disease activity in PsA, whereas vitamin D deficiency was not. Although patients with both obesity and vitamin D deficiency had the highest disease activity, obesity showed the strongest association with disease activity. These findings support routine assessment and management of obesity in PsA.

Keywords

References

  1. 1. Kannappan R, Kim S, Lau A, et al. Psoriatic Arthritis: From Diagnosis to Treatment. J Clin Med. 2025;14(22):8151. doi: 10.3390/jcm14228151.
  2. 2. Karmacharya P, Ogdie A, Eder L. Psoriatic arthritis and the association with cardiometabolic disease: a narrative review. Ther Adv Musculoskelet Dis. 2021;13:1759720X21998279. doi:10.1177/1759720X21998279.
  3. 3. Fatica M, Ferrigno S, Çela E, et al. Metabolic challenges of glucose and lipid dysregulation in psoriatic arthritis: a narrative review from pathogenesis to clinical practice. Acta Diabetol. 2025;62(11):1831- 1841. doi: 10.1007/s00592-025-02565-5.
  4. 4. Andreasson S, Södergren A. Prevalence of metabolic syndrome and its components in psoriatic arthritis compared with general population, cutaneous psoriasis, and other inflammatory arthropathies: a meta-analysis. Clin Rheumatol. 2025;44(10):3787- 3799. doi: 10.1007/s10067-025-07637-z.
  5. 5. Siebert S, Sattar N, Ferguson LD. Weighing in on obesity and psoriatic arthritis - Time to move beyond association to robust randomised trials. Joint Bone Spine. 2025;92(5):105904. doi:10.1016/j.jbspin.2025.105904.
  6. 6. Higos R, Renzi G, Taillandier P, et al. How Adipocytes Orchestrate Inflammation Within Adipose Tissue? Biomolecules. 2025;16(1):59. doi: 10.3390/biom16010059.
  7. 7. Haberman RH, Ogdie A, Merola JF, et al. The obesity-inflammation axis in psoriatic disease: mechanisms and therapeutic strategies. Nat Rev Rheumatol. 2026;22(3):151-164. doi: 10.1038/s41584-025-01326-6.
  8. 8. Kumthekar A, Ogdie A. Obesity and Psoriatic Arthritis: A Narrative Review. Rheumatol Ther. 2020;7(3):447-456. doi: 10.1007/s40744-020-00215-6.

Details

Primary Language

English

Subjects

Rheumatology and Arthritis

Journal Section

Research Article

Publication Date

September 9, 2026

Submission Date

June 13, 2026

Acceptance Date

July 23, 2026

Published in Issue

Year 2026 Volume: 17 Number: July, August, September 2026

APA
Ösken, S. (2026). Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 17(July, August, September 2026). https://doi.org/10.31067/acusaglik.1970448
AMA
1.Ösken S. Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis. Acibadem Univ Saglik Bilim Derg. 2026;17(July, August, September 2026). doi:10.31067/acusaglik.1970448
Chicago
Ösken, Sibel. 2026. “Association of Obesity and Vitamin D Deficiency With Disease Activity in Patients With Psoriatic Arthritis”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 (July, August, September 2026). https://doi.org/10.31067/acusaglik.1970448.
EndNote
Ösken S (September 1, 2026) Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 July, August, September 2026
IEEE
[1]S. Ösken, “Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis”, Acibadem Univ Saglik Bilim Derg, vol. 17, no. July, August, September 2026, Sept. 2026, doi: 10.31067/acusaglik.1970448.
ISNAD
Ösken, Sibel. “Association of Obesity and Vitamin D Deficiency With Disease Activity in Patients With Psoriatic Arthritis”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17/July, August, September 2026 (September 1, 2026). https://doi.org/10.31067/acusaglik.1970448.
JAMA
1.Ösken S. Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis. Acibadem Univ Saglik Bilim Derg. 2026;17. doi:10.31067/acusaglik.1970448.
MLA
Ösken, Sibel. “Association of Obesity and Vitamin D Deficiency With Disease Activity in Patients With Psoriatic Arthritis”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol. 17, no. July, August, September 2026, Sept. 2026, doi:10.31067/acusaglik.1970448.
Vancouver
1.Sibel Ösken. Association of Obesity and Vitamin D Deficiency with Disease Activity in Patients with Psoriatic Arthritis. Acibadem Univ Saglik Bilim Derg. 2026 Sep. 1;17(July, August, September 2026). doi:10.31067/acusaglik.1970448