Abstract Background/Aims Psoriatic arthritis (PsA) is a chronic inflammatory disease that develops in up to 30% of patients with psoriasis (PsO). Patients with PsA have an increased risk of coronary artery disease (CAD), a leading cause of mortality. Compared to carotid plaques, femoral artery plaques are more prevalent and considered stronger predictors of subclinical atherosclerosis and cardiovascular (CV) risk. The triglyceride-glucose (TyG) index, a surrogate of insulin resistance, has been shown to reflect systemic inflammation and adverse CV outcomes. This study aimed to compare femoral intima-media thickness (IMT) and TyG index in PsA patients versus PsO patients and healthy controls. Methods In this cross-sectional study, patients with PsA fulfilling CASPAR criteria, PsO patients without PsA, and healthy controls were recruited at Etlik City Hospital Rheumatology Clinic (Nov 2024-Jul 2025). Patients with prior CAD were excluded. Demographic, clinical, and laboratory data were recorded. Fasting tests were performed, and femoral IMT was assessed by a radiologist. TyG index was calculated as fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2. Results A total of 52 PsA, 50 PsO, and 50 healthy controls were included. Groups were comparable regarding sex and comorbidities. PsA patients were older than other groups (p = 0.028). Triglyceride and VLDL levels were significantly higher in PsA and PsO versus controls (p 0.01). TyG index values were significantly elevated in PsA (8.83 8.47-9.27) and PsO (8.80 8.45-9.25) compared to controls (p 0.001), but not different between PsA and PsO. Both right and left femoral IMT values were significantly higher in PsA and PsO than controls (p 0.001), with no difference between PsA and PsO. The optimal TyG cutoff for predicting plaque presence was 8.73 (AUC=0.696, 95% CI 0.587-0.804, p = 0.002), with sensitivity 76%, specificity 58.7%, and Youden index 0.35. TyG correlated positively with IMT in all participants (right: rs = 0.364, left: rs = 0.321; p 0.001). Conclusion This is the first study to evaluate TyG index and femoral IMT together in PsA and PsO. Both markers were increased versus controls, and their positive correlation supports the link between insulin resistance and subclinical atherosclerosis. Adding TyG index to femoral IMT assessment may enhance predictive power for early CV risk stratification in psoriatic disease. Larger prospective studies are warranted. Disclosure A. Temiz Gençoğlu: None. M. Yildirim Erol: None. E. Aydemir Gülöksüz: None. A. Keleşoğlu Dinçer: None.
Gençoğlu et al. (Wed,) studied this question.