Metabolic abnormalities in patients with inflammatory rheumatic diseases |
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| Affiliation: | 1. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;2. School of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, PR China;2. Department of Public Health and General Medicine, School of Integrated Traditional and Western Medicine, Anhui University of Traditional Chinese Medicine, Anhui, PR China;1. Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210;2. Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH 43210;3. Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH 43210;1. Department of Cardiology, Villa Bianca Hospital, Trento, Italy;2. Division of Cardiology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona Italy;3. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy;4. Department of Translational Medical Sciences, Federico II, University Hospital, School of Medicine, Naples, Italy;5. Greenberg Division of Cardiology, Weill Cornell Medical College, New York, NY, USA |
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| Abstract: | ![]()
Patients with rheumatoid arthritis (RA) experience an increased cardiometabolic risk factor burden that is substantially driven by systemic inflammation. This occurs less consistently in patients with ankylosing spondylitis (AS). Psoriatic arthritis most strongly associates with excess adiposity and metabolic risk. RA patients also often have systemic inflammation-induced proinflammatory high-density lipoprotein (HDL) cholesterol particles and lean/muscle mass loss in association with increased adiposity, a condition termed rheumatoid cachexia, which further enhances cardiovascular risk. The presence of proinflammatory HDL and lean mass loss was also reported in patients with AS. Individualized aerobic and resistance exercise programs can improve body composition and metabolic risk factor profiles in RA and AS. Future studies should assess how long-term lifestyle changes can be effectuated and if these can influence cardiovascular events in inflammatory rheumatic diseases. Herein, we review the current evidence on metabolic abnormalities in inflammatory arthritis. We propose management strategies and a research agenda. |
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| Keywords: | Rheumatoid arthritis Ankylosing spondylitis Psoriatic arthritis Metabolic abnormalities |
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