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Rheumatoid arthritis and metabolic syndrome

Nature Reviews Rheumatology volume 10, pages 691696 (2014) | Download Citation

Abstract

Rheumatoid arthritis (RA), especially active disease, is associated with considerable changes in body composition, lipids, adipokines and insulin sensitivity. Metabolic changes, such as increased total cholesterol, LDL cholesterol and triglyceride levels, occur even in preclinical RA. Active RA is associated with decreased lipid levels, BMI, fat and muscle mass, as well as altered lipid profiles. Some of these changes are also seen in metabolic syndrome, and could increase cardiovascular mortality. Importantly, the systemic inflammation underlying RA is an independent risk factor for cardiovascular disease. This Perspectives article summarizes data on the associations of various components of metabolic syndrome with RA, and discusses the effects of biologic therapy on these factors. The authors propose that components of metabolic syndrome should be monitored in patients with RA throughout the disease course, and argue that optimal disease control using biologic agents might attenuate several adverse effects of metabolic syndrome in these patients.

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Acknowledgements

The authors' research work is supported by research grant TÁMOP-4.2.2.A-11/1/KONV-2012-0031 for projects co-financed by the European Union and the European Social Fund (Z.S.); a bridging fund from the University of Debrecen Medical and Health Sciences Centre (Z.S.); a grant from Fondo de Investigaciones Sanitarias PI12/00060 (M.A.G.-G.) and RETICS programme RD12/0009/0013 from the Instituto de Salud Carlos III (M.A.G.-G.). The authors thank D. Kerekes for her expertise in preparing Figure 1.

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Affiliations

  1. Department of Angiology, Institute of Medicine, University of Debrecen Clinical Centre, Moricz Zs str, Debrecen 4032, Hungary.

    • György Kerekes
    •  & Pál Soltész
  2. Departments of Internal Medicine and Rheumatology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.

    • Michael T. Nurmohamed
  3. Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Avenida de Valdecilla s/n, 39011 Santander, Spain.

    • Miguel A. González-Gay
  4. Division of Metabolic Diseases, Institute of Medicine, University of Debrecen Medical and Health Sciences Centre, Nagyerdei str 98, Debrecen 4032, Hungary.

    • Ildikó Seres
    •  & György Paragh
  5. Department of Rheumatology, Szent Ferenc Hospital, Csabai kapu street 41, Miskolc 3529, Hungary.

    • Zsófia Kardos
    • , Zsuzsa Baráth
    •  & László Tamási
  6. Department of Rheumatology, Institute of Medicine, University of Debrecen, Faculty of Medicine, Nagyerdei str. 98, Debrecen 4032, Hungary.

    • Zoltán Szekanecz

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Contributions

Z.S., G.K., Z.K. and Z.B. researched data for the article; Z.S. and G.K. wrote the manuscript. All authors made substantial contributions to discussion of content and to review and/or editing of the manuscript before submission.

Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Zoltán Szekanecz.

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DOI

https://doi.org/10.1038/nrrheum.2014.121

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