THE CONNECTION BETWEEN RHEUMATOID ARTHRITIS, ADIPOSITY, AND METABOLIC SYNDROME: A COMPLEX INTERPLAY

Abstract

Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality, which is believed to be due to accelerated atherosclerosis and systemic inflammation. Adiposity has emerged as a critical feature of metabolic syndrome, which is strongly linked with cardiovascular disease (CVD). To establish a comprehensive management approach to control the cardiovascular risk in RA, a tight control of both RA and metabolic syndrome-related inflammation is mandatory. Adipose tissue is a dynamic organ that releases several inflammatory and immune mediators, including adipokines that contribute to inflammation resolution and have beneficial effects on obesity-linked metabolic disorders. This review examines the relationship between adiposity, joint and systemic inflammation, and the risk of metabolic syndrome in RA, as well as the pre-clinical markers of atherosclerosis that occur early in the disease. The authors also explore the importance of traditional cardiovascular risk factors, parameters of RA severity, and metabolic syndrome in predicting CVD. It highlights the role of Metabolic syndrome (MetS) as a cluster of cardiovascular disease risk factors and its prevalence in the general population and RA patients. Therefore, a better understanding of the pathophysiology underlying the link between adiposity, inflammation, and metabolic syndrome is essential for the development of combined, optimized approaches for preventing and managing the increased cardiovascular risk in RA patients