title: Rheumatoid arthritis and metabolic syndrome.
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.
authors.affiliation: Department of Angiology, Institute of Medicine, University of Debrecen Clinical Centre, Moricz Zs str, Debrecen 4032, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Kerekes
authors.affiliation: Departments of Internal Medicine and Rheumatology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Nurmohamed
authors.affiliation: Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Avenida de Valdecilla s/n, 39011 Santander, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
authors.affiliation: Division of Metabolic Diseases, Institute of Medicine, University of Debrecen Medical and Health Sciences Centre, Nagyerdei str 98, Debrecen 4032, Hungary.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Seres
authors.affiliation: Division of Metabolic Diseases, Institute of Medicine, University of Debrecen Medical and Health Sciences Centre, Nagyerdei str 98, Debrecen 4032, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Paragh
authors.affiliation: Department of Rheumatology, Szent Ferenc Hospital, Csabai kapu street 41, Miskolc 3529, Hungary.
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Kardos
authors.affiliation: Department of Rheumatology, Szent Ferenc Hospital, Csabai kapu street 41, Miskolc 3529, Hungary.
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Baráth
authors.affiliation: Department of Rheumatology, Szent Ferenc Hospital, Csabai kapu street 41, Miskolc 3529, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Tamási
authors.affiliation: Department of Angiology, Institute of Medicine, University of Debrecen Clinical Centre, Moricz Zs str, Debrecen 4032, Hungary.
authors.forename: Pál
authors.initials: P
authors.lastname: Soltész
authors.affiliation: Department of Rheumatology, Institute of Medicine, University of Debrecen, Faculty of Medicine, Nagyerdei str. 98, Debrecen 4032, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szekanecz
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D002100:Cachexia / Q000150:complications / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D050171:Dyslipidemias / Q000150:complications / Q000378:metabolism*; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000150:complications / Q000276:immunology / Q000378:metabolism*; D009765:Obesity / Q000150:complications / Q000378:metabolism*; D014280:Triglycerides / Q000378:metabolism
chemical_list: D018501:Antirheumatic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
references.citation: Clin Exp Rheumatol. 2009 Mar-Apr;27(2):222-8
references.pmid: 19473561
references.citation: Scand J Rheumatol. 2013;42(3):169-75
references.pmid: 23311768
references.citation: Ann Rheum Dis. 2013 Sep 1;72(9):1586-8
references.pmid: 23709269
references.citation: Arthritis Res Ther. 2013 Aug 22;15(4):R96
references.pmid: 23968456
references.citation: Nat Rev Rheumatol. 2009 Dec;5(12):677-84
references.pmid: 19901918
references.citation: J Rheumatol. 2008 Mar;35(3):398-406
references.pmid: 18203326
references.citation: Ann Rheum Dis. 2014 Jan;73(1):124-31
references.pmid: 23482473
references.citation: Nat Rev Rheumatol. 2013 Sep;9(9):513-23
references.pmid: 23774906
references.citation: Rheumatol Int. 2004 Jul;24(4):230-3
references.pmid: 14628150
references.citation: Clin Exp Rheumatol. 2006 Jan-Feb;24(1):83-6
references.pmid: 16539824
references.citation: Circulation. 2005 Nov 22;112(21):3337-47
references.pmid: 16301360
references.citation: Life Sci. 2003 May 9;72(25):2877-85
references.pmid: 12697270
references.citation: PLoS One. 2013 Oct 25;8(10):e78151
references.pmid: 24205134
references.citation: Nat Rev Rheumatol. 2010 Aug;6(8):445-51
references.pmid: 20647995
references.citation: Arthritis Rheum. 2010 Nov;62(11):3173-82
references.pmid: 20589684
references.citation: Autoimmun Rev. 2009 Jul;8(8):663-7
references.pmid: 19393192
references.citation: Arthritis Res Ther. 2011;13(5):R158
references.pmid: 21959042
references.citation: Nat Rev Rheumatol. 2011 Aug 02;7(9):528-36
references.pmid: 21808287
references.citation: Ann Rheum Dis. 2006 Sep;65(9):1198-201
references.pmid: 16414972
references.citation: Arthritis Res. 2002;4(6):R12
references.pmid: 12453315
references.citation: Arthritis Rheum. 2006 Sep;54(9):2765-75
references.pmid: 16947779
references.citation: Joint Bone Spine. 2014 Mar;81(2):189-90
references.pmid: 23932723
references.citation: Best Pract Res Clin Rheumatol. 2002 Dec;16(5):707-22
references.pmid: 12473269
references.citation: Arthritis Rheum. 2009 Sep 15;61(9):1248-56
references.pmid: 19714593
references.citation: Clin Exp Rheumatol. 2008 Mar-Apr;26(2):311-6
references.pmid: 18565254
references.citation: Ann Rheum Dis. 2010 Jul;69(7):1310-4
references.pmid: 19854708
references.citation: Mediators Inflamm. 2013;2013:461849
references.pmid: 23690663
references.citation: Rheumatology (Oxford). 2007 Dec;46(12):1824-7
references.pmid: 18032540
references.citation: Ann Rheum Dis. 2008 Jun;67(6):769-74
references.pmid: 17965124
references.citation: Clin Exp Rheumatol. 2008 Jul-Aug;26(4):596-603
references.pmid: 18799090
references.citation: Semin Arthritis Rheum. 2011 Dec;41(3):393-400
references.pmid: 21665247
references.citation: Joint Bone Spine. 2008 Jan;75(1):22-4
references.pmid: 17888710
references.citation: Arthritis Rheum. 1999 Mar;42(3):443-7
references.pmid: 10088766
references.citation: Ann Rheum Dis. 2009 Apr;68(4):460-9
references.pmid: 19286905
references.citation: Arthritis Rheum. 2009 Oct;60(10):2870-9
references.pmid: 19790070
references.citation: Mediators Inflamm. 2013;2013:710928
references.pmid: 23431244
references.citation: Circ J. 2004 Nov;68(11):975-81
references.pmid: 15502375
references.citation: Arthritis Res Ther. 2009;11(6):R161
references.pmid: 19883500
references.citation: JAMA. 2003 Oct 1;290(13):1709-10
references.pmid: 14519703
references.citation: Atherosclerosis. 2009 Dec;207(2):502-6
references.pmid: 19643412
references.citation: Scand J Rheumatol. 2012 May;41(3):186-91
references.pmid: 22416768
references.citation: Arthritis Care Res (Hoboken). 2013 Jan;65(1):107-12
references.pmid: 22674870
references.citation: Nat Rev Immunol. 2006 Oct;6(10):772-83
references.pmid: 16998510
references.citation: J Rheumatol. 2005 Mar;32(3):435-42
references.pmid: 15742434
references.citation: Arthritis Res Ther. 2006;8(3):R82
references.pmid: 16646989
references.citation: Arthritis Care Res (Hoboken). 2012 Oct;64(10):1471-9
references.pmid: 22514152
references.citation: Clin Exp Rheumatol. 2010 Jan-Feb;28(1):56-62
references.pmid: 20346239
references.citation: Lancet. 2005 Apr 16-22;365(9468):1415-28
references.pmid: 15836891
references.citation: J Rheumatol. 2006 Dec;33(12):2425-32
references.pmid: 17080519
references.citation: Ann Rheum Dis. 2010 Feb;69(2):325-31
references.pmid: 19773290
references.citation: Ann Rheum Dis. 2011 Mar;70(3):482-7
references.pmid: 21216812