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.
