Barry Stevie, Sheng Emily, Baker Joshua F
Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Perelman School of Medicine, University of Pennsylvania and Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.
Arthritis Care Res (Hoboken). 2025 Apr 2. doi: 10.1002/acr.25537.
Patients with rheumatoid arthritis (RA) may have metabolic disruption, which can contribute to adverse long-term outcomes, for multiple reasons. Patients with RA appear to have a higher risk of sarcopenia, type 1 and type 2 diabetes mellitus, metabolic syndrome, and hypertension. Systemic inflammation in RA can cause a "lipid paradox," with reduced low-density lipoprotein being associated with higher rates of cardiovascular disease. In this review, we discuss changes to body composition, insulin resistance, lipids, and blood pressure that often occur in patients with RA. We examine the current understanding of the mechanisms underlying disruptions in metabolic pathways in RA, their clinical effects, and how treatment affects these changes.
类风湿关节炎（RA）患者可能因多种原因出现代谢紊乱，这可能导致不良的长期后果。RA患者似乎患肌肉减少症、1型和2型糖尿病、代谢综合征及高血压的风险更高。RA中的全身炎症可导致“脂质悖论”，即低密度脂蛋白降低与心血管疾病发生率较高相关。在本综述中，我们讨论了RA患者常出现的身体成分、胰岛素抵抗、脂质及血压的变化。我们研究了目前对RA代谢途径紊乱的潜在机制、其临床影响以及治疗如何影响这些变化的理解。
