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Obesity, adipose tissue and cardiovascular risk in rheumatoid arthritis


Authors: L. Šenolt;  M. Kuklová;  H. Hulejová;  L. Andres Cerezo
Authors‘ workplace: Revmatologický ústav, Klinika revmatologie 1. LF UK Praha
Published in: Čes. Revmatol., 20, 2012, No. 2, p. 43-52.
Category: Overview Reports

Overview

Obesity is associated with low inflammatory activity and is a risk factor for severe cardiovascular and metabolic diseases. The occurrence of cardiovascular diseases in rheumatoid arthritis is two times higher than in the general population. Rheumatoid arthritis is associated with an unfavourable metabolic condition - chronic inflammation, and lack of exercise causes loss of muscle mass and increased accumulation of adipose tissue. This condition is referred to as rheumatoid cachexia or sarcopenic obesity and occurs in individuals with increased or mainly with normal body mass index. Obesity in rheumatoid arthritis affects many aspects. It can be a potential risk factor for seronegative subset of the disease. Obese patients with rheumatoid arthritis tend to have more active disease course and worse quality of life. On the other hand, there is some evidence that obese patients with rheumatoid arthritis have less joint erosions, and slower structural progression. The higher incidence of cardiovascular disease and increased mortality in rheumatoid arthritis are probably not directly dependent on the body mass index, but rather dependent on the inflammatory activity of the disease. On the contrary, very thin patients appear to be the more vulnerable group. The aim of this review is to summarize the relationship between obesity, the severity of rheumatoid arthritis and cardiovascular risk profile in the context of new knowledge on the role of adipokines in the pathogenesis of metabolic and inflammatory diseases.

Key words:
rheumatoid arthritis, obesity, adipose tissue, mortality, inflammation, adipokines


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