Metabolic Consequences of Rheumatoid Arthritis

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.