Metabolic Consequences of Rheumatoid Arthritis.

Patients with rheumatoid arthritis (RA) may have metabolic disruption for multiple reasons that can contribute to adverse long-term outcomes. RA patients appear to have a higher risk of sarcopenia, type 1 and type 2 diabetes, 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.