Metabolic syndrome in patients with rheumatoid arthritis: clinical implications

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by swelling, tenderness, and destruction of synovial joints, leading to severe disability and premature mortality. The severity of inflammation is linked to an increased risk of cardiovascular mortality in the affected persons. Patients with RA are more prone for accelerated atherosclerosis than the general population. Atherosclerosis is in turn a risk factor for cardiovascular disease (CVD). Metabolic syndrome (MetS) is a major risk factor for the development of CVD. Evaluation of patients with RA for MetS appears to be clinically relevent because, not only are patients with RA more prone to develop atherosclerotic CVD, but when an associated MetS coexists this risk is further amplified. Investigations into the relationship between RA and the MetS have yielded conflicting results. While some studies reported a higher prevalence of MetS in patients with RA, others did not document such association. It has also been demonstrated that drugs which decrease rheumatoid inflammation are also useful in decreasing the MetS component of the disease.