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Lipid and Metabolic Changes in Rheumatoid Arthritis

  • RHEUMATOID ARTHRITIS (LW MORELAND, SECTION EDITOR)
  • Published:
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Abstract

While the most obvious manifestations of rheumatoid arthritis (RA) involve inflammation and damage in the synovial joints, the systemic effects of the condition are widespread and life-threatening. Of particular interest is the ‘lipid paradox’ of RA, where patients with a numerically equivocal starting lipid profile have a significantly raised risk of cardiovascular (CV) events and response to therapy results in a ‘normalization’ of lipid levels and reduction in events. Changes in lipids can be seen before overt disease manifestations which suggest that they are closely linked to the more widespread inflammation-driven metabolic changes associated with tumour necrosis factor (TNF). Cachexia involves a shift in body mass from muscle to fat, which may or may not directly increase the cardiovascular risk. However, since TNF inhibition is associated with reduction in cardiovascular events, it does suggest that these widespread metabolic changes involving lipids are of importance. Analysis of single lipids or metabolites have been used to identify some of the key changes, but more recently, metabolomic and lipidomic approaches have been applied to identify a broad spectrum of small molecule changes and identify potentially altered metabolic pathways. Further work is needed to understand fully the metabolic changes in lipid profiles and identify novel ways of targeting desired profile changes, but work so far does suggest that a better understanding may allow management of patients to downregulate the systemic effects of their disease that puts them at risk of cardiovascular complications.

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Catherine M. McGrath is a National Institute for Health Research (NIHR) Academic Clinical Fellow. She reports that during 1997-2005, she was employed by bcm (Alliance Boots) and Wyeth Biopharma (now Pfizer) and with whom she has preserved pensions.

Stephen P. Young declares no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by the authors.

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Authors and Affiliations

  1. School of Immunity and Infection, Rheumatology Research Group, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

    Catherine M. McGrath & Stephen P. Young

  2. Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Lyndon, West Bromwich, West Midlands, B71 4HJ, UK

    Catherine M. McGrath

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  1. Catherine M. McGrath
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  2. Stephen P. Young
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Correspondence to Stephen P. Young.

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This article is part of the Topical Collection on Rheumatoid Arthritis

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McGrath, C.M., Young, S.P. Lipid and Metabolic Changes in Rheumatoid Arthritis. Curr Rheumatol Rep 17, 57 (2015). https://doi.org/10.1007/s11926-015-0534-z

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  • DOI: https://doi.org/10.1007/s11926-015-0534-z

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