CLINICALANDPATHOGENETICASSESSMENTOFTHEIMPACTOFMETABOLICSYNDROMEONTHECOURSEOFRHEUMATOIDARTHRITIS
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Rheumatoidarthritisisachronicsystemicinflammatorydiseasefrequentlyaccompaniedbymetabolicdisturbancesthatsignificantlyinfluencediseaseprogressionandlong-termoutcomes.Metabolicsyndrome,characterizedbyinsulinresistance,dyslipidemia,abdominalobesity,andarterialhypertension,hasbeenincreasinglyrecognizedasanimportantcomorbidityinpatientswithrheumatoidarthritis.Thisstudyaimstoassesstheclinicalandpathogeneticimpactofmetabolicsyndromeonthecourseofrheumatoidarthritis.Theanalysisshowsthatmetabolicsyndromeishighlyprevalentamongpatientswithrheumatoidarthritisandisassociatedwithincreasedinflammatoryactivity,moresevereclinicalmanifestations,andahigherriskofcardiovascularandskeletalcomplications.Chronicsystemicinflammationmediatedbypro-inflammatorycytokinesrepresentsakeymechanismlinkingjointdamagewithmetabolicabnormalities.Insulinresistanceandadipokineimbalancefurtherintensifyinflammatorypathways,creatingabidirectionalinteractionthatacceleratesdiseaseprogression.Thesefindingsunderlinetheimportanceofearlyidentificationandcomprehensivemanagementofmetabolicsyndromeinpatientswithrheumatoidarthritistoimprovediseasecontrolandreducecomorbidity-relatedmorbidity.
