Rheumatoid Arthritis and obesity - clinical relevance

Abstract

Introduction. Rheumatoid Arthritis(RA) is a chronic, autoimmune disease. It affects synovial joints, producing symmetrical arthritis and it leads to damage and deformity. The obesity is a significant risk factor for the development of RA. Purpose. The goal is to determine the impact of obesity in evolution of RA. Material and methods. Through the PubMed, NCBI, NIH databases Jrheum and ScienceDirect et al. 50 publications were selected on the subject. Results. It appears that obesity seems to affect several aspects of the life of RA patients. Obese individuals are an increased risk of developing RA. The accumulation of white adipose tissue contributes to given that this tissue secretes adipokines, leptin, adiponectin, resistin, and visfatin, all of which may be involved in immunity and inflammation. Obesity in RA has been associated with an increased risk of mortality ,cardiovascular comorbidity, total joint replacement, work disability, high medical costs, and impaired quality of life. There are less likely response to anti-tumor necrosis factor agents anti-TNFs), is associated with a decreased likelihood of reaching remission in RA patients treated with anti-TNFs, decreased treatment response to combination therapy with synthetic disease modifying antirheumatic drugs. Patients, who are extremely obese experienced a more rapid decline in function, as well as more rapidly progressing disability and pain, however, greater weight loss in persons with RA who were already underweight was linked to increasing disability, possibly due to age-related fragility. Conclusions. Obesity could explain 52% of the recent rise in incidence of RA. Obese patients with RA are less likely to respond to different combination therapy.