Artrite reumatoide e síndrome metabólica

Abstract

Nos ultimos 20 anos, tem sido demonstrado que a artrite reumatoide (AR) pode reduzir a expectativa de vida de 3 a 10 anos em comparacao com a populacao em geral. Atualmente, a doenca cardiovascular (DCV) e a principal causa de morte nos pacientes com AR, e a ocorrencia de infarto agudo do miocardio pode ser ate quatro vezes maior nesses pacientes. A resposta infl amatoria sistemica de etiologia autoimune, somada a presenca de sindrome metabolica (SM), torna duas vezes maior o risco de DCV fatal ou nao fatal e da aterosclerose coronariana, independentemente da idade e sexo. A artrite reumatoide tem sido associada a aumento da prevalencia de SM, mas o papel das diferentes caracteristicas da doenca, tais como a duracao da doenca, atividade e tratamento com glucocorticoides nao estao bem definidos. O objetivo deste trabalho e revisar a prevalencia de SM e os fatores implicados no desenvolvimento de aterosclerose nos pacientes com AR, avaliando os aspectos clinicos da AR e sua associacao com o desenvolvimento de SM.

In the past 20 years, the life expectancy of patients with rheumatoid arthritis (RA) has been shown to be reduced by three to ten years as compared to that of the general population. Currently, cardiovascular disease (CVD) is the major cause of death in patients with RA, and acute myocardial infarction can be up to four times more frequent in these patients. The autoimmune systemic infl ammatory response, along with the presence of metabolic syndrome (MetS), doubles the risk for fatal or non-fatal CVD and coronary atherosclerosis, regardless of age and sex. Rheumatoid arthritis has been associated with increased prevalence of MetS, but its role in the different characteristics of the disease, such as disease duration, activity, and treatment with glucocorticoids, is not well defi ned. This study aimed at reviewing the prevalence of MetS and the factors implicated in the development of atherosclerosis in RA patients, assessing the clinical aspects of RA and its association with the development of MetS.