Sara Ferrigno1 · Eneida Çela1 · Mauro Fatica1,2 · Benedetta Monosi1 · Arianna D’Antonio1 · Paola Conigliaro1 · Marina Cardellini3,4 · Susanna Longo3,4 · Massimo Federici3,4 · Maria Sole Chimenti1
Received: 20 February 2026 / Accepted: 26 March 2026 © The Author(s) 2026
Abstract
Rheumatoid arthritis (RA) is an inflammatory disease characterized by a higher burden of cardiovascular and metabolic diseases than in the general population. Altered lipid and glucose metabolic pathways are widely observed, primarily due to chronic inflammation. However, metabolic dysfunction may also affect RA pathogenesis, further enhancing immune cell activation and joint damage. Glucose and lipid alterations observed in RA help define the comorbidity burden of this disease, significantly affecting disease activity and prognosis. The aim of the present review is to describe the role of metabolic dysfunctions in RA and to examine how disease activity and treatments can influence these conditions. We also summarized the main management strategies based on current literature and developed a cardiometabolic monitoring algorithm across different clinical settings to support daily patient care of these patients.
Keywords Rheumatoid arthritis · Glucose metabolism · Lipid metabolism · Atherogenesis · Inflammation · Immune-metabolism · Cardiovascular risk
Sara Ferrigno and Eneida Çela contributed equally to this manuscript
Communicated by Salvatore Corrao, M.D
Sara Ferrigno
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1 Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
2 Academic Rheumatology Unit, Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Giovanni Paolo II, C/da Tappino, Campobasso 86100, Italy
3 Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
4 Center for Atherosclerosis, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Georgios Mavraganis1 · Dimitrios Bampatsias1,2 · Christina Konstantaki1 · Kamil Stankowski3,4 ·Stavros Athanasopoulos1 · Chrysoula Moustou1 · Alexandros Alexandropoulos1 · Stefano Figliozzi3,4 ·Angelos Soranides1 · Ioannis Petropoulos1 · Dimitrios Klettas5 · Kimon Stamatelopoulos1,6 ·Georgios Georgiopoulos1,7
Received: 12 December 2025 / Accepted: 15 March 2026 © The Author(s) 2026
Introduction Diabetic cardiomyopathy (DCM) often evades diagnosis before manifestation of clinical symptoms. In this study we explored how cardiometabolic traits influence early cardiac structure and function in asymptomatic people living with diabetes (PwD), using advanced imaging.
Methods We conducted a cross-sectional study of 88 participants: 57 people living with type 2 diabetes (PwT2D), 16 people living with type 1 diabetes (PwT1D) and 15 controls. All subjects underwent transthoracic echocardiography and/or cardiac magnetic resonance (CMR) imaging. Strain analysis, perfusion indices, and tissue characterization (T1, T2, and extracellular volume) were assessed. Arterial stiffness via pulse wave velocity (PWV), ventricular-arterial coupling (VAC), circulating biomarkers and liver fibrosis indices were evaluated.
Results PwD had lower cardiac index than controls. Global longitudinal strain (GLS) and global radial strain were lower in both diabetes mellitus (DM) groups, while left atrial strain was most impaired in PwT2D (β-coefficient= − 11.77, P=0.003). DM duration≥10 years was associated with worse GLS (β-coefficient= − 2.18, P=0.033) and right VAC (β-coefficient= − 0.27, P=0.027) after multivariable analysis. While tissue characterization and perfusion indices showed no significant group differences, tight glycemic control in PwD correlated with improved myocardial strain parameters. PwT2D exhib-ited greater arterial stiffness (β-coefficient=1.52, P=0.003). In PwD, elevated non-alcoholic fatty liver disease score cor-related with increased left ventricular mass (β-coefficient=6,195, P=0.022) and decreased left ventricular ejection fraction (LVEF) (β-coefficient= − 3.12, P=0.017). Higher growth differentiation factor levels were associated with reduced LVEF (β-coefficient= − 0.005, P=0.029).
Conclusion This multimodal imaging study highlights myocardial and vascular changes in asymptomatic PwD. Early com-prehensive cardiovascular assessment may help identify dysfunction before overt heart failure develops.
Keywords Diabetic cardiomyopathy · Cardiac magnetic resonance · Echocardiography · Arterial stiffness · Ventricular-arterial coupling · Liver fibrosis
原创: 胡海涛 负压引流与创面修复
临床中遇到很多特殊伤口:他们来诊时,伤口外敷各种特殊‘敷料’,有墙土粉、木炭粉、爽身粉、树皮、烟丝、烟灰、冷饭、草屑、木屑,甚至有黑色的锅灰,从锅底刮出来的……
DF 中山二院糖尿病足中心
原创: 十六点五 中山二院糖尿病足中心
糖尿病足的切口设计是糖尿病足局部脓肿及窦道治疗的第一步,也是最关键的一步之一,由于糖尿病足脓肿和窦道的多样性,以及糖尿病足病人全身情况的不一致,因此,要找到糖尿病足切口的设计规律比较困难,我们根据大量的临床实践,制定了以下的一些原则。
在上节中提到局部鉴别皮肤组织的“死活”是一个难题,有读者问有关在创面表面用“亚甲基蓝”染料染色来鉴别的问题,这种方法是一种比较古老的方法,对于相对较干净的伤口的效果比较好,对于严重感染的伤口容易出现误报,而且为了最大程度的保护足的结构和功能,一般采取蚕食性的方法进行清创,用这些染料染色后,反而有时候会干扰对肉芽组织生长的判断,容易造成清创过多的情况,因此,目前应用较少(也比较难得到有证书能够在临床应用的这种染料)。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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