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
赫曼关爱健康 中诺医疗
随着医护人员对伤口护理质量及病患生活质量追求的提高，敷料无痛更换及敷料的止痛效果正获得越来越多的重视。以往大家更多的关注敷料更换时的无痛、无二次损伤，随着新型敷料的使用逐渐增多，医护人员也需更加重视敷料贴附时的止痛效果。
导语：高血压、高血脂、高血糖，再加上高尿酸，被这四种慢性病缠上的人，既需要按时服药，吃喝等还要受到诸多限制，可称得上最让人无可奈何了！
送你四张“处方”，趁还来得及，看懂四高、防四高、降四高！
去疤痕 中诺医疗
相信很多人都看过《金刚狼》这部电影。
那部电影中，吸引人的不仅仅是狼叔健硕的肌肉和刀锋般的钢爪，还有就是狼叔无论怎么受伤都可以自我修复的能力。
那么现实生活中，疤痕到底可以自我修复吗?
医学界内分泌频道 中诺医疗
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
扫一扫了解详情:
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