The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Mechanistic, Epidemiologic Clues Suggest Possible Link Between Obesity, Inflammation in Rheumatoid Arthritis

Mechanistic, Epidemiologic Clues Suggest Possible Link Between Obesity, Inflammation in Rheumatoid Arthritis

October 11, 2016 • By Kurt Ullman

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Although no direct scientific evidence exists, both mechanistic and epidemiologic clues suggest a possible link between obesity and RA.

Although no direct scientific evidence exists, both mechanistic and epidemiologic clues suggest a possible link between obesity and RA.
Suzanne Tucker/shutterstock.com

Obesity has an established systemic inflammatory component. Could that be a trigger for the inflammation seen in rheumatoid arthritis (RA) and other rheumatic diseases? Although there is no direct scientific evidence, both mechanistic and epidemiologic clues do give some intriguing suggestions of a possible link.

You Might Also Like
  • Obesity Associated with Increased Inflammatory Markers in Rheumatoid Arthritis
  • EULAR 2014: Osteoarthritis and Obesity Link
  • Obesity’s Effects on Inflammatory Markers in Patients with RA
Explore This Issue
October 2016
Also By This Author
  • Gene to Block TNF Linked to Multiple Sclerosis but not Rheumatoid Arthritis

“At first, we thought that fat was involved only in energy storage and helping insulate the body from cold,” says Michael B. Brenner, MD, chief of the Division of Rheumatology, Immunology and Allergy at Brigham and Women’s Hospital in Boston. “We now realize that there is an entire immune system within adipose tissue [AT] that switches from a Type 2 anti-inflammatory state to a pro-inflammatory state characterized by many of the same cytokines and cells that we see in RA.”

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

All Fat Not Created Equal

It has also been established that all fat is not created equal. Visceral fat has a larger number of leukocytes and a greater influence on systemic metabolism than subcutaneous fat.

The color is also important. White adipose tissue is a component of energy storage and insulation, and produces the adipocyte hormones, leptin and adiponectin. Brown fat produces heat and is a key regulator of basal metabolic rate and weight. Beige fat is induced by cold and exercise, and produces heat.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Good & Bad Cytokines & Immune Cells

In the lean state, Interleukin (IL) 4, IL-10 and IL-13 are the main cytokines produced. IL-4 and IL-13 drive M2 (alternatively activated) macrophages, and IL-10 does that in addition to blocking the effects of tumor necrosis factor (TNF) and Nuclear Factor kB (NF-kB), all of which inhibits inflammation. There are also higher levels of regulatory T cells (Tregs) in AT in the lean state.1

In obesity, there is a completely different response, showing an increase in what Dr. Brenner calls “bad leukocytes.” At higher body mass index (BMI) levels, there is an up-regulation of M1 macrophages and various T cells that results in higher levels of TNFα, IL-1β, Interferon γ and lower levels of IL-10, IL-4 and IL-13. This mix tends to increase the level of inflammation and is responsible for insulin resistance.2

If you overeat, fat cells get very large, doubling in size when 10 lbs. are gained. Then they start to rupture, which releases material that is supposed to be intracellular into the fat tissue. This, in turn, triggers the macrophages to come in and clean up the debris.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 4 5 6 7 | Single Page

Filed Under: Conditions, Rheumatoid Arthritis Tagged With: clues, epidemiologic, inflammation, link, mechanistic, Obesity, Pathogenesis, Research, Rheumatoid arthritis, risk factorIssue: October 2016

You Might Also Like:
  • Obesity Associated with Increased Inflammatory Markers in Rheumatoid Arthritis
  • EULAR 2014: Osteoarthritis and Obesity Link
  • Obesity’s Effects on Inflammatory Markers in Patients with RA
  • 2013 ACR/ARHP Annual Meeting: Genetic Research Yields Clues to Pathogenesis of Rheumatoid Arthritis, Psoriatic Arthritis

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)