Research progress on the interaction mechanism of glucose and lipid metabolism and intervention strategies in rheumatoid arthritis

Rheumatoid arthritis (RA), a chronic autoimmune disease, has a complex interaction with glucose and lipid metabolism in pathological process. Glucose metabolism reprogramming disrupts the metabolic homeostasis of the microenvironment and activates aerobic glycolysis to drive synovial proliferation and inflammation; lipid metabolism dysfunction reshapes the inflammatory regulatory network through lipid-derived mediators. The interplay between glucose and lipid metabolism jointly drives the "metabolism-inflammation" vicious cycle, in which the metabolic hub role of acetyl coenzyme A, the bidirectional regulatory role of lactate, the synergistic regulation of metabolic signals, and the organelle interaction between mitochondria and lipid droplets collectively exacerbate the pathological progression of RA. This review systematically focuses on the abnormal characteristics and interaction mechanisms of the two core pathways of glucose and lipid metabolism in RA, proposes intervention strategies and research directions targeting metabolic homeostasis based on metabolic targets, and provides important scientific references for the in-depth analysis of the pathological mechanism of RA and the development of targeted metabolic intervention therapies.