Adipocytokine Profiling and Cardiovascular Risk Stratification in Rheumatoid Arthritis: Literature Review

Rheumatoid arthritis (RA) is associated with an increased burden of cardiovascular disease (CVD), reflecting interactions among persistent systemic inflammation, traditional cardiometabolic risk factors, and treatment exposure. Conventional risk scores may underestimate cardiovascular risk in some patients with RA. This narrative review examines the potential role of adipokines in linking synovial inflammation and metabolic dysfunction to vascular disease. It discusses the context-dependent cardiovascular associations of adiponectin, the pro-inflammatory signaling of leptin, resistin, visfatin, and chemerin, and the proposed protective roles of omentin, vaspin, and apelin. Emerging observations connect adipokine profiles with measures of subclinical atherosclerosis and selected clinical outcomes; however, methodological heterogeneity and residual confounding constrain causal and prognostic interpretations. We also consider venous thromboembolism, cardiometabolic multimorbidity, and treatment-related risk, including the clinical safety context of JAK inhibitors. At present, adipokine profiling remains investigational and should complement research, not replace established cardiovascular risk assessment and control of disease activity and conventional risk factors.