Over the past few decades, the connection between metabolism and various inflammatory and rheumatic diseases has been an area of active investigation. Nonetheless, the precise mechanisms underlying these relationships remain a topic of ongoing debate, owing in part to conflicting data. This discrepancy can be attributed to the predominant focus on peripheral mechanisms in research into the metabolic consequences of rheumatic diseases. However, a wealth of evidence supports the notion that the central nervous system, specifically the hypothalamus, has an important influence on metabolic homeostasis. Notably, links have been established between crucial hypothalamic mechanisms responsible for regulating energy balance (including food intake, thermogenesis, and glucose and lipid metabolism), such as AMP-activated protein kinase, and the pathophysiology of rheumatoid arthritis. This Review aims to comprehensively examine the current understanding of central metabolic control in rheumatic diseases and explore potential therapeutic options that target this pathophysiological mechanism.

在过去的几十年里，新陈代谢与各种炎症和风湿性疾病之间的联系一直是积极研究的领域。尽管如此，这些关系背后的确切机制仍然是一个持续争论的话题，部分原因是数据相互矛盾。这种差异可归因于在研究风湿性疾病的代谢后果时主要关注外围机制。然而，大量证据支持中枢神经系统，特别是下丘脑，对代谢稳态有重要影响的观点。值得注意的是，负责调节能量平衡的关键下丘脑机制（包括食物摄入、产热和葡萄糖和脂质代谢），例如 AMP 活化蛋白激酶，与类风湿性关节炎的病理生理学之间已经建立了联系。本综述旨在全面检查目前对风湿性疾病中枢代谢控制的认识，并探索针对这种病理生理机制的潜在治疗选择。