Metabolic syndrome meets osteoarthritis

Area of Science:

• Rheumatology and Endocrinology
• Metabolic and Musculoskeletal Research

Background:

• Metabolic osteoarthritis (OA) is recognized as a distinct OA subtype.
• Established links exist between OA and metabolic syndrome (MetS), including its individual components.

Purpose of the Study:

• To review shared etiological mechanisms between OA and MetS.
• To propose metabolic OA as a fifth component of MetS.
• To identify potential therapeutic strategies by integrating OA and MetS concepts.

Main Methods:

• Comprehensive review of existing literature on OA and MetS.
• Analysis of shared pathophysiological pathways including inflammation, oxidative stress, and endothelial dysfunction.
• Examination of the roles of hypertension, dyslipidemia, hyperglycemia, and obesity in OA development.

Main Results:

• Hypertension contributes to OA via subchondral ischemia and altered nutrient exchange.
• Dyslipidemia and hyperglycemia promote OA through ectopic lipid deposition, oxidative stress, and advanced glycation end-products.
• Obesity-related factors, such as adipokines, exacerbate OA by promoting inflammation and cartilage degradation.

Conclusions:

• Metabolic OA shares fundamental mechanisms with MetS, including inflammation, oxidative stress, and endothelial dysfunction.
• Metabolic OA is proposed as the fifth component of MetS.
• Unifying the understanding of OA and MetS offers promising therapeutic opportunities.