Obesity versus osteoarthritis: beyond the mechanical overload

Area of Science:

• Public Health
• Rheumatology
• Metabolic Disease

Background:

• Obesity is a global epidemic and a major risk factor for numerous diseases, including type 2 diabetes, hypertension, and osteometabolic conditions.
• Osteoarthritis (OA), the most common rheumatic disease, causes significant disability, particularly in individuals over 65, affecting weight-bearing joints like knees and hips.
• The rising prevalence of OA, even in non-weight-bearing joints, suggests obesity's role extends beyond mechanical overload.

Purpose of the Study:

• To explore the intricate relationship between obesity and osteoarthritis.
• To elucidate the underlying mechanisms linking obesity and OA development.
• To identify potential therapeutic targets for preventing or managing OA in obese individuals.

Main Methods:

• Literature review correlating obesity and osteoarthritis.
• Analysis of metabolic and inflammatory pathways involved in both conditions.
• Examination of the role of systemic inflammation and hormonal resistance in joint degeneration.

Main Results:

• Increased fat mass, particularly from saturated fatty acids, promotes low-grade systemic inflammation.
• Obesity leads to insulin and leptin resistance; elevated leptin levels exhibit pro-inflammatory properties.
• Leptin directly impacts articular cartilage, initiating inflammatory processes and disrupting tissue homeostasis, leading to degeneration.

Conclusions:

• Obesity is confirmed as a significant risk factor for osteoarthritis.
• Systemic inflammation and leptin resistance are key mechanisms linking obesity to OA.
• Physical activity and dietary modifications can reverse inflammation and leptin resistance, potentially preventing or slowing OA progression.