Osteoarthritis and cardiometabolic diseases: shared mechanisms, modifiable risk factors, and integrated management
Patricia Yl Chan1, Shiwen Yuan2, David J Hunter3,4
1Northen Clinical School, Kolling Institute of Medical Research, St Leonards, NSW, Australia.
Insights
Osteoarthritis (OA) and cardiometabolic diseases (CMD) share risk factors and worsen each other. Lifestyle interventions targeting weight and activity are key for managing these interconnected chronic conditions.
Area of Science:
- Explores the intricate relationship between musculoskeletal health and metabolic well-being.
Background:
- Osteoarthritis (OA) and cardiometabolic diseases (CMD) are prevalent chronic conditions with shared risk factors, including obesity, insulin resistance, dyslipidemia, hypertension, and inflammation.
- Systemic inflammation, driven by factors like advanced glycation end-products, adipokines, and cytokines (e.g., IL-6, CRP), exacerbates both joint deterioration in OA and cardiovascular problems in CMD.
Purpose of the Study:
- To review the bidirectional relationship between OA and CMD.
- To highlight the importance of lifestyle interventions and multidisciplinary care for managing shared risk factors.
Main Methods:
- Comprehensive literature search across major databases (MEDLINE, PubMed, Embase, Cochrane, Scopus, CIAP, Google Scholar) from January 2011 to October 2025.
- Synthesis of evidence supporting the interconnectedness of OA and CMD.
Main Results:
- Evidence confirms a bidirectional link: OA exacerbates CMD risk through reduced physical activity, while CMD accelerates OA via vascular and metabolic stress.
- Lifestyle interventions, including weight management and physical activity, are crucial in the absence of disease-modifying drugs.
- Multidisciplinary care focusing on shared modifiable risk factors improves patient outcomes.
Conclusions:
- Future research should focus on shared molecular pathways (e.g., multi-omics), biomarker validation, and multimodal interventions integrating musculoskeletal and metabolic health.
- A patient-centered approach is essential for reducing the overall burden of OA and CMD.
Introduction:
Osteoarthritis (OA) and cardiometabolic diseases (CMD), including metabolic syndrome, type 2 diabetes, and cardiovascular disease, are common chronic disorders sharing risk factors, mechanisms, and societal burdens. Obesity, insulin resistance, dyslipidaemia, hypertension, and inflammation link joint damage with vascular and metabolic issues. Factors such as advanced glycation end-products, adipokines, and cytokines including interleukin-6 and C-reactive protein drive systemic and local inflammation, accelerating joint deterioration and cardiovascular problems.
Areas Covered:
We searched MEDLINE, PubMed, Embase, Cochrane, Scopus, CIAP, and Google Scholar from January 2011 to October 2025. Evidence supports a bidirectional relationship where OA worsens cardiometabolic risk via inactivity, and CMD accelerates OA through vascular and metabolic stress. Without disease-modifying drugs, lifestyle interventions like weight management and physical activity are key. Multidisciplinary care targeting shared modifiable risk factors can improve outcomes.
Expert Opinion:
Future research should investigate shared molecular pathways using approaches like multi-omics, validate early-detection biomarkers, and assess multimodal interventions that link musculoskeletal and metabolic health. A patient-centered approach to OA and CMD offers the best chance to reduce disability and disease burden.
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