Obesity versus osteoarthritis: beyond the mechanical overload.

Angélica Rossi Sartori-Cintra,Priscila Aikawa,Dennys Esper Correa Cintra

doi:10.1590/s1679-45082014rb2912

Angélica Rossi Sartori-Cintra, Priscila Aikawa + Show 1 more

Open Access

https://doi.org/10.1590/s1679-45082014rb2912

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Abstract

Obesity is currently considered a major public health problem in the world, already reaching epidemic characteristics, according to the World Health Organization. Excess weight is the major risk factor associated with various diseases, such as type 2 diabetes mellitus, hypertension, dyslipidemia and osteometabolic diseases, including osteoporosis and osteoarthritis. Osteoarthritis is the most prevalent rheumatic disease and the leading cause of physical disability and reduced quality of life of the population over 65 years. It mainly involves the joints that bear weight - knees and hips. However, along with the cases of obesity, its prevalence is increasing, and even in other joints, such as hands. Thus, it is assumed that the influence of obesity on the development of OA is beyond mechanical overload. The purpose of this review was to correlate the possible mechanisms underlying the genesis and development of these two diseases. Increased fat mass is directly proportional to excessive consumption of saturated fatty acids, responsible for systemic low-grade inflammation condition and insulin and leptin resistance. At high levels, leptin assumes inflammatory characteristics and acts in the articular cartilage, triggering the inflammatory process and changing homeostasis this tissue with consequent degeneration. We conclude that obesity is a risk factor for osteoarthritis and that physical activity and changes in diet composition can reverse the inflammatory and leptin resistance, reducing progression or preventing the onset of osteoarthritis.

Highlights

According to the World Health Organization (WHO), obesity has already reached epidemic proportions, affecting over one billion adults worldwide. It is the major risk factor associated with various diseases, such as insulin resistance and type 2 diabetes mellitus (DM2), hypertension, dyslipidemias and some kinds of
Obesity is strongly associated with a series of disturbances, like asthma and nonalcoholic steatohepatitis, in addition to osteometabolic diseases, such as osteoporosis and osteoarthritis.[1]. Osteoarthritis (OA) is the most prevalent osteometabolic rheumatic disease, and the main cause of physical incapacity and reduced quality of life of the population aged over 65 years
These changes occur preferably in joints that bear body weight, such as knees and hip.[3] along with the increased prevalence of obesity in the world population, there has been an increase in cases of OA in non-weight bearing joints, such as hand and temporomandibular (TMJ) joints.[4]. In this way, the influence of obesity in the development of OA is thought to go beyond joint overload due to the increase in body mass index (BMI).(5)

Summary

INTRODUCTION

According to the World Health Organization (WHO), obesity has already reached epidemic proportions, affecting over one billion adults worldwide. The condition predisposes to the development of DM2 and contributes to the increase in fat mass and continuity of inflammation, changing the cell signal pathways of some organs, such as the liver, skeletal muscles, lungs, endothelium and articular cartilages.[8] Due to the inflammatory capacity acquired by leptin when produced in high amounts, several studies reported it as the initial factor in the genesis of other peripheral inflammatory disorders such as OA.[14]. Main experimental studies with phenotypes of obesity and type 2 diabetes mellitus, induced by a saturated fat-rich diet (high lipid content), and their relations with onset and progression of osteoarthritis

Conclusion

CONCLUSION