Metabolic syndrome meets osteoarthritis

Abstract

Metabolic osteoarthritis (OA) has now been characterized as a subtype of OA, and links have been discovered between this phenotype and metabolic syndrome (MetS)--both with individual MetS components and with MetS as a whole. Hypertension associates with OA through subchondral ischaemia, which can compromise nutrient exchange into articular cartilage and trigger bone remodelling. Ectopic lipid deposition in chondrocytes induced by dyslipidemia might initiate OA development, exacerbated by deregulated cellular lipid metabolism in joint tissues. Hyperglycaemia and OA interact at both local and systemic levels; local effects of oxidative stress and advanced glycation end-products are implicated in cartilage damage, whereas low-grade systemic inflammation results from glucose accumulation and contributes to a toxic internal environment that can exacerbate OA. Obesity-related metabolic factors, particularly altered levels of adipokines, contribute to OA development by inducing the expression of proinflammatory factors as well as degradative enzymes, leading to the inhibition of cartilage matrix synthesis and stimulation of subchondral bone remodelling. In this Review, we summarize the shared mechanisms of inflammation, oxidative stress, common metabolites and endothelial dysfunction that characterize the aetiologies of OA and MetS, and nominate metabolic OA as the fifth component of MetS. We also describe therapeutic opportunities that might arise from uniting these concepts.

An update on the pathophysiology of osteoarthritis

“…Throughout life, cartilage is continually remodeled as chondrocytes replace the degraded matrix macromolecules with newly synthesized components, although it is recognized that this is an exceptionally slow process in adults; proteoglycan turnover can take up to 2 decades whereas the half-life of collagen is estimated to range from several decades to more than 100 years (20)(21)(22). Although articular cartilage can tolerate a tremendous amount of intensive and repetitive physical stress, it manifests a striking inability to heal even a minor injury (2 (23), it has inflammatory and metabolic components (1,16,(24)(25)(26)(27).…”

Síndrome metabólico y otros factores asociados a gonartrosis

“…Mayores valores de c-HDL mostraron estar relacionados con una menor presencia de gonartrosis, hallazgo que está en concordancia con lo esperado, ya que el SM, el cual se encontró asociado a mayor gonartrosis en el mismo análisis, se caracteriza por valores bajos de c-HDL. Estudios bioquímicos y celulares sugieren que todos estos factores pudieran estar implicados en la patogénesis de la degeneración del cartílago articular en conjunto con la obesidad, y que se relacionan con la secreción de citocinas proinflamatorias, las cuales pudieran ser marcadores útiles de progresión a degeneración articular 10,[26][27][28] . Debido a esto se analizaron los valores de PCR, que es un marcador de inflamación inespecífico y que se ha reportado aumentado en los pacientes con obesidad y SM.…”

Метаболічний Синдром Як Міждисциплінарна Проблема (Огляд Літератури)

“…У групах хворих на ЦД 2-го типу поширеність МС виявилася найвищою -до 90 % [7]. А в групі хворих на МС у 15-20 % випадків він трансформу-ється в ЦД 2-го типу [21]. Протягом 10 років у 50 % пацієнтів з МС може розвиватися ЦД 2-го типу [9].…”