Section of Rheumatology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Best Pract Res Clin Rheumatol. 2010 Feb;24(1):15-26. doi: 10.1016/j.berh.2009.08.006.
Although older age is the greatest risk factor for osteoarthritis (OA), OA is not an inevitable consequence of growing old. Radiographic changes of OA, particularly osteophytes, are common in the aged population, but symptoms of joint pain may be independent of radiographic severity in many older adults. Ageing changes in the musculoskeletal system increase the propensity to OA but the joints affected and the severity of disease are most closely related to other OA risk factors such as joint injury, obesity, genetics and anatomical factors that affect joint mechanics. The ageing changes in joint tissues that contribute to the development of OA include cell senescence that results in development of the senescent secretory phenotype and ageing changes in the matrix including formation of advanced glycation end-products that affect the mechanical properties of joint tissues. An improved mechanistic understanding of joint ageing will likely reveal new therapeutic targets to slow or halt disease progression. The ability to slow progression of OA in older adults will have enormous public health implications given the ageing of our population and the increase in other OA risk factors such as obesity.
虽然年龄增长是骨关节炎（OA）的最大风险因素，但 OA 并非衰老的必然结果。OA 的影像学改变，特别是骨赘，在老年人群中很常见，但许多老年人的关节疼痛症状可能与影像学严重程度无关。肌肉骨骼系统的衰老变化增加了患 OA 的倾向，但受影响的关节和疾病的严重程度与其他 OA 风险因素密切相关，如关节损伤、肥胖、遗传和影响关节力学的解剖因素。导致 OA 发展的关节组织衰老变化包括细胞衰老，导致衰老分泌表型的发展，以及基质中的衰老变化，包括形成影响关节组织机械性能的高级糖基化终产物。对关节衰老的机制的深入了解可能会揭示新的治疗靶点，以减缓或阻止疾病进展。鉴于人口老龄化以及肥胖等其他 OA 风险因素的增加，能够减缓老年人 OA 的进展将具有巨大的公共卫生意义。
