Rai Muhammad Farooq, Sandell Linda J
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Crit Rev Eukaryot Gene Expr. 2011;21(2):131-42. doi: 10.1615/critreveukargeneexpr.v21.i2.30.
Osteoarthritis (OA), the most common form of arthritis, is associated with joint malfunction and chronic disability in the aged population. It is a multifactorial disorder to which several factors-such as age, sex, trauma, and obesity-contribute significantly. Obesity is one of the most influential but modifiable risk factors because it exerts an increased mechanical stress on the tibiofemoral cartilage. However, the high prevalence of OA in obese individuals in non-weightbearing areas, like finger joints, suggests that the link between being overweight and OA lies with factors other than simple biomechanics. An important correlation has been made between obesity and inflammation. Adipose tissues (and the infrapatellar fat pad) play an important role in this context because they are the major source of cytokines, chemokines, and metabolically active mediators called adipokines (or adipocytokines). These metabolic factors are known to possess catabolic and proinflammatory properties and to orchestrate the pathophysiological processes in OA. This review provides information on the relationship between obesity and OA through biomechanical and biochemical factors and highlights the functions of important obesity-related inflammatory products in the initiation and progression of OA. This information will broaden our thinking in identifying the targets for both prevention and intervention for OA.
骨关节炎（OA）是最常见的关节炎形式，与老年人群的关节功能障碍和慢性残疾有关。它是一种多因素疾病，年龄、性别、创伤和肥胖等多种因素对其有显著影响。肥胖是最具影响力但可改变的风险因素之一，因为它会增加胫股关节软骨的机械应力。然而，在非负重区域（如手指关节）的肥胖个体中OA的高患病率表明，超重与OA之间的联系在于简单生物力学之外的因素。肥胖与炎症之间已建立了重要关联。在这种情况下，脂肪组织（以及髌下脂肪垫）起着重要作用，因为它们是细胞因子、趋化因子和称为脂肪因子（或脂肪细胞因子）的代谢活性介质的主要来源。已知这些代谢因子具有分解代谢和促炎特性，并在OA中协调病理生理过程。本综述通过生物力学和生化因素提供了肥胖与OA之间关系的信息，并强调了重要的肥胖相关炎症产物在OA发生和发展中的作用。这些信息将拓宽我们在确定OA预防和干预目标方面的思路。
