Osteoarthritis and Metabolic Syndrome

Osteoarthritis (OA) is the most common cause of joint inflammation. OA is commonly attributed to aging, overuse, and joint degeneration from increased mechanical loading of the neck, lower back, hips, knees, and feet in obesity.

Recently, there is an interest in the association of OA and MetS. This makes sense, considering that there has been an increasing rise in the number of osteoarthritides that parallels the incidence of metabolic syndrome.

Areas_affected_by_osteoarthritis — Common Osteoarthritis Sites

Metabolic Syndrome (MetS) is a constellation of conditions that include obesity, high blood sugar, high triglycerides, low HDL, and hypertension. A person with at least 3 of the above has MetS and is more likely to develop cardiovascular disease.

Even though knee OA has been historically associated with being obese, the inflammation seen in the joints of the wrists and fingers cannot be explained by the increased biomechanical load of obesity.

1280px-Heberden-Arthrose — The hard knobs in the middle finger joints and the farthest joints are signs of Osteoarthritis.

Osteoarthritis has been associated with diabetes, insulin resistance, high blood sugar, excessive intraabdominal fat that generates pro-inflammatory proteins, and reactive oxygen species that promote inflammation.

Both OA and MetS are associated with increased inflammatory markers in the blood like the C-reactive protein. Elevation of leptin, a pro-inflammatory and appetite hormone is seen in MetS, is also linked to OA because of its role in bone and cartilage synthesis.

800px-Osteoarthritis_left_knee — Primary osteoarthritis of the left knee.

Steroid injections are prescribed to severe osteoarthritis patients to decrease the inflammation. Steroid injections can damage the cartilage in the long run, which is why it is only given every six weeks and usually not more than three or four times a year. In between, the patients are prescribed anti-inflammatory drugs.

In a recent study that followed 156 knee OA patients for one year, the group of patients with osteoarthritis who received exercise, manual therapy, and education scored better on the WOMAC score. The WOMAC score is based on the pain scale, stiffness, and physical function. The exercise group also reported a higher sense of general well-being than the group that received steroid injections only.

The results can be explained by the use of exercise in the physical therapy group. In previously written articles in this blog, How Can Exercise Prolong Life? And Myokines: An Introduction discussed the many health benefits acquired with physical activity and exercise. Exercise also addresses the source of inflammation of the knees, which is from metabolic syndrome.

Thanks for reading.

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