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. 

Exercise
Different Exercises For Osteoarthritis

Thanks for reading.

Related Readings:

  1. The Metabolic Syndrome
  2. Rheumatoid Arthritis and Metabolic Syndrome
  3. Osteoarthritis and Metabolic Syndrome
  4. Gout and Metabolic Syndrome
  5. Psoriasis and Metabolic Syndrome.
  6. How to Do Intermittent Fasting
  7. If You Know Anybody Male who is 55 and Older, Read This!
  8. The Game-Changing Uses of KAATSU
  9. How to Start a Fire or How to be Active from Sedentary
  10. The Surprising Benefits of Sweating

References:

  1. K.M. Huffman and W.E. Kraus. Osteoarthritis and the metabolic syndrome: more evidence that the etiology of OA is different in men and women. Osteoarthritis Cartilage. 2012 Jul; 20(7): 603–604.
  2. Yoshimura et al. Association of knee osteoarthritis with the accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance in Japanese men and women: the ROAD studyJ Rheumatol. 2011 May;38(5):921-30. 
  3. Sowers et al.  Knee osteoarthritis in obese women with cardiometabolic clusteringArthritis Rheum. 2009 Oct 15;61(10):1328-36. doi: 10.1002/art.24739.
  4. Rhoan et al. Corticosteroid injection versus a physical therapy approach for the management of knee osteoarthritis: a randomized clinical trial. April 2019Volume 27, Supplement 1, Page S32 

Image Credits:

  • Different osteoarthritis sites By US federal government – http://www.niams.nih.gov/health_info/Osteoarthritis/default.asp, Public Domain, https://commons.wikimedia.org/w/index.php?curid=40173053
  • Osteoarthritis hands By Drahreg01 – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=1358952
  • Osteoarthritis X-ray  James Heilman, MD
  • Exercises from the US federal  government – http://www.niams.nih.gov/health_info/Osteoarthritis/default.asp

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