Metabolic Disorders Significantly Increase Osteoarthritis Risk

Osteoarthritis is a joint disorder, a disease of wear and tear. Traditionally, its risk has been associated with aging. However, science has also known that its risk is higher in obese individuals or those living with diabetes. 

However, it now appears that there is a stronger association between osteoarthritis and metabolic disorders. This is especially true regarding osteoarthritis at a young age. 

Traditionally, mechanical stress from repetitive movements or excess weight was considered the primary culprit behind OA. However, recent research suggests the significant role of metabolic abnormalities in the disease process. It might be the primary factor in many individuals. 

In recent years, science has better understood metabolic disorders like obesity. Now, it is known that fat tissues are not just merely energy stores. Adipose tissues are also endocrine organs. Higher activity of these fatty tissues results in the production of inflammatory mediators, increasing the risk of various health disorders, including osteoarthritis.

Rethinking Osteoarthritis: Metabolic Abnormalities Take Center Stage

The new research sheds light on the strong association between metabolic abnormalities and the development of OA. Individuals with obesity, type II diabetes, and dyslipidemia (abnormal blood fat levels) were found to be at a considerably higher risk of developing OA compared to those with healthy metabolic profiles. 

Interestingly, this association extends beyond weight-bearing joints like knees and hips, affecting even non-weight-bearing joints such as those in the hands. This unexpected finding challenges the long-held notion that mechanical stress solely dictates OA development, prompting researchers to investigate the role of metabolic factors.

It seems that one key underlying mechanism is the release of inflammatory cytokines from fat tissue. These inflammatory molecules, acting like messengers, can travel throughout the body and inflict damage on joint cartilage, leading to the hallmark features of OA, including pain, stiffness, and reduced mobility. 

Additionally, elevated blood sugar levels have been shown to damage cartilage directly, further accelerating the progression of OA. These findings suggest that metabolic imbalances can create a pro-inflammatory environment that hastens the degeneration of joint cartilage. That is why it is no surprise that almost half of those living with diabetes would develop some kind of arthritis or joint pains.

Another area of interest to science is how altered fat metabolism may also contribute to joint disorders. At present, there is a poor understanding of the underlying mechanism. Nonetheless, it is evident that dyslipidemia also significantly increases the risk of OA.

Researchers also reviewed existing studies investigating specific dietary patterns' effects on OA risk. Notably, a Mediterranean diet, rich in fruits, vegetables, whole grains, and healthy fats while limiting red meat and processed foods, was associated with a lower risk of developing OA based upon the historical understanding of the Mediterranean diet.  

A more nuanced approach might suggest a tremendous anti-inflammatory response from infrared light photobiomodulation and the production of intramitochondrial melatonin.  The grain consumption used in the traditional approach also is not as refined, and the consumption of meat is under represented, as is the value of intermittent religious fasting and deep personal social relationships.

Clearly, a diet high in glycemic load, a measure of how quickly food raises blood sugar levels, was linked to an increased risk of OA. These findings suggest that dietary modifications may play a crucial role in preventing and managing OA. However, further research is needed to fully clarify the underlying mechanisms by which diet exerts its influence.

In conclusion,

There is now compelling evidence that metabolic abnormalities are major risk factors for OA. The release of inflammatory mediators from fat tissue and the direct damaging effects of high blood sugar on cartilage are proposed as potential mechanisms contributing to the disease process. 

Source:

Wei, G., Lu, K., Umar, M., Zhu, Z., Lu, W. W., Speakman, J. R., Chen, Y., Tong, L., & Chen, D. (2023). Risk of metabolic abnormalities in osteoarthritis: A new perspective to understand its pathological mechanisms. Bone Research, 11(1), 1–16. https://doi.org/10.1038/s41413-023-00301-9