当代谢综合征遇到骨关节炎

Metabolic syndrome meets osteoarthritis ( Review )
作者:Zhuo, Q.a, Yang, W.b, Chen, J.a, Wang, Y.a
机构: 中国人民解放军总医院骨科
期刊: NAT REV RHEUMATOL2012年12月12期8卷

Metabolic osteoarthritis (OA) has now been characterized as a subtype of OA, and links have been discovered between this phenotype and metabolic syndrome (MetS) - both with individual MetS components and with MetS as a whole. Hypertension associates with OA through subchondral ischaemia, which can compromise nutrient exchange into articular cartilage and trigger bone remodelling. Ectopic lipid deposition in chondrocytes induced by dyslipidemia might initiate OA development, exacerbated by deregulated cellular lipid metabolism in joint tissues. Hyperglycaemia and OA interact at both local and systemic levels; local effects of oxidative stress and advanced glycation end-products are implicated in cartilage damage, whereas low-grade systemic inflammation results from glucose accumulation and contributes to a toxic internal environment that can exacerbate OA. Obesity-related metabolic factors, particularly altered levels of adipokines, contribute to OA development by inducing the expression of proinflammatory factors as well as degradative enzymes, leading to the inhibition of cartilage matrix synthesis and stimulation of subchondral bone remodelling. In this Review, we summarize the shared mechanisms of inflammation, oxidative stress, common metabolites and endothelial dysfunction that characterize the aetiologies of OA and MetS, and nominate metabolic OA as the fifth component of MetS. We also describe therapeutic opportunities that might arise from uniting these concepts. © 2012 Macmillan Publishers Limited.

Department of Orthopaedics, Chinese PLA General Hospital, Fuxing Road 28#, Haidian District, Beijing 100853, China

通讯作者:Wang, Y.; Department of Orthopaedics, Chinese PLA General Hospital, Fuxing Road 28#, Haidian District, Beijing 100853, China; email:yannwang301@yahoo.com
学科代码:风湿病学   关键词:谢综合
来源: Scopus
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