Biomedical Engineering Reference
In-Depth Information
Obesity, Osteoarthritis and Aging:
The Biomechanical Links
Yao Fu and Timothy M. Griffin
Abstract Obesity increases osteoarthritis (OA) risk in both knee and hand joints,
although the greatest impact is on the knee. The accelerated onset of OA that
occurs with obesity has major health and financial consequences for individuals
and society. Thus, it is critical to understand how obesity increases the risk of OA
to develop effective strategies to prevent disease onset and/or slow disease pro-
gression. Obesity alters knee joint loading by increasing the knee adduction
moment; however, it is difficult to predict how obesity affects the local cartilage
mechanical environment because obesity alters joint loading frequency, magni-
tude, and duration both positively and negatively depending on the anatomical
location and time-scale of analysis. In particular, obesity is associated with sig-
nificant reductions in overall physical activity levels. Recent advances in the use of
MRI to quantify in vivo diurnal strains provide a new approach for identifying the
net effect of obesity on articular cartilage deformation. A growing number of
clinical and animal studies indicate a role for systemic factors, such as high dietary
fat and excess adiposity, in increasing OA risk. Adipose tissue secretes immu-
noregulatory molecules called adipokines, which are increasingly recognized for
their ability to perturb joint tissue homeostasis. However, identifying a specific
role for systemic inflammatory factors in knee OA pathogenesis is not well
understood due to the challenge of isolating the biomechanical aspects of aging
and obesity from the inflammatory changes. Identifying the role of adipokines in
modifying OA risk is expected to require a better understanding of the connection
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