Obesity and arthritis.
Obesity and arthritis.
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DOI：
10.1258/mi.2008.008018
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发表时间：
2008-12-01
期刊：
影响因子：
--
通讯作者：
Magliano, Malgorzata
中科院分区：
文献类型：
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作者：
Magliano, Malgorzata
超过 20% 的英国成年人口患有肥胖症，而且其患病率正在上升。肥胖可导致各种肌肉骨骼问题，并与运动障碍和关节疼痛独立相关。肥胖会增加放射学膝骨关节炎 (OA) 的风险，但对疾病进展的影响较小。与髋部和手部 OA 的相关性较弱，但意味着过量的脂肪组织会产生体液因子，改变关节软骨的代谢。据推测，瘦素系统可能是肥胖代谢异常与骨关节炎风险增加之间的联系。尽管肥胖最初被认为会增加类风湿性关节炎 (RA) 的风险，但进一步的研究表明，体重较重的 RA 患者的放射学疾病进展较少，并且可能有更好的生存率。另一方面，肥胖与高尿酸血症和痛风性关节炎密切相关。高体重与代谢综合征独立相关，并可能导致痛风患者心血管发病率增加。减轻体重应该是骨关节炎和痛风治疗的重要组成部分。由于年轻时的肥胖与晚年骨关节炎和痛风的发展相关，因此旨在降低肥胖发生率的预防性公共卫生策略至关重要。
Obesity affects over 20% of the UK's adult population and its prevalence is rising. Obesity can lead to a variety of musculoskeletal problems and is independently associated with locomotor disability and joint pain. Obesity increases the risk of radiographic knee osteoarthritis (OA), but has a lesser effect on disease progression. The association with hip and hand OA is weaker, but implies that excess adipose tissue produces humoral factors, altering articular cartilage metabolism. It has been postulated that the leptin system could be a link between metabolic abnormalities in obesity and increased risk of OA. Although obesity was initially thought to increase the risk of rheumatoid arthritis (RA), further studies showed, that heavier patients with RA have less radiological disease progression and possibly better survival. On the other hand, obesity is strongly associated with hypeuricaemia and gouty arthritis. High body weight correlates independently with metabolic syndrome and may contribute to increased cardiovascular morbidity in patients with gout. Weight reduction should be an important part of treatment for OA and gout. Because obesity at a young age correlates with the development of OA and gout in later life, preventive public health strategies aimed at lowering the incidence of obesity are of most importance.