Review doi:10.1093/rheumatology/keu464

Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis Eva Thijssen1, Arjan van Caam1 and Peter M. van der Kraan1 OA is a degenerative joint disease characterized by articular cartilage degradation, osteophyte formation, synovitis, and subchondral bone sclerosis. One of OAs main risk factors is obesity. To date, it is not fully understood how obesity results in OA. Historically, this link was ascribed to excessive joint loading as a result of increased body weight. However, the association between obesity and OA in nonweight-bearing joints suggests a more complex aetiology for obesity-induced OA. In the present review, the link between obesity and OA is discussed. First, the historical view of altered joint loading leading to wear and tear of the joint is addressed. Subsequently, the effects of a disturbed lipid metabolism, low-grade inflammation, and adipokines on joint tissues are discussed and linked to OA. Taken together, inflamed adipose tissue and dyslipidaemia play pivotal roles in obesity-induced OA. It becomes increasingly clear that the link between obesity and OA transcends excessive loading. Key words: obesity, osteoarthritis, joint loading, dyslipidaemia, low-grade inflammation, cytokines, adipokines, cartilage, synovium, bone. Rheumatology key messages. The link between obesity and OA transcends excessive loading.. Inflamed adipose tissue and obesity-related dyslipidaemia play pivotal roles in obesity-induced OA.. Targeting adipokines and cytokines might benefit obese OA patients