Obesity and osteoarthritis: Is leptin the link?

Washington University School of Medicine, St. Louis, Missouri.
Arthritis & Rheumatology (Impact Factor: 7.87). 10/2009; 60(10):2858-60. DOI: 10.1002/art.24862
Source: PubMed
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    ABSTRACT: Osteoarthritis (OA) is a common disease affecting patients at different ages regardless of gender or ethnicity. As with many chronic diseases, OA is thought to have a multifactorial aetiology, which is not fully understood. Whereas the pathophysiological process of OA can be analysed at a cellular and molecular level, the interaction between genes and lifestyle remains an important factor in the development of this disease. The expanding awareness of different genes that may play a role in OA, together with many chemical mediators thought to be associated with the progression of the disease, will help in better management of this condition. Some of the chemical mediators recently implicated in this condition are the adipokines (leptin, adiponectin and resistin). Few but consistent studies suggest that leptin in association with obesity could be an important factor in OA aetiology. Hence, this could establish a strong and direct molecular link between patient life style (nurture) and the pathological process of OA (nature). However, neither a clear mechanism nor a direct clinical association linking leptin to OA has yet been established. In this article, we explore some of the genetic and environmental factors in OA aetiology. We discuss leptin in obesity and assess its possible association with OA aetiology. This should emphasise the important role of health professionals in treating obesity in order to control OA symptoms and possibly progression.
    International Orthopaedics 09/2013; 37(12). DOI:10.1007/s00264-013-2088-x · 2.02 Impact Factor
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    ABSTRACT: Objective. The objective of the present study was to evaluate the relationships between fat mass, muscle mass, fat/muscle mass ratio, metabolic syndrome, and musculoskeletal pain in community residents.Methods. In the Korean Health and Genome Study, 1530 participants (mean ± SD age 60.8 ± 8.60) completed pain questionnaires and underwent dual x-ray absorptiometry to calculate body composition. Pain was categorized according to the number of pain regions, such that the most severe category of pain was widespread pain, defined as pain above the waist, below the waist, on both sides of the body, and in the axial region. Metabolic syndrome was defined using the International Diabetes Federation 2005 recommendations, and the association between metabolic syndrome and pain was evaluated by dividing the population into four groups, according to the presence/absence of metabolic syndrome and of high BMI.Results. Total fat mass and fat/muscle ratio were significantly and positively associated with musculoskeletal pain only among females. Compared to the lowest quartile of fat/muscle ratio, the odds ratios for widespread pain of other quartiles were significantly increased after adjustment of confounders. Widespread pain was more prevalent among those with metabolic syndrome in both normal- and high-BMI subjects, especially among females.Conclusions. Increase in fat mass and fat/muscle mass ratio was significantly associated with musculoskeletal pain among females. Widespread pain was significantly associated with a high fat/muscle ratio after adjusting for confounders. Understanding the relation between fat mass and pain may provide insights into preventative measures and therapeutic strategies for musculoskeletal pain. © 2014 American College of Rheumatology.
    08/2014; DOI:10.1002/art.38861
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    ABSTRACT: Numerous studies have suggested the importance of leptin against autoimmune diseases such as systemic lupus erythematosus (SLE), Multiple sclerosis (MS) and psoriasis. To summarize our current understandings of the role of leptin in inflammatory responses and rheumatoid arthritis (RA), a systematic review was conducted to assess the discrepancy of leptin in RA and its effect on immunity according to different studies. Recently, emerging data have indicated that leptin is involved in the pathological function of RA, which is common in autoimmune disorders. This review discusses the possible consequences of leptin levels in RA. Blocking the key signal pathways of leptin and inhibiting leptin activity like leptin antagonist may be a promising way for therapeutic potential of RA at risk of detrimental effects. However, leptin was increased in patients with RA and may also regulate joint damage as well. Thus, more understanding of the mechanism of leptin in RA would be advantageous in the future.
    Clinical & Experimental Immunology 05/2014; DOI:10.1111/cei.12372 · 3.28 Impact Factor