Obésité et arthrose, du lien mécanique au lien métabolique

Obesity and osteoarthritis, from the mechanic to the metabolic side

Résumé

Ľarthrose est la pathologie articulaire la plus fréquente touchant aussi bien les genoux, les hanches que les mains. Outre le vieillissement et les antécédents de traumatisme articulaire, ľobésité est un facteur de risque majeur ďarthrose des articulations portantes (hanches, genoux). Ceci s’explique par la transduction au niveau des chondrocytes de contraintes mécaniques excessives en un processus ďinflammation articulaire et de dégradation enzymatique du cartilage. Il existe également un lien systémique entre arthrose et obésité, illustré par une augmentation du risque ďarthrose des mains (articulations non portantes) chez les sujets obèses, possiblement expliquée par les adipokines. Au-delà de ľarthrose liée à ľobésité, on définit désormais ľarthrose associée au syndrome métabolique (ou arthrose métabolique) englobant le lien avec ľobésité mais également ľassociation de ľarthrose avec les autres composantes du syndrome métabolique (hypertension artérielle, diabète ou insulino-résistance et dyslipidémie). De nombreux mécanismes physiopathologiques sont communs à ces pathologies telles que ľinflammation chronique de bas grade et le stress oxydant. Cette nouvelle approche de ľarthrose en fonction des phénotypes (métabolique, lié à ľâge ou post-traumatique) devrait permettre ďenvisager de nouvelles perspectives thérapeutiques et de personnaliser la prise en charge des patients.

Abstract

Osteoarthritis (OA) is the most common joint disease affecting knees, hips and hands. In addition to aging and history of joint trauma, obesity is a major risk factor for OA of weight bearing joints (hips, knees). It can be explained by the conversion of mechanical stress into joint inflammation and subsequent cartilage degradation process. There is also a systemic link between obesity and OA, illustrated by an increased risk of hand OA (non-weight-bearing joints) in obese subjects, possibly explained by adipokines disturbances. Beyond OA-related obesity, metabolic syndromerelated OA (or “metabolic OA”) is progressively delineated, including the link with obesity but also the association with other components of the metabolic syndrome (i.e., hypertension, diabetes mellitus or insulin resistance and dyslipidemia). Many pathophysiological mechanisms are common to these diseases such as chronic low-grade inflammation and oxidative stress. This new approach of OA based on phenotypes (i.e., metabolic, age-related or post-trauma) should lead to consider new therapeutic prospect and to better tailor patients care.

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Courties, A., Sellam, J. Obésité et arthrose, du lien mécanique au lien métabolique. Obes 10, 277–282 (2015). https://doi.org/10.1007/s11690-014-0453-6

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Mots clés

  • Obésité
  • Arthrose
  • Adipokines
  • Stress mécanique
  • Syndrome métabolique

Keywords

  • Obesity
  • Osteoarthritis
  • Adipokines
  • Mechanical stress
  • Metabolic syndrome