Metabolic syndrome and osteoarthritis joint pain
Metabolic Syndrome is a precursor to diabetes, heart disease, and it could make healing more challenging. Metabolic Syndrome is categorized by a group of medical conditions that have in common an ability to increase levels of insulin production. This is primarily due to excessive carbohydrate intake and overeating.
Before you read on, if you have questions about Metabolic syndrome and osteoarthritis joint pain, get help and information form our Caring Medical staff
Some of the conditions associated with Metabolic Syndrome include:
- High blood pressure,
- Elevated blood sugar levels,
- High “bad” cholesterol and triglyceride levels,
- Low “good” cholesterol, and
- Increased abdominal obesity and abdominal fat.
When you gain weight, you gain osteoarthritis and joint pain
Dr. Karel Pavelka of the Czech republic has published his findings in the Fall 2017 issue of the Czech language journal Internal Medicine. Here are his bullet points:
- Dr. Karel Pavelka examined the problems concerning relationships between the metabolic syndrome and osteoarthritis, and states that the prevalence of metabolic syndrome in patients with OA is higher than in those without osteoarthritis (59 % vs 23 %).
- It remains problematic that one of the main components of metabolic syndrome is obesity which in itself is a risk factor for osteoarthritis development in the weight-bearing joints, not for osteoarthritis in the hands.
- Note: This is problematic because it has been thought obesity caused joint degeneration because of weight load. In research on patients with hand osteoarthritis and obesity, it was found that obesity cause inflammation leading to osteoarthritis, weight bearing had nothing to do with it. This is covered in our companion article Excessive weight and joint pain – the inflammation connection.
- Over the last decade evidence has been gained about adipose (fat) tissue being the source of numerous cytokines (small proteins that send pro-inflammatory and anti-inflammatory messages to damaged joints) and adipokines, which are also cell signalling messenger proteins but secreted by fat cells which may cause inflammation of low-activity synovial tissue, sometimes also called “meta-inflammation.”
- Research has been published this year concluding that the secretion activity of the potentially pro-inflammatory adipokines (from the fat) may differ in the synovial membrane, infrapatellar fat body (the fat pad behind the knee cap) and in abdominal fat.
- It is evident that the components of metabolic syndrome and osteoarthritis can share a common pathological process which is an “adipose tissue associated inflammation.” The changed secretion profile of pro-inflammatory adipokines is present in obese individuals, an older population and postmenopausal women, the populations at high risk for both metabolic syndrome and osteoarthritis.1
Simply, inflammation that causes metabolic syndrome and osteoarthritis, travel the same pathways.
State Medical University researchers in Russia have published their observations on 164 patients with osteoarthritis. Eighty-two patients were diagnosed with Metabolic Syndrome, Eighty-two were not and used as controls.
In the 82 patients with Metabolic Syndrome, clear indications of the negative impact of the disorder were seen:
- the frequency of joint injuries and multiple joint injuries.
- the prevalence of synovitis (synovial inflammation of the knee),
- and the intensity of joint pain and inflammation were significantly higher than in the non-Metabolic Syndrome group.2
- Recent advances in the study of metabolic syndrome-associated osteoarthritis have focused on a better understanding of the role of metabolic diseases in inducing or aggravating joint damage. Research into models of obesity, diabetes, or dyslipidemia (high cholesterol) have helped to better decipher this association.
- This research gives emerging evidence that, beyond the role of common pathogenic mechanisms for metabolic diseases and osteoarthritis (i.e., low-grade inflammation and oxidative stress), metabolic diseases have a direct systemic effect on joints.3
Obesity related synovitis comes before cartilage deterioration
University researchers in Australia write in the journal PLoS One (Public Library of Science one) of the established risks obesity plays in osteoarthritis. In this research the Australian team looked for a connection between inflammation, obesity, and osteoarthritis.
The researchers fed Wistar rats a high-carbohydrate, high-fat diet for period of 8 and 16 weeks. The study showed that, obesity induced by this diet is associated with spontaneous and local inflammation of the synovial membranes in the rats even before the cartilage degradation.
This was followed by increased synovitis and increased macrophage infiltration (immune cells are now invading the areas causing swelling and edema) into the synovium and a predominant elevation of pro-inflammatory M1 macrophages (A specific type of immune cell).
This study demonstrates a strong association between obesity and a dynamic immune response locally within synovial tissues before cartilage degradation.4
In other words the joint environment is becoming a diseased joint environment on its way to joint death and joint replacement.
Knee pain is a whole body disease
Doctors in Spain in their research from February 2017 in the journal Maturitas also suggest that there needs to be an understanding of all the factors that can come into play in knee pain and joint breakdown and how these factors interact with each other.
These researchers looked at
- genetic alterations (changing in the joint environment from healthy to diseased),
- being sex hormone deficit,
- aging with mechanical factors and
- systemic inflammation-associated metabolic syndrome
As the typical characteristics of a patient with knee joint breakdown.5
Recognizing these problems early in joint pain treatment may optimize the design of individualized treatments in osteoarthritis. The Spanish researchers suggest an identification and classification of patients, much like we do here at Caring Medical and Rehabilitation Services.
We look at the:
- Joint instability
- is there bone destruction?
- is ther metabolic syndrome?
- is there inflammatory problems?
The problems of Insulin
Also from February 2017, doctors writing in the journal Medical hypotheses offered evidence making a connection between insulin, inflammation, and joint pain here are the bullet points of their findings.
- Osteoarthritis progression is obesity-related.
- High levels of insulin in obesity and metabolic syndrome can induce numerous complications.
- Insulin can increase proliferation of chondrocytes (Cartilage building blocks) but can also simultaneously prevents their differentiation into specific type of cells. In other words the building blocks of cartilage multiple but do not differentiate – that is become cartilage.
- Hyperinsulinemia or too much insulin effects the thyroid by reducing the circulating level of serum T4 and conversion of T4 to T3, mimicking hypothyroidism, because thyroid hormones are necessary for the maturation of chondrocytes.
- Decreasing insulin levels can prevent osteoarthritis progression and/or improve the treatment process.6
Reducing circulation insulin levels can be achieved in many cases with health-professional guided lifestyle and dietary changes.
The same French team cited above also examined the recent advances in the knowledge of osteoarthritis and its association with obesity and metabolic syndrome through systemic mechanisms.
“In (2016), type 2 diabetes has been described in two (studies) as an independent risk factor for osteoarthritis.” In these animal studies, diabetic rodents display a spontaneous and a more severe osteoarthritis than their non-diabetic counterparts.
The negative impact of diabetes on joints could be explained by the induction of oxidative stress and pro-inflammatory cytokines (systemic low grade inflammation) and by joint tissues exposed to chronic high glucose concentration. 7
We have more articles on this subject on this site, please see:
If you have questions about Metabolic syndrome and osteoarthritis joint pain, get help and information form our Caring Medical staff
1 Pavelka K. [Osteoarthritis as part of metabolic syndrome?] Vnitr Lek. 2017 Fall;63(10):707-711.
2 Vasilyeva LV, Lakhin DI. Clinical features of osteoarthritis in patients with metabolic syndrome. Terapevticheskii arkhiv. 2017;89(5):65.
3 Courties A, Sellam J, Berenbaum F. Metabolic syndrome-associated osteoarthritis. Curr Opin Rheumatol. 2017 Mar;29(2):214-222..
4 Sun AR, Panchal SK, Friis T, Sekar S, Crawford R, Brown L, Xiao Y, Prasadam I. Obesity-associated metabolic syndrome spontaneously induces infiltration of pro-inflammatory macrophage in synovium and promotes osteoarthritis. PLoS One. 2017 Aug 31;12(8):e0183693. doi: 10.1371/journal.pone.0183693. eCollection 2017.
5 Herrero-Beaumont G, Roman-Blas JA, Bruyère O, Cooper C, Kanis J, Maggi S, Rizzoli R, Reginster JY. Clinical settings in knee osteoarthritis: Pathophysiology guides treatment. Maturitas. 2017 Feb;96:54-57. [Pubmed]
6 Askari A, Ehrampoush E, Homayounfar R, Bahramali E, Farjam M. Serum insulin in pathogenesis and treatment of osteoarthritis. Med Hypotheses. 2017 Feb;99:45-46.
7 Courties A, Sellam J. Osteoarthritis and type 2 diabetes mellitus: What are the links? Diabetes Res Clin Pract. 2016 Dec;122:198-206. doi: 10.1016/j.diabres.2016.10.021. Epub 2016 Nov 5.