Metabolic syndrome and osteoarthritis

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 increased levels of insulin production. This is primarily due to excessive carbohydrate intake and overeating.

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.

Now let’s look at some troubling studies:

Doctors in France have just published their research on factors effecting joint healing and metabolic syndrome: They write:

  • 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.1

Doctors in Spain in their research from February 2017 also suggest that there needs to be an understanding of the “complex interactions of genetic alterations (changing in the joint environment from healthy to diseased), being sex hormone deficit, and aging with mechanical factors and systemic inflammation-associated metabolic syndrome lead to joint damage.”

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 with osteoarthritis as those with or a combination of:

  • biomechanical (joint breakdown)
  • osteoporotic (bone destruction)
  • metabolic (lifestyle problems)
  • and inflammatory.2

The problems of Insulin

Also from February 2017, doctors in Iran offered evidence making a connection between insulin, inflammation, and joint pain here are the bullet points of their findings.

  • Osteoarthritis is one of the major health problems that’s development and progression is obesity-related. We believe that higher levels of insulin may explains this link especially.
  • High levels of insulin in obesity and metabolic syndrome can induce numerous complications. Insulin can increase proliferation of chondrocytes but simultaneously, it prevents their differentiation. In other words the building blocks or cartilage multiple but do not differentiate – because cartilage.
  • Moreover, hyperinsulinemia reduces 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.3

Reducing circulation insulin levels can be achieved in many cases with health-professional guided lifestyle and dietary changes.

Knee osteoarthritis is not only a whole joint disease but a whole body disease

Doctors in France examined the recent advances in the knowledge of osteoarthritis and its association with obesity and metabolic syndrome through systemic mechanisms.

“In the past year (2106), 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, which can be partially prevented by diabetes treatment.

The negative impact of diabetes on joints could be explained by the induction of oxidative stress and pro-inflammatory cytokines but also by advanced age products accumulation in joint tissues exposed to chronic high glucose concentration.

Insulin resistance might also impair joint tissue because of a local insulin resistance of diabetic synovial membrane but also by the systemic low grade inflammation state related to obesity and insulin resistant state.”4

Now that the problem has been identified, we can appreciate the complexity of metabolic syndrome and osteoarthritis.

1 Courties A, Sellam J, Berenbaum F. Metabolic syndrome-associated osteoarthritis. Curr Opin Rheumatol. 2017 Mar;29(2):214-222. [Pubmed]
2 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]
3. 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. [Pubmed]
4. 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. [Pubmed]


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