title: Osteoarthritis, obesity and type 2 diabetes: The weight of waist circumference.
abstract: BACKGROUND
  Obesity and type 2 diabetes (T2D) significantly increase the risk of developing an arthritic condition.
  
  
  METHODS
  We performed a review of literature on the pathophysiological mechanisms that underpin the relationships between obesity, T2D and osteoarthritis (OA).
  
  
  RESULTS
  The pathophysiology of the link between obesity and OA is related to both the direct effect of excess mechanical loads being placed on the cartilage and to an adipose tissue effect. Adipocytes produce and release adipokines (e.g. leptin). They are also the seat of a local inflammatory reaction when the adipose tissue is ectopic (visceral vs. subcutaneous adipose tissue), and then systemic effects that add even more to a micro-inflammatory mechanism. In diabetics, insulin resistance can add to these mechanisms, which can damage cartilage, bone and synovial tissue. These all act together to reduce mobility in obese subjects and contribute to a vicious cycle centered on OA, especially when the obesity is predominantly abdominal and/or associated with T2D.
  
  
  CONCLUSIONS
  Prevention of obesity-related OA must be the focus in high-risk subjects, such as those who are obese with metabolic syndrome>"metabolically healthy" obese, have T2D, and normal weight subjects with abdominal obesity (defined as waist circumference>102cm for men and 88cm for women). The primary component of this prevention effort is weight loss combined with a balanced diet and regular physical activity.
authors.affiliation: Department of Sport Medicine and Functional Explorations, University-Hospital (CHU), G.-Montpied Hospital, 63003 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, 63000 Clermont-Ferrand, France; Clermont University, University of Auvergne, Unité de Nutrition Humaine, BP 10448, 63000 Clermont-Ferrand, France. Electronic address: mduclos@chu-clermontferrand.fr.
authors.forename: Martine
authors.initials: M
authors.lastname: Duclos
mesh_terms: D001696:Biomechanical Phenomena; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D010003:Osteoarthritis / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000503:physiopathology; D055105:Waist Circumference; D015431:Weight Loss
keywords: Abdominal obesity; Adipokines; Obesity; Osteo-arthrosis; Physical activity; Type 2 diabetes