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      Osteoarthritis in the XXIst Century: Risk Factors and Behaviours that Influence Disease Onset and Progression

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          Abstract

          Osteoarthritis (OA) is a growing public health problem across the globe, affecting more than half of the over 65 population. In the past, OA was considered a wear and tear disease, leading to the loss of articular cartilage and joint disability. Nowadays, thanks to advancements in molecular biology, OA is believed to be a very complex multifactorial disease. OA is a degenerative disease characterized by “low-grade inflammation” in cartilage and synovium, resulting in the loss of joint structure and progressive deterioration of cartilage. Although the disease can be dependent on genetic and epigenetic factors, sex, ethnicity, and age (cellular senescence, apoptosis and lubricin), it is also associated with obesity and overweight, dietary factors, sedentary lifestyle and sport injuries. The aim of this review is to highlight how certain behaviors, habits and lifestyles may be involved in the onset and progression of OA and to summarize the principal risk factors involved in the development of this complicated joint disorder.

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          Most cited references89

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          Metabolic syndrome meets osteoarthritis.

          Metabolic osteoarthritis (OA) has now been characterized as a subtype of OA, and links have been discovered between this phenotype and metabolic syndrome (MetS)--both with individual MetS components and with MetS as a whole. Hypertension associates with OA through subchondral ischaemia, which can compromise nutrient exchange into articular cartilage and trigger bone remodelling. Ectopic lipid deposition in chondrocytes induced by dyslipidemia might initiate OA development, exacerbated by deregulated cellular lipid metabolism in joint tissues. Hyperglycaemia and OA interact at both local and systemic levels; local effects of oxidative stress and advanced glycation end-products are implicated in cartilage damage, whereas low-grade systemic inflammation results from glucose accumulation and contributes to a toxic internal environment that can exacerbate OA. Obesity-related metabolic factors, particularly altered levels of adipokines, contribute to OA development by inducing the expression of proinflammatory factors as well as degradative enzymes, leading to the inhibition of cartilage matrix synthesis and stimulation of subchondral bone remodelling. In this Review, we summarize the shared mechanisms of inflammation, oxidative stress, common metabolites and endothelial dysfunction that characterize the aetiologies of OA and MetS, and nominate metabolic OA as the fifth component of MetS. We also describe therapeutic opportunities that might arise from uniting these concepts.
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            Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project.

            To report contemporary estimates of the prevalence of knee-related osteoarthritis (OA) outcomes in African Americans and Caucasians aged > or = 45 years. Weighted prevalence estimates for knee symptoms, radiographic knee OA, symptomatic knee OA, and severe radiographic knee OA were calculated for age, ethnic, and sex subgroups, in 3018 participants (33% African Americans, 38% men) in the baseline examination (1991-97) of The Johnston County Osteoarthritis Project, a population-based study of OA in North Carolina. Radiographic knee OA was defined as Kellgren-Lawrence radiographic grade > or = 2, severe radiographic knee OA as grades 3 and 4, and symptomatic knee OA as knee symptoms in a knee with radiographic OA. Knee symptoms were present in 43%, 28% had radiographic knee OA, 16% had symptomatic knee OA, and 8% had severe radiographic knee OA. Prevalence was higher in older individuals and women. African Americans had slightly higher prevalence of knee symptoms, radiographic knee OA, and symptomatic knee OA, but significantly higher prevalence of severe radiographic knee OA compared to Caucasians. Policy should be directed to increasing education of the public and the medical community about the high prevalence of these conditions, especially in these subgroups, to decrease their impact and ultimately prevent them.
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              Body mass index associated with onset and progression of osteoarthritis of the knee but not of the hip: the Rotterdam Study.

              To investigate the relationship between body mass index (BMI) and the incidence and progression of radiological knee as well as of radiological hip osteoarthritis. Cohort study. Population based. 3585 people aged > or =55 years were selected from the Rotterdam Study, on the basis of the availability of radiographs of baseline and follow-up. Incidence of knee or hip osteoarthritis was defined as minimally grade 2 at follow-up and grade 0 or 1 at baseline. The progression of osteoarthritis was defined as a decrease in joint space width. x Rays of the knee and hip at baseline and follow-up (mean follow-up of 6.6 years) were evaluated. BMI was measured at baseline. A high BMI (>27 kg/m(2)) at baseline was associated with incident knee osteoarthritis (odds ratio (OR) 3.3), but not with incident hip osteoarthritis. A high BMI was also associated with progression of knee osteoarthritis (OR 3.2). For the hip, a significant association between progression of osteoarthritis and BMI was not found. On the basis of these results, we conclude that BMI is associated with the incidence and progression of knee osteoarthritis. Furthermore, it seems that BMI is not associated with the incidence and progression of hip osteoarthritis.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                16 March 2015
                March 2015
                : 16
                : 3
                : 6093-6112
                Affiliations
                [1 ]Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy; E-Mails: flaviayellow@ 123456tiscali.it (F.C.A.); mszychlinska@ 123456unict.it (M.A.S.); pacastro@ 123456unict.it (P.C.)
                [2 ]Department of Biomedical and Biotechnological Sciences, Pathology Section, School of Medicine, University of Catania, 95123 Catania, Italy; E-Mail: mdirosa@ 123456unict.it
                [3 ]The D-BOARD European Consortium for Biomarker Discovery, Department of Veterinary Preclinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK; E-Mail: a.mobasheri@ 123456surrey.ac.uk
                [4 ]Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Arthritis Research UK Pain Centre, Medical Research Council and Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK
                [5 ]Center of Excellence in Genomic Medicine Research (CEGMR), King Fahd Medical Research Center (KFMRC), King AbdulAziz University, Jeddah 21589, Saudi Arabia
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: g.musumeci@ 123456unict.it ; Tel.: +39-0-953-782-043; Fax: +39-0-953-782-034.
                Article
                ijms-16-06093
                10.3390/ijms16036093
                4394521
                25785564
                24c9048e-3557-4d63-a0ae-0efc6d12c482
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 02 February 2015
                : 12 March 2015
                Categories
                Review

                Molecular biology
                osteoarthritis (oa),risk factors,diet,sedentary lifestyle,high intensity and ballistic sports

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