Osteoarthritis and Cardiovascular Diseases: is Meta-Inflammation the Missing Link?

Osteoarthritis (OA) was found associated with atherosclerosis, metabolic syndrome, more cardiovascular diseases (CVD) and higher cardiovascular morbidity and mortality. However, it remains unclear whether these conditions only coexist in ageing patients presenting shared traditional cardiovascular risk factors, including age, obesity and disability-related sedentary lifestyle, or are further interconnected. Interestingly, the accumulation of metabolic syndrome components was associated with the development and progression of knee OA, supporting the concept of metabolic OA. Recent research suggests key roles of meta-inflammation, and adipokines in the pathogenesis of OA, metabolic syndrome and CVD. While leptin may be one cornerstone mediator linking obesity, metabolic syndrome, OA, and CVD, the exact role of adiponectin remains controversial in both CVD and OA as it may exert both pro-inflammatory and anti-inflammatory properties. However, the relationship between adipokines and OA as well as CVD is being uncovered and require further investigation. In any case, if meta-inflammation is truly the pivotal link interconnecting OA, metabolic syndrome, and CVD, managing dyslipidemia, hyperglycemia, hypertension and weight in OA patients may be beneficial not only for cardiovascular reasons but also perhaps to delay OA progression.