دورية أكاديمية

Our biology working against us in obesity: A narrative review on implications for management of osteoarthritis.

التفاصيل البيبلوغرافية
العنوان: Our biology working against us in obesity: A narrative review on implications for management of osteoarthritis.
المؤلفون: Cicuttini FM; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia., Proietto J; Department of Medicine, The University of Melbourne, Melbourne, VIC, 3010, Australia., Lim YZ; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
المصدر: Osteoarthritis and cartilage open [Osteoarthr Cartil Open] 2023 Sep 09; Vol. 5 (4), pp. 100407. Date of Electronic Publication: 2023 Sep 09 (Print Publication: 2023).
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101767068 Publication Model: eCollection Cited Medium: Internet ISSN: 2665-9131 (Electronic) Linking ISSN: 26659131 NLM ISO Abbreviation: Osteoarthr Cartil Open Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [London] : Elsevier Ltd., [2019]-
مستخلص: Obesity is the major modifiable risk factor for osteoarthritis (OA). A major focus of management in OA is weight loss. Although we live in an obesogenic environment, obesity has a predominantly genetic and epigenetic basis. This explains a person's weight set point which is defended by biological mechanisms making weight loss difficult to achieve and maintain long term, regardless of the methods used. Significant weight regain occurs after weight loss, with weight tending to return to pre-treatment levels after cessation of interventions including the glucagon-like peptide-1 (GLP-1) agonists. An area that has received little attention is the slow, insidious weight creep of 0.5-1 kg/year over adulthood that sees individuals relentlessly increase weight. There is evidence that low intensity, personalised lifestyle interventions can prevent this weight creep, providing patients with achievable goals. In this narrative review, we examine the evidence for weight loss in OA, the biological mechanisms that make weight loss difficult to achieve and maintain and the potential negative impacts on patients. We review the evidence for preventing weight gain, the improvement in patient outcomes and the potential for significant healthcare savings through reduced knee replacements. We propose a combined approach of weight loss when indicated, together with targeting weight creep across adult years and the potential role of metformin. Implementing these combined approaches is likely to be more effective in improving patient related outcomes, reducing joint damage and healthcare costs, than our current focus on achieving weight loss in OA.
Competing Interests: JP receives payments from Novo Nordisk and I Nova for educational program and medical advisory board. All other authors declare no conflicts of interest. The funders of the study had no role in the study design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
(© 2023 The Authors.)
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فهرسة مساهمة: Keywords: Obesity; Osteoarthritis; Review
تواريخ الأحداث: Date Created: 20230925 Latest Revision: 20230926
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10514453
DOI: 10.1016/j.ocarto.2023.100407
PMID: 37744021
قاعدة البيانات: MEDLINE
الوصف
تدمد:2665-9131
DOI:10.1016/j.ocarto.2023.100407