Impact of obesity on musculoskeletal system

Abstract

Overweight and obesity are big problem facing human health in general; Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. There are several ways to measure obesity; the most accurate is Body Mass Index (BMI). There are several causes of obesity e.g. Increase energy intake, Decrease energy expenditure, Genetic, Alcoholism, Drug induced, Sedentary life and Endocrinal causes. Multiple hormones are involved in the regulation and pathophysiology of obesity, including gut-related hormones e.g. Ghrelin, oxyntomodulin and Peptide YY (PYY), adipokines and Leptin. It is now clear that adipokines have multiple relevant roles in the body, and many research efforts illustrate the network among white adipose tissue, metabolic disorders, and inflammatory diseases and the main source of all proinflammatory adipokines is the dysfunctional adipose tissue. Also molecular research during the last decade revealed that many wingless-type MMTV integration site family members (WNT) signaling molecules act as negative regulators of adipogenesis in cell lines. Obesity has a significant impact on the musculoskeletal system being associated with both degenerative and inflammatory conditions. Recent studies have added evidence to support a positive relationship between obesity and LBP. Much of the focus has been placed upon C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and adiponectin due to the profusion of evidence and their connection to deleterious musculoskeletal conditions. Also elevated BMI significantly increases the extent and global severity of disc degeneration and narrowing of the disc space. There is cross-talk between fat and bone which constitutes a homoeostatic feedback system in which adipokines and molecules secreted by osteoblasts and osteoclasts represent the link of an active bone-adipose axis e.g. leptin, adiponectin, resistin and IL6. Although these data indicate that obesity exerts a protective effect on bone tissue, more recent studies have described an opposite event.