Sexual dimorphism and osteoarthritis: The role of leptin

By E. Anne Ouellette, MD, MBA, and Anna-Lena Makowski, HTL

The differences between men’s and women’s expression of hereditary osteoarthritis (OA) are now well known. Not only are women more often affected by OA than men, but obese women have a higher risk of OA developing than obese men do. The risk of OA development in obese individuals increases by between 9 percent and 13 percent per kilogram increase in body weight.

Biomechanical factors are the major causes of OA in weight-bearing joints. The joint loading alters site-specific gene expression of cartilage, resulting in the onset of OA. But scientists have also found a link between obesity and OA in the non–weight-bearing joints of the hand. It is possible that leptin—a peptide hormone product of the obesity gene—plays a role in OA development, although the exact mechanism for its involvement is still being researched.

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