Obesity has a pivotal and multifaceted role in pain associated with osteoarthritis (OA), extending beyond the mechanistic influence of BMI. It exerts its effects both directly and indirectly through various modifiable risk factors associated with OA-related pain. Adipose tissue dysfunction is highly involved in OA-related pain through local and systemic inflammation, immune dysfunction, and the production of pro-inflammatory cytokines and adipokines. Adipose tissue dysfunction is intricately connected with metabolic syndrome, which independently exerts specific effects on OA-related pain, distinct from its association with BMI. The interplay among obesity, adipose tissue dysfunction and metabolic syndrome influences OA-related pain through diverse pain mechanisms, including nociceptive pain, peripheral sensitization and central sensitization. These complex interactions contribute to the heightened pain experience observed in individuals with OA and obesity. In addition, pain management strategies are less efficient in individuals with obesity. Importantly, therapeutic interventions targeting obesity and metabolic syndrome hold promise in managing OA-related pain. A deeper understanding of the intricate relationship between obesity, metabolic syndrome and OA-related pain is crucial and could have important implications for improving pain management and developing innovative therapeutic options in OA.

肥胖在骨关节炎 (OA) 相关疼痛中发挥着关键和多方面的作用，其影响超出了 BMI 的机械影响。它通过与 OA 相关疼痛相关的各种可改变的危险因素直接或间接地发挥其作用。脂肪组织功能障碍通过局部和全身炎症、免疫功能障碍以及促炎细胞因子和脂肪因子的产生与 OA 相关疼痛密切相关。脂肪组织功能障碍与代谢综合征密切相关，代谢综合征独立地对 OA 相关疼痛产生特定影响，这与 BMI 的关系不同。肥胖、脂肪组织功能障碍和代谢综合征之间的相互作用通过不同的疼痛机制影响 OA 相关疼痛，包括伤害性疼痛、外周敏化和中枢敏化。这些复杂的相互作用导致骨关节炎和肥胖患者的疼痛体验加剧。此外，对于肥胖症患者来说，疼痛管理策略的效率较低。重要的是，针对肥胖和代谢综合征的治疗干预有望治疗骨关节炎相关疼痛。更深入地了解肥胖、代谢综合征和 OA 相关疼痛之间的复杂关系至关重要，并且可能对改善 OA 疼痛管理和开发创新治疗方案产生重要影响。