Degenerative spine and joint diseases, including intervertebral disc degeneration (IDD), ossification of the spinal ligaments (OSL), and osteoarthritis (OA), are common musculoskeletal diseases that cause pain or disability to the patients. However, the pathogenesis of these musculoskeletal disorders is complex and has not been elucidated clearly to date. As a matter of fact, the spine and joints are not independent of other organs and tissues. Recently, accumulating evidence demonstrates the association between obesity and degenerative musculoskeletal diseases. Obesity is a common metabolic disease characterized by excessive adipose tissue or abnormal adipose distribution in the body. Excessive mechanical stress is regarded as a critical risk factor for obesity-related pathology. Additionally, obesity-related factors, mainly including lipid metabolism disorder, dysregulated pro-inflammatory adipokines and cytokines, are reported as plausible links between obesity and various human diseases. Importantly, these obesity-related factors are deeply involved in the regulation of cell phenotypes and cell fates, extracellular matrix (ECM) metabolism, and inflammation in the pathophysiological processes of degenerative spine and joint diseases. In this study, we systematically discuss the potential cellular and molecular mechanisms underlying obesity in these degenerative musculoskeletal diseases, and hope to provide novel insights for developing targeted therapeutic strategies.

退行性脊柱和关节疾病，包括椎间盘退化 （IDD）、椎韧带骨化 （OSL） 和骨关节炎 （OA），是导致患者疼痛或残疾的常见肌肉骨骼疾病。然而，这些肌肉骨骼疾病的发病机制很复杂，迄今为止尚未明确阐明。事实上，脊柱和关节并不独立于其他器官和组织。最近，越来越多的证据表明肥胖与退行性肌肉骨骼疾病之间存在关联。肥胖是一种常见的代谢性疾病，其特征是脂肪组织过多或体内脂肪分布异常。过度的机械应力被认为是肥胖相关病理的关键危险因素。此外，据报道，肥胖相关因素，主要包括脂质代谢紊乱、失调的促炎脂肪因子和细胞因子，是肥胖与各种人类疾病之间的合理联系。重要的是，这些肥胖相关因素深度参与细胞表型和细胞命运的调节、细胞外基质 （ECM） 代谢以及退行性脊柱和关节疾病病理生理过程中的炎症。在这项研究中，我们系统地讨论了这些退行性肌肉骨骼疾病中肥胖的潜在细胞和分子机制，并希望为开发靶向治疗策略提供新的见解。