Figure 1.

Contributing factors of obesity in metabolic OA. Systemically, adipocyte tissue increases, followed by a heightened adipokine release. In the joint, monocytes infiltrate, and a polarization switch occurs in macrophage phenotype from M2- to M1-like macrophages leading to increased release of pro-inflammatory cytokines and degrading enzymes. Both systemic and local factors contribute to a chronic state of low-grade inflammation that can lead to OA development, which is potentially further aggravated once damage occurs in the joint. ATM: adipose tissue macrophages. Created with BioRender.com, accessed on 9 March 2023.