Metabolic changes in healthy and osteoarthritic chondrocytes associated with insulin resistance. Thin arrows, healthy chondrocyte. Bold arrows, insulin resistance-related changes in osteoarthritic chondrocyte. ECM, extracellular matrix; MMPs-matrix metalloproteinases; P2X/P2Y, purinergic receptors; IRS, insulin receptor substrate; ATP, adenosine triphosphate; PDH, pyruvate dehydrogenase; ETC, electron transport chain; С, Complex; NADH, nicotinamide adenine dinucleotide reduced; G6P, glucose-6-phosphate; AGEs, advanced glycation endproducts; TCA, tricarboxylic acid; FFAs, free fatty acids; CPT, carnitine:palmitoyl-CoA transferase; CRAT, carnitine acyltransferase; ACLY, ATP-citrate lyase.