Insulin resistance typically leads to lipid metabolism disorders, resulting in elevated plasma levels of free fatty acids, which can directly affect chondrocytes, promoting oxidative stress and inflammation, and accelerating cartilage degradation.[5,27] Furthermore, adipose tissue, as an active endocrine organ, secretes various adipokines, such as leptin and adiponectin, which have been implicated in OA progression. This evidence concerns the gene ADIPOQ and Insulin resistance.