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Combining the different arms of gut microecology, iron metabolism, cell death in this hypothesis, it offers a new explanatory model for investigating gut-joint axis in OA and proposes possible targets for OA intervention strategies including changes of gut microbiota or ferroptosis

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It also modulates PDHA1 and PI3K-Akt-mTOR signaling to promote lipid metabolism disorders and PDE3B (promoting cAMP-mediated lipolysis)

The review also delves into an examination of various nutritional antioxidants, namely vitamin C, vitamin E, carotenoids, selenium, zinc, polyphenols, coenzyme Q10, and probiotics, and elucidates their role in mitigating the adverse effects of oxidative stress arising from imbalances in adrenal hormone levels