Being overweight may also play a role in OA in other joints, including the hips, hands, and shoulders, although in those cases the role is not well defined. For example, one study showed a moderate relationship between obesity and the development of hip OA, but only limited evidence of an association between obesity and bilateral hip OA.16 OA in these joints may be related to mechanical factors, abnormalities in intermediary metabolism in adipose tissue, or the production of cytokines