膝骨关节炎是常见的骨科疾病，其在中老年人群中发病率高，治疗难度大，病理机制尚未完全清楚。目前研究发现肥胖、脂代谢异常与膝骨关节炎的发生发展有较强的相关性，而关节滑液包含许多代谢产物并直接参与关节内代谢调节，能直接反映关节局部脂质代谢状态。膝骨关节炎患者关节滑液中的脂质代谢谱包括多种脂肪酸及其相关代谢产物如肉碱、乙酰辅酶 A 等，还包括多种磷脂类物质以及脂肪细胞因子如脂联素、瘦素和抵抗素等。其中花生四烯酸、部分短链饱和脂肪酸等脂质及相关代谢产物可能在膝骨关节炎疾病发展过程中存在双向调节作用，值得深入研究。本文就膝骨关节炎患者关节滑 液的脂质代谢特点的相关文献进行综述，旨在明确关节滑液脂代谢与膝骨关节炎疾病发生发展的相关性，为防治膝骨关节炎提供新思路。 

Knee osteoarthritis is a common orthopedic disease with treatment difficulties， which has a high incidence rate in middle-aged and elderly people. Its pathological mechanism has not been fully understood. Current researches have found a strong correlation between obesity， abnormal lipid metabolism， and the occurrence and development of knee osteoarthritis. Synovial fluid of joints contains many metabolites and directly participates in the regulation of intra-articular metabolism， which can directly reflect the local lipid metabolism status of joints. The lipid metabolism profile in the synovial fluid of patients with knee osteoarthritis includes a variety of fatty acids and their related metabolites such as carnitine， acetyl coenzyme A， as well as a variety of phospholipids and adipocytokines such as adiponectin， leptin， and resistin. Among them， lipids such as arachidonic acid， some shortchain saturated fatty acids， and related metabolites may have a bidirectional regulatory function in the development of KOA， which is worthy of in-depth study. In this paper， we review the literature on the characteristics of lipid metabolism in synovial fluid of patients with knee osteoarthritis， with the aim of clarifying the correlation between lipid metabolism in synovial fluid and the occurrence and development of knee osteoarthritis， and providing some new ideas for the prevention and treatment of knee osteoarthritis.