TL;DR
Obesity and older age were significantly associated with severe knee osteoarthritis, while sex was not, and weight management may help reduce the risk of disease progression.
Age >60 years, female sex, overweight or obesity status, occupations involving heavy physical activity, and a history of knee trauma were significantly associated with poor quality of life among patients with knee osteoarthritis in Ubung Village.
Increased Body Mass Index is significantly associated with greater severity of knee osteoarthritis, and weight reduction may play an important role in preventing progression and improving clinical outcomes in knee osteoarthritis patients.
Background: Obesity is the major modifiable risk factor for knee osteoarthritis (OA) but the amount of weight loss needed to reduce structural progression in the real world is not well defined. Materials and Methods: In this single-center prospective cohort study, 400 adults with obesity (body-mass index [BMI] (cid:21) 30 kg/m 2 ) and Kellgren–Lawrence grade 2–3 knee OA were enrolled and assessed at baseline and 12 months. The main outcome was structural progressors, defined as those with a loss in medial femorotibial cartilage thickness of (cid:21) 0.10 mm on 3-Tesla MRI and/or a loss in joint-space width [JSW] of (cid:21) 0.20 mm. Associations were assessed using multivariable statistical analyses. Results: Of 400 enrolled participants (mean age 58.6 years; 66.3% women), 374 (93.5%) completed follow-up; 154 (38.5%) lost <5%, 121 (30.2%) lost 5–10%, and 125 (31.2%) lost (cid:21) 10% of body weight. Of these, 93.5%, 71.1% and 21.6% progressed structurally, respectively (P<0.001). Greater weight loss was associated with significantly less cartilage and joint space loss (P<0.001). After adjustment, the odds of structural progression were markedly lower with 5–10% (adjusted odds ratio [aOR] 0.17; 95% CI 0.08–0.36) and (cid:21) 10% weight loss (aOR 0.02; 95% CI 0.01–0.04) versus <5%. Secondary outcomes also improved with greater weight loss (P<0.001). Conclusions: In adults with obesity and knee OA, greater 12-month weight loss was associated with markedly less structural progression, with a clear dose-response gradient and an apparent threshold near 10%. The clinical data presented here support weight-loss magnitude as a clinically-relevant treatment target.
Elevated SUA levels are significantly associated with greater radiological severity, increased pain intensity and poorer functional status in patients with knee OA.
There is a need for an integrated assessment combining clinical evaluation and radiological findings to guide treatment planning for patients with knee OA, and BMI is a major risk factor for osteoarthritis.
A potential role for vascular and systemic mechanisms in KOA progression is supported and the importance of cardiovascular health in patients with KOA is highlighted to highlight the importance of cardiovascular health in patients with KOA.
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