Obesity and body mass index: Past and future considerations in osteoarthritis research

Association of ambient air pollution with hospital admissions for major osteoarthritis diseases: A national case-crossover study in China

OBJECTIVES

To investigate the acute effects of short-term exposure to ambient air pollution on the risk of hospital admissions for osteoarthritis (OA) and its major subtypes.

METHODS

Hospital admission data on OA and its major subtypes were sourced from two major urban medical insurance systems in China, covering the period from 2013 to 2017. A two-stage, time-stratified case-crossover design was used to investigate the acute effects of short-term exposure to ambient air pollutants on hospital admissions for OA across 278 Chinese cities with available hospital admission data over 50 cases. The conditional logistic regression model was utilized to assess city-specific associations, which were subsequently pooled by employing a random-effects model.

RESULTS

A total of 1,404,095 OA-related hospital admissions were included. At the main time windows, per interquartile range increases in PM2.5 (particulate matter with an aerodynamic diameter of ≤ 2.5 μm), PM10 (particulate matter with an aerodynamic diameter of ≤ 10 μm), NO2 (nitrogen dioxide), SO2 (sulfur dioxide), O3 (ozone), and CO (carbon monoxide) were associated with significant increases in OA-related admissions by 0.70 % (95 % CI: 0.12 %, 1.28 %), 1.08 % (95 % CI: 0.47 %, 1.69 %), 4.50 % (95 % CI: 3.36 %, 5.65 %), 2.75 % (95 % CI: 1.79 %, 3.72 %), 1.33 % (95 % CI: 0.57 %, 2.10 %) and 1.77 % (95 % CI: 0.76 %, 2.79 %), respectively. Short-term exposures to ambient air pollutants were also associated with increased hospital admissions for major OA subtypes, especially gonarthrosis. The attributable fractions of OA admissions ranged from 0.87 % for PM2.5 to 6.22 % for NO2.

CONCLUSIONS

Short-term exposure to ambient air pollution is significantly associated with an increased risk and burden of OA admissions.

The relationship between radiological OA severity or body weight and outcomes following a structured education and exercise therapy program (GLA:D®) for people with knee osteoarthritis

BACKGROUND

Clinicians may presume people with higher bodyweight or greater OA severity do not respond to exercise therapy for knee osteoarthritis (OA), but few studies have examined this.

OBJECTIVE

To examine the relationship between radiographical OA severity or bodyweight and pain and functional outcomes following a structured education and exercise therapy program (Good Life with OsteoArthritis from Denmark: GLA:D®).

METHODS

33 participants with knee OA were assessed at baseline and week 8 following GLA:D®. Outcomes were pain (Visual analogue scale (VAS) 0-100), Knee Injury and Osteoarthritis Outcome Score-12 (KOOS-12 total), 40 m-fast-paced walk and 30-s chair stand. Multilevel models were used to define the severity of OA in medial, lateral and patellofemoral compartments using the Kellgren-Lawrence (KL) system and to examine the relationship between compartment severity, bodyweight and outcomes.

RESULTS

No meaningful relationships between bodyweight and response to GLA:D® were found for any outcome measures. Greater medial OA compartment severity was related to less improvement in pain, KOOS-12 and chair stand repetitions. However, all levels of lateral compartment severity had similar improvements, and greater patellofemoral compartment severity was related to more improvement for KOOS-12 and pain.

CONCLUSION

Bodyweight may have little influence on a person's response to a structured education and exercise therapy program. While people with greater medial compartment severity were less likely to improve following the program, OA severity in the PF and lateral compartments was not a barrier to improvement.

Lateral patellar tilting can also result in cartilage lesions of tibial plateau - the characteristic features of excessive lateral pressure syndrome: a retrospective study of 141 cases

BACKGROUND

To comprehensively summarize the characteristics of cartilage and other knee joint lesions associated with excessive lateral pressure syndrome (ELPS).

METHODS

Patients diagnosed with ELPS and admitted to our department between October 1, 2015, and September 30, 2023 were retrospectively included in this study. Prior to undergoing arthroscopic examination and surgery, all included patients underwent knee MRI evaluation. The lesion regions and corresponding lesion grading of each knee joint were meticulously documented, and the concordance between imaging and arthroscopic evaluation was quantified. All patients were categorized based on age and gender, and further comparison of each group was made.

RESULTS

There were 82 male participants and 59 female participants included. No significant differences in age or side distribution were observed. Regarding gender comparison, there were no statistically significant differences in imaging observations (P = 0.940) and arthroscopic examinations (P = 0.237). There were no significant differences observed in radiographic incidences among all three groups divided by age, while during arthroscopic examination, a significantly higher incidence was found in over 50 group compared to both those under 20 and those aged between 20 and 50. The incidence of Graded that both radiographic evaluation and arthroscopic observation demonstrated a significantly higher incidence in the > 50 years old group compared to the other two groups.

CONCLUSIONS

In addition to patellofemoral joint cartilage lesions, excessive lateral pressure syndrome (ELPS) of the patella can also cause cartilage lesions in the central region of the medial tibial plateau and posterior region of the lateral tibial plateau. These specific sites of lesion are not influenced by gender or age. The incidence of full-thickness cartilage defects gradually increases with age.

TRIAL REGISTRATION

The Ethics Committee of the Third Hospital of Peking University approved this study. (No.: IRB00006761-M2021002) LEVEL OF EVIDENCE: IV Case series.

Association of weight-adjusted waist index with all-cause and cardiovascular mortality in individuals with osteoarthritis

BACKGROUND

The Weight-Adjusted waist index (WWI) is a novel obesity assessment parameter that has been shown to be associated with mortality in various chronic disease populations and is also linked to the onset of osteoarthritis (OA). The aim of this study is to investigate whether WWI is associated with all-cause and cardiovascular mortality in OA population.

METHODS

The study analyzed a cohort of 3,554 OA patients drawn from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018. Kaplan-Meier survival curves, Cox proportional hazards regression models, and subgroup analyses were utilized to assess the association between WWI and mortality outcomes. The dose-response relationship was examined using a restricted cubic spline (RCS) model.

RESULTS

Among the 3,554 OA individuals, 611 participants were determined as deceased (13%), and 26% of the deaths were due to cardiovascular causes. The fully adjusted Cox proportional hazards model revealed that elevated WWI values were significantly associated with a higher risk of all-cause mortality (HR = 1.28, 95% CI 1.07‒1.52). The association between WWI and cardiovascular mortality in OA patients was only observed in the minimally adjusted model (HR = 1.43, 95% CI 1.12‒1.81). A similar conclusion was observed when the participants were grouped according to WWI tertiles. Kaplan-Meier survival curves demonstrated elevated mortality rates among individuals with higher WWI. The dose-response analysis indicated a linear positive relationship between WWI and mortality rates. The above associations remained consistent across all subgroups.

CONCLUSION

Elevated WWI levels were associated with a higher risk of all-cause mortality in OA individuals independently.

CLINICAL TRIAL NUMBER

Not applicable.

Association between conicity index (C-index), relative fat mass (RFM), and osteoarthritis (OA): evidence from NHANES 2003-2018

BACKGROUND

Obesity is considered an important risk factor for osteoarthritis (OA), with conicity index (C-index), relative fat mass (RFM) are two novel anthropometric measures of obesity. To investigate the association between OA and these two indicators, we conducted this study.

METHODS

We used data from the National Health and Nutrition Examination Survey (NHANES) to investigate the association between C-index, RFM, and OA. First, the participants were divided into two groups according to whether they had OA, and we compared the baseline characteristics of the two groups. Then, C-index and RFM were divided into quartiles (Q1, Q2, Q3, Q4) for multivariate regression analysis. Additionally, we applied restricted cubic spline (RCS) to assess whether the relationship is non-linear. Finally, we conducted a subgroup interaction analysis to investigate whether this relationship varies across different subgroups.

RESULTS

The study included 34,707 participants, with a weighted OA prevalence of 7.7%. Significant differences in C-index and RFM were observed between OA and non-OA groups. Treating C-index and RFM as categorical variables, logistic regression showed significantly higher OA risk in Q4 compared to Q1: for C-index, Q4 (OR = 1.60; 95% CI: 1.33-1.93; P < 0.001); for RFM, Q4 (OR = 2.07; 95% CI: 1.57-2.73; P < 0.001). The RCS results show that the relationship between C-index and OA is non-linear, while the relationship between RFM and OA is linear. Subgroup interaction analysis showed some interaction effects.

CONCLUSIONS

This study reveals detailed relationships between C-index, RFM, and OA, which may be better indicators of obesity in assessing OA risk.

The non-linear relationships between fat mass and lean body mass with arthritis

INTRODUCTION

Body composition has been associated with various health outcomes, but its specific relationship with arthritis risk remains unclear. The study aimed to examine the associations between lean body mass (LBM) and fat mass (FM) with arthritis risk in men and women and to identify their threshold values.

METHODS

The data were obtained from the CHARLS, a prospective cohort study from 2011 to 2018. Multivariate Cox regression models evaluated the associations between LBM and FM and arthritis risk. Smoothing curves and two-piece linear regression models were applied to identify the inflection points of LBM and FM associated with arthritis risk.

RESULTS

A total of 6,761 participants were included in this study. During a mean follow-up period of 6.66 years, 944 participants (13.96%) developed new-onset arthritis, with an incidence rate of 20.72 per 1,000 person-years. Multivariate Cox regression analysis demonstrated a significant linear association between FM and the risk of new-onset arthritis in men. Individuals in the highest FM quartile (Q4) had the highest risk of developing arthritis (HR = 1.25, 95% CI: 1.03-1.51). Two-piece linear regression models revealed nonlinear relationships between LBM, FM, and arthritis risk. Specifically, in men, LBM was negatively associated with arthritis risk when it was below 43.79 kg (HR = 0.97, 95% CI: 0.95-0.99), but this association was no longer significant above this threshold (HR = 1.01, 95% CI: 0.98-1.03). In women, arthritis risk significantly decreased when LBM exceeded 39.04 kg (HR = 0.92, 95% CI: 0.87-0.96). Additionally, in women, FM exhibited a U-shaped relationship with arthritis risk, with the lowest risk observed at an FM level of 17.16 kg.

CONCLUSIONS

Among Chinese adults aged 45 and older, maintaining appropriate levels of LBM and FM may help reduce arthritis risk. Based on the nonlinear findings, it is recommended to maintain LBM below 43.79 kg for men, above 39.04 kg for women, and to keep FM at approximately 17.16 kg for women, which may be appropriate.

Quantifying knee-adjacent subcutaneous fat in the entire OAI baseline dataset - Associations with cartilage MRI T2, thickness and pain, independent of BMI

OBJECTIVE

Knee-adjacent subcutaneous fat (kaSCF) has emerged as a potential biomarker and risk factor for osteoarthritis (OA) progression. This study aims to develop an artificial intelligence-based tool for the automatic segmentation of kaSCF thickness and evaluate the cross-sectional associations between kaSCF, cartilage thickness, magnetic resonance imaging-based cartilage T2 relaxation time, knee pain, and muscle strength independent of body mass index (BMI).

DESIGN

Baseline 3.0T MR images of the right knee from the entire Osteoarthritis Initiative cohort (n=4796) were used to quantify average values of kaSCF, cartilage thickness, and T2 using deep learning algorithms. Regression models (adjusted for age, gender, BMI, and race) were used to evaluate the associations between standardized kaSCF and outcomes of cartilage thickness, T2, pain, and knee extension strength.

RESULTS

Model prediction CVs for kaSCF thickness ranged from 3.57% to 9.87% across femoral and tibial regions. Greater average kaSCF was associated with thinner cartilage in men (std. β= -0.029, 95% CI: -0.050 to -0.007, p=0.010) and higher T2 in women (std. β=0.169, 95% CI: 0.072 to 0.265, p=0.001). Greater kaSCF was also associated with lower knee extension force (std. β= -15.36, 95% CI: -20.39 to -10.33, p<0.001) and higher odds of frequent knee pain (std. odds ratio=1.156, 95% CI: 1.046 to 1.278, p=0.005) across all participants.

CONCLUSIONS

Greater kaSCF was associated with thinner cartilage in men, higher T2 in women, reduced knee strength, and greater knee pain, independent of BMI. These findings suggest a potential role of kaSCF as a predictor for knee osteoarthrits-related structural, functional, and clinical outcomes independent of the effects of BMI.

Correlation Between Metabolic Score for Visceral Fat and Cardiovascular-Kidney-Metabolic Syndrome: Analysis of NHANES 2011-2020

Background: Cardiovascular-kidney-metabolic (CKM) syndrome with high incidence and mortality rates is a prevalent health issue globally. The Metabolic Score for Visceral Fat (METS-VF), as a new index for valuating visceral adipose tissue, has been reported to be closely related to a variety of diseases. However, whether the METS-VF can be an indicator to predict the risk of CKM syndrome remains unclear. Methods: We selected National Health and Nutrition Examination Survey (NHANES) database data from the 2011-2020 year cycles and conducted analyses between the METS-VF and CKM syndrome utilizing weighted Cox regression models, subgroup and interaction analysis, and restricted cubic spline (RCS) analysis. We also used receiver operating characteristic (ROC) curves to analyze and compare the diagnostic predictive ability of the METS-VF, the BMI, and other indicators assessing adipose tissue, including the VAI, fat mass, and lean mass, in CKM syndrome. Results: In this study, the average age was 34.40 ± 0.61 years in the non-CKM patients, while the average age was over 40.38 ± 0.62 years in the CKM patients. Additionally, there was a greater proportion of male patients in the CKM patients (over 49.04%) in comparison with the non-CKM patients (37.94%). The average METS-VF was higher in the CKM patients (over 6.63 ± 0.02) compared with the non-CKM patients (5.62 ± 0.03). We found the METS-VF had a positive correlation with CKM syndrome and was hardly affected by other confounding factors. The METS-VF was more closely associated with CKM syndrome in the subgroup of age 20-59 and female patients. In addition, the METS-VF had better diagnostic ability for CKM syndrome than the body mass index (BMI) and other indicators. Conclusions: The METS-VF is a potentially actionable indicator that had a positive correlation with CKM risk. The METS-VF may be used as a possible reference in the management of CKM syndrome.

Association between body roundness index and osteoarthritis/rheumatoid arthritis: a cross-sectional study

To explore the relationship between the Body Roundness Index (BRI) and the prevalence of osteoarthritis (OA) and rheumatoid arthritis (RA) among American adults, providing new insights for identifying OA and RA in adults. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2015-2023 and conducted a large cross-sectional study. BRI was calculated based on body measurements, while OA and RA cases were identified through questionnaires. Participants under 20 years of age and those with incomplete data were excluded. Weighted multivariate logistic regression models, restricted cubic spline (RCS) functions, and stratified analyses were used to assess the relationship between BRI levels and the prevalence of OA and RA in American adults. To further evaluate BRI's diagnostic potential for OA and RA, receiver operating characteristic (ROC) curves were employed to analyze and calculate the area under the curve (AUC). After screening, 17,544 participants were included, with 2,382 cases of OA (13.58%) and 987 cases of RA (5.63%). Multivariate logistic regression analyses showed a positive correlation between BRI and OA prevalence in American adults in both the unadjusted and adjusted models. A similar correlation was observed for RA in the unadjusted and partially adjusted models (P < 0.001), but the fully adjusted model showed no significant association between BRI and RA (P > 0.05). In the unadjusted model, the prevalence of OA in the highest BRI quartile was 3.47 times than that of the lowest quartile (95% CI: 2.84, 4.24, P < 0.001). Even in the fully adjusted model, the prevalence of OA in the highest BRI quartile remained 1.46 times higher than that of the lowest quartile (95% CI: 1.02, 2.08, P < 0.05). RCS curves demonstrated a non-linear relationship between BRI and both OA and RA, with a significant increase in prevalence as BRI levels rose (P < 0.001). Subgroup analyses and forest plots indicated a positive correlation between BRI and OA and RA in most subgroups (P < 0.05). ROC curves showed that BRI had a better predictive ability for OA and RA risk compared to BMI. There is a significant positive correlation between BRI and the prevalence of OA and RA in American adults, especially OA. Maintaining a lower BRI may help prevent the onset of OA and RA.

Global burden of osteoarthritis among postmenopausal women in 204 countries and territories: a systematic analysis for the Global Burden of Disease Study 2021

OBJECTIVES

Our study aimed to provide global burden and temporal trends in the incidence, prevalence, and disability-adjusted life-years (DALYs) of osteoarthritis (OA) among postmenopausal women from 1990 to 2021.

METHODS

The study employed data from the Global Burden of Disease (GBD) Study 2021. Four subtypes of OA affecting the hip, knee, hand, and other joints among postmenopausal women were included. Age-standardised rates (ASRs) were derived with reference to the global age standard, and temporal patterns were scrutinised through estimated annual percentage change (EAPC) assessments. The impact of age, body mass index (BMI), and Socio-demographic Index (SDI) were all considered.

RESULTS

From 1990 to 2021, there were more than 1.3-fold increases in OA incidence, prevalence, and DALYs among postmenopausal women globally, with EAPCs of 0.211, 0.356, and 0.395, respectively. Knee OA carried the heaviest burden, while hip OA bore the least. Higher SDI regions had higher burden, and inequalities linked to SDI among countries had intensified over time. East Asia and high-income Asia Pacific experienced the most substantial increments in OA burden. High BMI significantly influences the burden of OA, especially in countries within high, high-middle, and middle SDI, where DALYs attributed to high BMI exceed 20%.

CONCLUSIONS

The burden of OA among postmenopausal women continues to escalate, highlighting its significant impact on the global health of postmenopausal women. Necessarily, effective monitoring and management of risk factors, targeted lifestyle adjustments for BMI, and policy interventions accounting for demographic disparities are required to ease OA in postmenopausal women.

Aortic, musculoskeletal and organ characteristics on computed tomography in knee osteoarthritis - an explorative study in the IMI-APPROACH cohort

The systemic associations with knee osteoarthritis (KOA) are incompletely understood. This study explores aortic disease, musculoskeletal and organ findings in patients with KOA in relation to their symptoms or radiographic abnormalities. Full body computed tomography (CT) scans of 255 IMI-APPROACH participants were investigated using an automated analysis of multislice CT (Voronoi Health Analytics) that extracts aortic size and calcifications, and volumes and densities of bones, muscles, fat compartments and thoracic and abdominal organs. The CT measurements were primarily related to KOA as measured with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual scores and automated knee radiograph analysis of osteophytes, bone sclerosis and joint space width. The median age was 67 years, body mass index (BMI) 26.8 kg/m2 and 78% were female. About half had Kellgren-Lawrence grade ≥ 2. Larger knee osteophyte area was associated with a larger aortic volume (RSpearman=0.21,P = 0.001), which can be due to elongation or dilatation. We observed an association between more symptoms and increased psoas (RSpearman=-0.23,P < 0.001) and lower leg (RSpearman=-0.23,P < 0.001) muscle density, suggesting less microscopic muscle fat. Symptomatic KOA was associated with substantially lower lung volume (771 ml difference between 50% worst and 50% best WOMAC), but not with visible lung disease. Lung volume and density were significantly associated with the physical functioning WOMAC component. These associations remained significant after adjustment for age, sex and BMI. KOA is associated with significant systemic changes, including altered aortic and organ volumes. These correlations suggest that KOA's impact may extend beyond the joints. Future research should explore the causal relationships and therapeutic implications associations.

Two-Thirds Maintain High Adherence to Digital Education and Exercise Therapy With Comparable Outcomes Across Adherence Clusters: A Registry Study Including Data From Over 14 000 Patients in Sweden

OBJECTIVE: To explore trajectories of 12-week adherence to a digital education and exercise therapy for knee and hip osteoarthritis (OA), associations with baseline characteristics, and trajectories of patient-reported outcomes measures (PROMs) up to 1-year follow-up. DESIGN: Retrospective cohort (registry) study. METHODS: Weekly data on adherence (ie, the percentage of completed activities [exercises, lessons, and quizzes]) were obtained over 12 weeks (n = 14 097). Longitudinal k-means clustering was used to identify adherence trajectory clusters. Associations of baseline characteristics with adherence trajectory clusters were assessed using multinomial logistic regression. Trajectories of each PROM (pain, function, and general health) from baseline up to 1-year follow-up (measured at 3-month intervals) across adherence trajectory clusters were explored using generalized estimating equations adjusted for baseline characteristics. RESULTS: Four adherence trajectory clusters were identified: "high-persistent" (68.0%), "high-declining" (16.6%), "moderate-increasing" (8.5%), and "moderate-declining" (6.9%). Multinomial logistic regression suggested that female sex, older age, lower body mass index, lower education, living outside metropolitan cities, higher level of physical activity, less anxiety/depression, no fear of movement, having walking difficulties, and higher readiness to do exercise were associated with a higher probability of assignment to "high-persistent" than other clusters. Beliefs/perceptions and sociodemographic factors accounted for most of the explained variation in adherence trajectory clusters. While "high-persistent" cluster generally reported better outcomes than other clusters, these differences were small. CONCLUSION: While there were variations in adherence to the digital treatment, participants reported clinically comparable PROMs regardless of their adherence trajectory cluster. J Orthop Sports Phys Ther 2025;55(1):1-12. Epub 22 November 2024. doi:10.2519/jospt.2024.12864.

Association between obesity measurement indexes and symptomatic knee osteoarthritis among the Chinese population: analysis from a nationwide longitudinal study

BACKGROUND

The current literature lacks robust clinical data and evidence delineating the relationship between obesity measurement indexes and knee osteoarthritis (KOA). Consequently, this investigation seeks to elucidate the potential link between obesity measurement indexes and KOA among Chinese adults in a nationally representative study.

METHODS

Firstly, this research performed an observational study in the China Health and Retirement Longitudinal Study (CHARLS). The variables were extracted from interviews and compared between KOA and non-KOA participants. The relationship between obesity measurement indexes and KOA was analyzed by multivariate logistic regression. Restricted cubic spline (RCS) regression tests the nonlinearity of the relationship between obesity measurement indexes and KOA. Subgroup analyses were performed by sex to verify the robustness of the findings.

RESULTS

In this cross-sectional analysis, we found a positive association between obesity measurement indexes and KOA. These results did not change on multiple imputations(BMI: OR = 1.02, 95% CI, 1.01-1.04, P < 0.05; WHtR: OR = 2.85, 95% CI, 1.08-7.51, P < 0.05; BRI: OR = 1.07, 95% CI, 1.01-1.12, P < 0.05; BFP: OR = 1.02 95% CI, 1.00-1.03, P < 0.05). All the effects of obesity measurement indexes with KOA are present in females. None of the stratifying variables significantly affected the association between obesity measurement indexes and KOA. RCS regression test revealed the linear positive correlation between obesity measurement indexes and KOA.

CONCLUSION

In this cross-sectional study, we found a significant association between obesity measurement indexes and KOA. This relationship is not affected by stratification and confounding factors.

Association between sarcopenic obesity and osteoarthritis: The potential mediating role of insulin resistance

BACKGROUND

Sarcopenic obesity (SO) and osteoarthritis (OA) are highly prevalent musculoskeletal conditions that significantly impair health-related quality of life.

AIM

This study investigated the association between SO and OA, and explored the potential mediating role of insulin resistance in this relationship. We utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018.

METHODS

This cross-sectional analysis employs NHANES data collected from 1999 to 2018, including participants aged 18 years and older. SO was assessed using dual-energy X-ray absorptiometry (DXA) measurements. Insulin resistance was estimated using the triglyceride-glucose (TyG) index. OA status was based on self-reported physician diagnosis. Statistical analyses included weighted logistic regression, restricted cubic spline (RCS) interaction analysis, mediation analysis using structural equation modeling (SEM), and receiver operating characteristic (ROC) curve analysis. Subgroup analyses were conducted based on age, sex, and diabetes status.

RESULTS

The sarcopenic obese group demonstrated the highest prevalence of OA (23.4 %), hypertension (47.8 %), and diabetes (12.0 %). Additionally, they exhibited elevated levels of triglycerides, cholesterol, glucose, blood urea nitrogen (BUN), creatinine, and uric acid. Logistic regression revealed significant positive associations between sarcopenic obesity, the TyG index, and OA risk. RCS analysis identified significant non-linear relationships and interactions of the TyG index with age, sex, and diabetes status on OA risk. Mediation analysis indicated that the TyG index mediated approximately 4.9 % of the effect of sarcopenic obesity on OA risk. ROC curve analysis demonstrated moderate diagnostic accuracy for the TyG index (AUC = 0.65), which improved when incorporated into the multivariate model (AUC = 0.78). Subgroup analyses confirmed significant associations between the TyG index and sarcopenic obesity with OA risk across different age, sex, and diabetes status categories.

CONCLUSION

Our findings suggest a significant correlation between insulin resistance, as measured by the TyG index, and elevated OA risk in individuals with sarcopenic obesity. Targeting insulin resistance through future research may be a promising avenue to lower OA risk in this population.

Association between the body roundness index and osteoarthritis: evidence from NHANES

Background

The body roundness index (BRI) is a quantitative measure used to evaluate the presence of obesity and the distribution of body fat. However, the relationship between the BRI and osteoarthritis (OA) is still unclear. This study aimed to examine the relationship between the BRI and the occurrence of OA.

Methods

This study was a cross-sectional analysis used to analyze data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. A variety of variables were included in this investigation, which employed logistic regression analysis to assess the correlation between the BRI and OA. The robustness of the results and the impact of stratification variables were evaluated using subgroup and sensitivity analyses. To evaluate the ability of the BRI to predict OA, receiver operating characteristic (ROC) analysis was performed.

Results

The analysis included 19,717 participants. Participants with OA had a significantly greater BRI than those without OA. Logistic regression analysis revealed a statistically significant positive correlation between the BRI and OA (OR = 1.18, 95% CI = 1.15-1.21, p-value <0.001). Despite the complete adjustment for covariates, this association remained stable (OR = 1.10, 95% CI = 1.04-1.17, p-value = 0.002). The results were corroborated by subgroup and sensitivity analyses, which demonstrated their robustness. Moreover, the BRI exhibited greater predictive accuracy for OA than did BMI.

Conclusion

The BRI and OA are significantly associated in adults in the United States. The risk of developing OA may be increased by elevated levels of the BRI. Monitoring levels of the BRI is essential to prevent or reduce the prevalence and advancement of OA.

Diabetes and Osteoarthritis: Exploring the Interactions and Therapeutic Implications of Insulin, Metformin, and GLP-1-Based Interventions

Diabetes mellitus (DM) and osteoarthritis (OA) are prevalent chronic conditions with shared pathophysiological links, including inflammation and metabolic dysregulation. This study investigates the potential impact of insulin, metformin, and GLP-1-based therapies on OA progression. Methods involved a literature review of clinical trials and mechanistic studies exploring the effects of these medications on OA outcomes. Results indicate that insulin, beyond its role in glycemic control, may modulate inflammatory pathways relevant to OA, potentially influencing joint health. Metformin, recognized for its anti-inflammatory properties via AMPK activation, shows promise in mitigating OA progression by preserving cartilage integrity and reducing inflammatory markers. GLP-1-based therapies, known for enhancing insulin secretion and improving metabolic profiles in DM, also exhibit anti-inflammatory effects that may benefit OA by suppressing cytokine-mediated joint inflammation and supporting cartilage repair mechanisms. Conclusions suggest that these medications, while primarily indicated for diabetes management, hold therapeutic potential in OA by targeting common underlying mechanisms. Further clinical trials are warranted to validate these findings and explore optimal therapeutic strategies for managing both DM and OA comorbidities effectively.