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Manatrakul R, Pirmoazen AM, Bharadwaj UU, Akkaya Z, Giesler PJ, Lynch JA, Nevitt MC, McCulloch CE, Joseph GB, Link TM. Thigh muscle and fat volumes are associated with knee cartilage abnormalities and bone marrow edema-like lesions: data from the osteoarthritis initiative. Skeletal Radiol 2024; 53:1279-1286. [PMID: 38206355 PMCID: PMC11096053 DOI: 10.1007/s00256-024-04565-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To investigate the associations of thigh muscle and fat volumes with structural abnormalities on MRI related to knee osteoarthritis. MATERIALS AND METHODS MRI studies of the thighs and knees from 100 individuals were randomly selected from the Osteoarthritis Initiative Cohort. Whole Organ MR Scoring (WORMS) and effusion-synovitis scoring were performed in all knee MRI. Thigh muscles, intermuscular fat, and subcutaneous fat were manually segmented in 15 consecutive MR thigh images. Radiographic Kellgren-Lawrence grades (KLG) were also obtained in all knee radiographs. Independent t-tests were used to investigate the associations between thigh muscle and fat volumes, and sex. Mixed-effects analyses were obtained to investigate the associations between thigh muscle and fat volumes, KLG, WOMAC pain score, cartilage and bone marrow WORMS, as well as effusion-synovitis scores. RESULTS Women had higher subcutaneous fat volume than men (616.82 vs. 229.13 cm3, p < 0.01) and men had higher muscle volumes than women (p < 0.01). Quadriceps (coef = -2.15, p = 0.01) and vastus medialis (coef = -1.84, p = 0.03) volumes were negatively associated with the WORMS cartilage scores. Intermuscular fat volume (coef = 0.48, p = 0.01) was positively associated with WORMS bone marrow edema-like lesion (BMEL) scores. The quadriceps (coef = -0.99, p < 0.01) and hamstring (coef = -0.59, p = 0.01) volumes were negatively associated with WORMS BMEL scores. No evidence of an association was found between thigh muscle and fat volumes with KLG and effusion-synovitis grading (p > 0.05). CONCLUSION Increased quadriceps and hamstring volumes were negatively associated with cartilage lesion and BMEL scores while no evidence of an association was found between thigh muscle and fat volumes, and radiographic knee osteoarthritis or effusion-synovitis grading.
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Affiliation(s)
- Rawee Manatrakul
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA.
- Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Amir M Pirmoazen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
- Department of Radiology, University of Florida, Jacksonville, FL, USA
| | - Upasana U Bharadwaj
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Zehra Akkaya
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Paula J Giesler
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
- Medical Center, University of Freiburg, Freiburg, Germany
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
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Sieroń D, Jabłońska I, Niemiec P, Lukoszek D, Szyluk K, Platzek I, Meusburger H, Delimpasis G, Christe A. Relationship between Outerbridge Scale and Chondropathy Femorotibial Joint in Relation to Gender and Age-The Use of 1.5T and 3.0T MRI Scanners. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111634. [PMID: 36422173 PMCID: PMC9697703 DOI: 10.3390/medicina58111634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
Background and Objective: Magnetic resonance imaging (MRI) enables the effective evaluation of chondromalacia of the knee joint. Cartilage disease is affected by many factors, including gender, age, and body mass index (BMI). The aim of this study was to check the relationship between the severity of chondromalacia of the femoro-tibial joint and age, gender, and BMI assessed with 1.5T and 3.0T MRI scanners. Materials and Methods: The cross-observational study included 324 patients—159 (49%) females and 165 (51%) males aged 8−87 (45.1 ± 20.9). The BMI of study group was between 14.3 and 47.3 (27.7 ± 5.02). 1.5T and 3.0T MRI scanners were used in the study. The articular cartilage of the knee joint was assessed using the Outerbridge scale. Results: The age of the patients showed a significant correlation with Outerbrige for each compartment of the femorotibial joint (Spearman’s rank correlation rho: 0.69−0.74, p < 0.0001). A higher correlation between BMI and Outerbridge was noted in the femur medial (rho = 0.45, p < 0.001) and the tibia medial (rho = 0.43, p < 0.001) than in the femur lateral (rho = 0.29, p < 0.001) and the tibia lateral compartment (rho = 0.34, p < 0.001). Conclusions: The severity of chondromalacia significantly depends on age and BMI level, regardless of gender.
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Affiliation(s)
- Dominik Sieroń
- Department of Radiology SLS, Inselgroup, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
- Correspondence:
| | - Izabella Jabłońska
- Recreation and Treatment Center “Glinik” 1, Wysowa-Zdrój 101 str, 38-316 Wysowa-Zdrój, Poland
| | - Paweł Niemiec
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 str, 40-752 Katowice, Poland
| | - Dawid Lukoszek
- Dawid Lukoszek Physiotherapy Osteopathy, 42-690 Hanusek, Poland
| | - Karol Szyluk
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- Department of Orthopaedic and Trauma Surgery, District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 str, 41-940 Piekary Śląskie, Poland
| | - Ivan Platzek
- Department of Radiology, Dresden University Hospital, Fetscherstr. 74, 01307 Dresden, Germany
| | - Hugo Meusburger
- Department of Radiology SLS, Inselgroup, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
| | - Georgios Delimpasis
- Department of Radiology SLS, Inselgroup, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
| | - Andreas Christe
- Department of Radiology SLS, Inselgroup, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
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Wang C, Zhu Y, Liu Z, Long H, Ruan Z, Zhao S. Causal associations of obesity related anthropometric indicators and body compositions with knee and hip arthritis: A large-scale genetic correlation study. Front Endocrinol (Lausanne) 2022; 13:1011896. [PMID: 36246900 PMCID: PMC9556900 DOI: 10.3389/fendo.2022.1011896] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/20/2022] [Indexed: 11/20/2022] Open
Abstract
Backgrounds Epidemiological studies have repeatedly investigated the association between obesity related anthropometric indicators and body compositions and osteoarthritis (OA). However, the results have remained inconsistent. This work aimed to investigate the genetic correlation and causal associations of obesity related anthropometric indicators and body compositions with knee and hip OA. Methods Single-nucleotide polymorphisms associated with the exposures were searched from the recent genome-wide association studies (GWAS) to obtain full statistics. Summary-level results of knee and hip OA were from the UK Biobank and arcOGEN. First, linkage disequilibrium score regression (LD score regression) was applied to detect the genetic correlation (rg). We further performed a series of sensitivity analyses as validation of primary mendelian randomization (MR) results and the specific evidence of potential causal effects was defined. Results We found that genetic components in OA had significant correlation with obesity related traits, except waist-to-hip ratio. In the univariable MR analysis, with the exception of waist-to-hip ratio, obesity related anthropometric indicators were causally associated with increased risks of knee and hip OA. For obesity related body compositions, higher fat-free mass in arm, leg, and whole body increased the risk of knee OA but only fat-free mass in leg showed a significant association with hip OA. Meanwhile trunk fat mass and trunk fat percentage, were associated with knee but not with hip OA. Higher fat mass, and fat percentage in arm, leg, and whole body increased the risk of both knee and hip OA. After adjusting for BMI, the multivariable MR showed maintained results in knee OA. However, in hip OA, only fat mass and fat-free mass in arm, leg, trunk and whole body were significantly associated with the risk of hip OA. Conclusion The present study suggests genetic evidence for certain causal associations of obesity related anthropometric indicators and body compositions with knee and hip OA, which may provide important insights for the prevention and treatment on OA.
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Affiliation(s)
- Chao Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yong Zhu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhi Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Haitao Long
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhe Ruan
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Shushan Zhao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Chopp-Hurley JN, Wiebenga EG, Keller HH, Maly MR. Nutrition risk, physical activity and fibre intake are associated with body composition in OA: analysis of the Canadian Longitudinal Study on Aging. BMJ Nutr Prev Health 2022; 5:191-200. [PMID: 36619336 PMCID: PMC9813624 DOI: 10.1136/bmjnph-2021-000319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/31/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Sarcopenic obesity is a key feature in osteoarthritis (OA). While ideal OA treatment involves physical activity and diet, how diet influences OA pathophysiology is unclear. We explored the associations between diet, nutrition risk and physical activity with body composition in older adults with OA. Methods Baseline data from the Canadian Longitudinal Study on Aging data set were analysed. Participants with hip, knee, hand or multiple forms of OA were included in this cross-sectional analysis. Body composition measures (lean, fat and total masses (kg) and body fat percentage) were separate dependent variables. Regression analyses were conducted to explore associations between body composition with dietary intake (high calorie snack, fibre), nutrition risk (SCREEN II) and physical activity (Physical Activity Scale for the Elderly). Results 1596 participants were 66.5 (9.0) years old with a body mass index of 28.2 (5.3) kg/m2. Higher fibre cereal intake was associated with higher lean mass (unstandardised beta coefficient 0.5 (0.1, 0.9), p=0.02) and lower body fat percentage (-0.3 (-0.6, 0.0), p=0.046). Lower nutrition risk was associated with higher lean mass (0.1 (0.0, 0.1), p=0.03), lower fat mass (-0.05 (-0.1, 0.0), p=0.009) and lower body fat percentage (-0.1 (-0.1, 0.0), p<0.001). Higher physical activity was associated with higher lean mass (0.01 (0.01, 0.02), p<0.001), lower fat mass (-0.01 (0.0, 0.0), p=0.005) and lower body fat percentage (-0.01 (0.0, 0.0), p<0.001). Conclusion Greater physical activity and lower nutrition risk were associated with better body composition. While fibre intake was also associated body composition, the CIs were wide suggesting weak associations.
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Affiliation(s)
- Jaclyn N Chopp-Hurley
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Emily G Wiebenga
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Heather H Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada,Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada
| | - Monica R Maly
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada,Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Go DJ, Kim DH, Guermazi A, Crema MD, Hunter DJ, Hwang HS, Kim HA. Metabolic obesity and the risk of knee osteoarthritis progression in elderly community residents: A 3-year longitudinal cohort study. Int J Rheum Dis 2021; 25:192-200. [PMID: 34877797 DOI: 10.1111/1756-185x.14255] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/29/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Metabolic syndrome is a major health problem worldwide associated with obesity, thus drawing attention to its relation to osteoarthritis (OA). However, it is still uncertain whether metabolic syndrome or body fat distribution is associated with knee OA. The aim of this longitudinal study was to elucidate the association between metabolic obesity and adverse structural changes of knee OA assessed by magnetic resonance imaging (MRI). METHODS Participants were recruited from the Hallym Aging Study cohort in Korea. Knee MRI scans, along with dual-energy X-ray absorptiometry, were assessed in 226 participants at baseline and after 3 years. The structural progression in the tibiofemoral joint was evaluated using the semi-quantitative Whole-Organ MRI Score (WORMS) for cartilage morphology and bone marrow lesions (BML). Logistic regression with generalized estimating equation was performed for associations of metabolic risk factors with worsening of WORMS scores at the subregional level. RESULTS In the medial compartment, fat mass in women was associated with cartilage loss, but the statistical significance disappeared after adjusting for body mass index. Metabolic syndrome and each of its components were not associated with cartilage loss or increase of BML. On the other hand, the interaction effects of metabolic syndrome on the association between obesity and knee OA progression were not significant. CONCLUSION In this cohort, metabolic effects of obesity on knee cartilage damage and BML were not demonstrated. Further large-scale studies are required to prove the causal relationship between metabolic obesity and knee OA.
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Affiliation(s)
- Dong Jin Go
- Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea
| | - Dong Hyun Kim
- Department of Social and Preventive Medicine, Hallym Research Institute of Clinical Epidemiology, Hallym University, Chuncheon, Korea
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michel Daoud Crema
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - Hyun Sook Hwang
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.,Institute for Skeletal Aging, Hallym University, Chuncheon, Korea
| | - Hyun Ah Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.,Institute for Skeletal Aging, Hallym University, Chuncheon, Korea
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Obesity Is Preferentially Associated With Patellofemoral Compartment Wear: A Magnetic Resonance Imaging Assessment. J Am Acad Orthop Surg 2021; 29:e722-e731. [PMID: 33273404 DOI: 10.5435/jaaos-d-20-00596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A well-known association exists between obesity and knee osteoarthritis (OA) for both incidence and progression of the disease. However, the cartilage wear patterns in OA associated with obesity are less well studied. METHODS The OA initiative, a prospective sample of 4,796 patients, was used for this study. After the application of inclusion and exclusion criteria, patients were stratified into increasing body mass index (BMI) cohorts (BMI < 25, 25 ≤ BMI < 30, 30 ≤ BMI < 40, and 40 ≤ BMI). Knee MRIs were assessed using the semiquantitative MRI Osteoarthritis Knee Score scores. Patellofemoral (PF), medial, and lateral compartment cartilage scores were compared among BMI cohorts, controlling for confounders using linear regression models. RESULTS In total, 2,006 patients were present in our cohort, 773 men (38.5%) and 1,233 women (61.5%); the mean age was 61.7 ± 8.9 years. Increasing BMI was independently associated with increasing grades of PF wear for both right and left knees in the lateral patella facet (right knee β: 0.208, 95% confidence interval [CI]: 0.128 to 0.288, P < 0.001, left knee β: 0.147, 95% CI: 0.056 to 0.237, P = 0.002), medial femoral trochlea (right knee β: 0.135, 95% CI: 0.065 to 0.204, P < 0.001, left knee β: 0.142, 95% CI: 0.063 to 0.221, P < 0.001), and lateral femoral trochlea (right knee β: 0.163, 95% CI: 0.093 to 0.232, P < 0.001, left knee β: 0.147, 95% CI: 0.067 to 0.226, P < 0.001). For the right knee, increasing BMI was associated with medial compartment wear in the posterior femoral area (β: 0.070, 95% CI: 0.015 to 0.126, P = 0.013) and lateral compartment wear in the central tibial area (β: 0.070, 95% CI: 0.002 to 0.138, P = 0.045). For the left knee, increasing BMI was associated with medial compartment wear in the central femoral area (β: 0.093, 95% CI: 0.016 to 0.171, P = 0.018). DISCUSSION Obesity is preferentially associated with increasing cartilage wear in the PF compartment in comparison to the tibiofemoral compartment. Physical therapy and exercise programs that promote weight loss should be modified to decrease forces on the PF joint.
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An S, Hu H, Li Y, Hu Y. Pyroptosis Plays a Role in Osteoarthritis. Aging Dis 2020; 11:1146-1157. [PMID: 33014529 PMCID: PMC7505276 DOI: 10.14336/ad.2019.1127] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/27/2019] [Indexed: 02/06/2023] Open
Abstract
Recent studies have revealed novel forms of cell death beyond the canonical types of cellular apoptosis and necrosis, and these novel forms of cell death are induced by extreme microenvironmental factors. Pyroptosis, a type of regulated cell death, occurs when pattern recognition receptors (PRRs) induce the activation of cysteine-aspartic protease 1 (caspase-1) or caspase-11, which can trigger the release of the pyrogenic cytokines interleukin-1β (IL-1β) and IL-18. Osteoarthritis (OA), the most common joint disease worldwide, is characterized by low-grade inflammation and increased levels of cytokines, including IL-1β and IL-18. Additionally, some damaged chondrocytes associated with OA exhibit morphological changes consistent with pyroptosis, suggesting that this form of regulated cell death may contribute significantly to the pathology of OA. This review summarizes the molecular mechanisms of pyroptosis and shows the critical role of NLRP3 (NLR family, pyrin domain containing 3; NLR refers to "nucleotide-binding domain, leucine-rich repeat") inflammasomes. We also provide evidence describing potential role of pyroptosis in OA, including the relationship with OA risk factors and the contribution to cartilage degradation, synovitis and OA pain.
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Affiliation(s)
- Senbo An
- 1Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huiyu Hu
- 2Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yusheng Li
- 1Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yihe Hu
- 1Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Meng T, Antony B, Venn A, Eckstein F, Cicuttini F, March L, Cross M, Dwyer T, Blizzard L, Jones G, Laslett LL, Ding C. Association of body composition, physical activity and physical performance with knee cartilage thickness and bone area in young adults. Rheumatology (Oxford) 2020; 59:1607-1616. [PMID: 31652312 DOI: 10.1093/rheumatology/kez498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/25/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe associations of body composition, physical activity and physical performance with knee cartilage thickness and subchondral bone area in young adults. METHODS Body composition, physical activity and physical performance were measured 4-5 years prior to knee MRI. Cartilage thickness and bone area were measured quantitatively from MRI. Associations were assessed using linear regression analysis, with mediators being identified using mediation analysis. RESULTS Participants (n = 186) were 31-41 years of age when the MRI was acquired and 48% were female. Greater lean mass was positively associated with cartilage thickness [β = 6.52 μm/kg (95% CI 0.86, 12.18)] and bone area [β = 13.37 mm2/kg (95% CI 5.43, 21.31)]. Physical performance measures were positively associated with cartilage thickness [long jump: β = 2.44 μm/cm (95% CI 0.70, 4.18); hand grip strength: 7.74 μm/kg (95% CI 1.50, 13.98); physical work capacity: 1.07 μm/W (95% CI 0.29, 1.85)] and bone area [long jump: β = 3.99 mm2/cm (95% CI 0.64, 7.34); hand grip strength: 19.06 mm2/kg (95% CI 7.21, 30.92); leg strength: 3.18 mm2/kg (95% CI 1.09, 5.28); physical work capacity: 3.15 mm2/W (95% CI 1.70, 4.60)]. Mediation analysis suggested these associations were mediated by lean mass (effect mediated: 27-95%). CONCLUSION Greater lean mass and better physical performance measured 4-5 years prior were associated with greater knee cartilage thickness and subchondral bone area in young adults, and the associations of physical performance were largely mediated by lean mass. These findings suggest lean mass may play an important role in maintaining knee joint health in young adults.
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Affiliation(s)
- Tao Meng
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Medical University, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lyn March
- Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - Marita Cross
- Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,George Institute for Global Health, University of Oxford, Oxford, UK
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Laura L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Identifying effector molecules, cells, and cytokines of innate immunity in OA. Osteoarthritis Cartilage 2020; 28:532-543. [PMID: 32044352 DOI: 10.1016/j.joca.2020.01.016] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 02/06/2023]
Abstract
Inflammatory changes are observed in affected joints of osteoarthritis (OA) patients and are thought to be involved in the pathology that develops along OA progression. This narrative review provides an overview of the various cell types that are present in the joint during OA and which alarmins, cytokines, chemokines, growth factors, and other mediators they produce. Moreover, the involvement of more systemic processes like inflammaging and its associated cellular senescence in the context of OA are discussed.
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Association of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) with Muscle Strength in Community-Dwelling Elderly with Knee Osteoarthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072260. [PMID: 32230913 PMCID: PMC7177915 DOI: 10.3390/ijerph17072260] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 12/15/2022]
Abstract
Purpose: The purpose of this study was to evaluate the correlation between muscle strength and knee symptoms (pain, stiffness, and functional limitation) regardless of the presence of radiologic knee osteoarthritis (RKOA) in community-dwelling elderly. Patients and methods: This cross-sectional study used data from the Namgaram-2 cohort. The Namgaram-2 cohort consisted of participants living in three rural communities. Such participants were included for studies on activity limitation due to age-related musculoskeletal disorders including knee osteoarthritis, osteoporosis, and sarcopenia. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a health assessment tool for patients with arthritis in lower extremities, was used to assess health-related quality of life (HRQOL). Muscle strengths were measured by knee strength (by using the isokinetic dynamometer) and hand grip strength. Results: The WOMAC pain of Kallgren–Lawrence (K/L) grade < 2 was correlated with age, grip strength, nutrition status, and knee extension 180 peak torque. The WOMAC pain of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade < 2 was correlated with having a spouse, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade ≥ 2 was correlated with knee extension 60 peak torque. The WOMAC function of K/L grade < 2 was correlated with age, grip strength, osteoporosis, nutrition status, and knee extension 180 peak torque. The WOMAC function of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. Conclusion: Muscle strength as measured by grip strength and knee extension was statistically significantly correlated with the WOMAC scores in patients with knee symptoms regardless of whether radiologic signs of knee osteoarthritis were observed.
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Munugoda IP, Pan F, Wills K, Mattap SM, Cicuttini F, Graves SE, Lorimer M, Jones G, Callisaya ML, Aitken D. Identifying subgroups of community-dwelling older adults and their prospective associations with long-term knee osteoarthritis outcomes. Clin Rheumatol 2020; 39:1429-1437. [PMID: 31912407 DOI: 10.1007/s10067-019-04920-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/21/2019] [Accepted: 12/27/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To identify subgroups of community-dwelling older adults and to assess their longitudinal associations with long-term osteoarthritis (OA) outcomes. METHODS 1046 older adults aged 50-80 years were studied. At baseline, body mass index (BMI), pedometer-measured ambulatory activity (AA), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) determined knee pain and information on comorbidities were obtained. Tibial cartilage volume and bone-marrow lesions (BMLs) were assessed using MRI at baseline and 10 years and total knee replacements (TKR) by data linkage to the Australian Orthopaedic Association National Joint Replacement Registry. Latent class analysis was used to determine participant subgroups, considering baseline BMI, AA, pain and comorbidities, and linear mixed-effects or log-binomial models were used to assess the associations. RESULTS Three subgroups/classes were identified: subgroup 1 (43%): Normal/overweight participants with higher AA, lower pain and lower comorbidities; subgroup 2 (32%): Overweight participants with lower AA, mild pain and higher comorbidities; subgroup 3 (25%): Obese participants with lower AA, mild pain and higher comorbidities. Subgroup 3 had greater cartilage volume loss (β - 60.56 mm3, 95% CI - 105.91, - 15.21) and a higher risk of TKR (RR 3.19, 95% CI 1.75, 5.81), compared to subgroup 1. Subgroup 2 was not associated with cartilage volume change (β 13.06 mm3, 95% CI - 30.87, 57.00) or risk of TKR (RR 1.16, 95% CI 0.56, 2.36), compared to subgroup 1. Subgroup membership was not associated with worsening BMLs. CONCLUSIONS Our findings suggest the existence of homogeneous subgroups of participants and support the utility of identifying patterns of characteristics/risk factors that may cluster together and using them to identify subgroups of people who may be at a higher risk of developing and/or progressing OA. Key Points • Complex interplay among characteristics/factors leads to conflicting evidence between ambulatory activity and knee osteoarthritis. • Distinct subgroups are identifiable based on ambulatory activity, body mass index, knee pain, and comorbidities. • Identifying subgroups can be used to determine those who are at risk of developing/progressing osteoarthritis.
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Affiliation(s)
- Ishanka P Munugoda
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Siti M Mattap
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Victoria, Australia
| | - Stephen E Graves
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia
| | - Michelle Lorimer
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michele L Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Long H, Xie D, Zeng C, Wei J, Wang Y, Yang T, Xu B, Qian Y, Li J, Wu Z, Lei G. Association between body composition and osteoarthritis: A systematic review and meta‐analysis. Int J Rheum Dis 2019; 22:2108-2118. [PMID: 31651091 DOI: 10.1111/1756-185x.13719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 08/12/2019] [Accepted: 09/03/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Huizhong Long
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Dongxing Xie
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Chao Zeng
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
- Center for Clinical Technology and Research of Joint Surgery of Hunan Province Changsha China
| | - Jie Wei
- Health Management Center Xiangya Hospital Central South University Changsha China
| | - Yilun Wang
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Tuo Yang
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Bei Xu
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Yuxuan Qian
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Jiatian Li
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Ziying Wu
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Guanghua Lei
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
- Center for Clinical Technology and Research of Joint Surgery of Hunan Province Changsha China
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13
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Kang HY, Shin D, Kang EK. Correlation of Pressure Pain Threshold with Segmental Water Content among Female Farmers. TOHOKU J EXP MED 2019; 248:217-223. [PMID: 31366820 DOI: 10.1620/tjem.248.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Body composition (BC) is related to the pathogenesis of musculoskeletal disease, especially research focused on the role of fat and muscle mass. This study aimed to identify the associations between the pressure pain threshold (PPT) and pain-related factors including BC. A total of 64 healthy farmers (21 males and 43 females) were recruited, and baseline data were analyzed cross-sectionally. Demographic characteristics (sex, age, marital status, education duration, current status of smoking and alcohol drinking, height, body weight, and underlying diseases) and a psychologic characteristic (a Korean version of the Beck Depression Inventory [BDI]) were assessed. Additionally, body composition analysis using bioelectrical impedance analysis (BIA) was performed. PPT was measured by applying an increasing amount of blunt pressure using a 1 cm2 hard rubber end at the thenar region of the right hand with a constant increase in pressure of 50 kPa/s. The PPT was measured on a single day, and the average value was used for analysis. The male group (67.00 ± 9.12 years) was older than the female group (62.21 ± 6.77 years; p = 0.021). In the body composition analysis, only segmental water of the right arm was positively related to PPT (β = 0.331, p = 0.030) in the multivariate linear regression analysis. In conclusion, hydration status was related to PPT with clinical implication that sufficient hydration could reduce the pain susceptibility. Thus, when assessing the painful condition, checking the hydration status could be helpful before the intensive treatment.
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Affiliation(s)
- Hee Yong Kang
- Department of Anesthesiology and Pain Medicine, Kyung Hee University
| | - Dabi Shin
- Department of Rehabilitation Medicine, Kangwon National University Hospital, and School of Medicine, Kangwon National University
| | - Eun Kyoung Kang
- Department of Rehabilitation Medicine, Kangwon National University Hospital, and School of Medicine, Kangwon National University
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14
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Brady SRE, Urquhart DM, Hussain SM, Teichtahl A, Wang Y, Wluka AE, Cicuttini F. High baseline fat mass, but not lean tissue mass, is associated with high intensity low back pain and disability in community-based adults. Arthritis Res Ther 2019; 21:165. [PMID: 31277706 PMCID: PMC6612201 DOI: 10.1186/s13075-019-1953-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022] Open
Abstract
Objectives Low back pain is the largest contributor to disability worldwide. The role of body composition as a risk factor for back pain remains unclear. Our aim was to examine the relationship between fat mass and fat distribution on back pain intensity and disability using validated tools over 3 years. Methods Participants (aged 25–60 years) were assessed at baseline using dual-energy X-ray absorptiometry (DXA) to measure body composition. All participants completed the Chronic Pain Grade Scale at baseline and 3-year follow-up. Of the 150 participants, 123 (82%) completed the follow-up. Results Higher baseline body mass index (BMI) and fat mass (total, trunk, upper limb, lower limb, android, and gynoid) were all associated with high intensity back pain at either baseline and/or follow-up (total fat mass: multivariable OR 1.05, 95% CI 1.01–1.09, p < 0.001). There were similar findings for all fat mass measures and high levels of back disability. A higher android to gynoid ratio was associated with high intensity back pain (multivariable OR 1.04, 95% CI 1.01–1.08, p = 0.009). There were no associations between lean mass and back pain. Conclusions This cohort study provides evidence for the important role of fat mass, specifically android fat relative to gynoid fat, on back pain and disability.
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Affiliation(s)
- Sharmayne R E Brady
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia.
| | - Sultana Monira Hussain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Andrew Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
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Abstract
The classification and monitoring of individuals with early knee osteoarthritis (OA) are important considerations for the design and evaluation of therapeutic interventions and require the identification of appropriate outcome measures. Potential outcome domains to assess for early OA include patient-reported outcomes (such as pain, function and quality of life), features of clinical examination (such as joint line tenderness and crepitus), objective measures of physical function, levels of physical activity, features of imaging modalities (such as of magnetic resonance imaging) and biochemical markers in body fluid. Patient characteristics such as adiposity and biomechanics of the knee could also have relevance to the assessment of early OA. Importantly, research is needed to enable the selection of outcome measures that are feasible, reliable and validated in individuals at risk of knee OA or with early knee OA. In this Perspectives article, potential outcome measures for early symptomatic knee OA are discussed, including those measures that could be of use in clinical practice and/or the research setting.
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16
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Herrero-Beaumont G, Pérez-Baos S, Sánchez-Pernaute O, Roman-Blas JA, Lamuedra A, Largo R. Targeting chronic innate inflammatory pathways, the main road to prevention of osteoarthritis progression. Biochem Pharmacol 2019; 165:24-32. [PMID: 30825432 DOI: 10.1016/j.bcp.2019.02.030] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/26/2019] [Indexed: 12/15/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disease characterized by cartilage degradation, osteophyte formation, subchondral bone sclerosis, and synovitis. Systemic factors such as obesity and the components of the metabolic syndrome seem to contribute to its progression. Breakdown of cartilage ensues from an altered balance between mechanical overload and its absorption by this tissue. There is in this context a status of persistent local inflammation by means of the chronic activation of innate immunity. A broad variety of danger-associated molecular patterns inside OA joint are able to activate pattern recognition receptors, mainly TLR (toll-like receptor) 2 and 4, which are overexpressed in the OA cartilage. Chronic activation of innate immune responses in chondrocytes results in a robust production of pro-inflammatory cytokines and chemokines, as well as of tissue-destructive enzymes, downstream of NF-κB and MAPK (mitogen activated protein kinase) dependent pathways. Besides, the toxic effects of an excess of glucose and/or fatty acids, which share the same pro-inflammatory intracellular signalling pathways, may add fuel to the fire. Not only high concentrations of glucose can render cells prone to inflammation, but also AGEs (advanced glycation end products) are integrated into the TLR signalling network through their own innate immune receptors. Considering these mechanisms, we argue for the control of both primary inflammation and proteolytic catabolism as a preventive strategy in OA, instead of focusing treatment on the enhancement of anabolic responses. Even though this approach would not return to normal already degraded cartilage, it nonetheless might avoid damage extension to the surrounding tissue.
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Affiliation(s)
| | - Sandra Pérez-Baos
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | | | - Jorge A Roman-Blas
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | - Ana Lamuedra
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | - Raquel Largo
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain.
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Association of childhood adiposity measures with adulthood knee cartilage defects and bone marrow lesions: a 25-year cohort study. Osteoarthritis Cartilage 2018; 26:1055-1062. [PMID: 29775733 DOI: 10.1016/j.joca.2018.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/04/2018] [Accepted: 05/01/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the associations between childhood adiposity measures and adulthood knee cartilage defects and bone marrow lesions (BMLs) measured 25 years later. METHODS 327 participants from the Australian Schools Health and Fitness Survey (ASHFS) of 1985 (aged 7-15 years) were followed up 25 years later (aged 31-41 years). Childhood measures (weight, height and skinfolds) were collected in 1985. Body mass index (BMI), overweight status and fat mass were calculated. Participants underwent 1.5 T knee magnetic resonance imaging (MRI) during 2008-2010, and cartilage defects and BMLs were scored from knee MRI scans. Log binomial regressions were used to examine the associations. RESULTS Among 327 participants (47.1% females), 21 (6.4%) were overweight in childhood. Childhood adiposity measures were associated with the increased risk of adulthood patellar cartilage defects (Weight relative risk (RR) 1.05/kg, 95% confidence interval (CI) 1.01-1.09; BMI 1.10/kg/m2, 1.01-1.19; Overweight 2.22/yes, 1.21-4.08; fat mass 1.11/kg, 1.01-1.22), but not tibiofemoral cartilage defects. Childhood adiposity measures were not significantly associated with adulthood knee BMLs except for the association between childhood overweight status and adulthood patellar BMLs (RR 2.87/yes, 95% CI 1.10-7.53). These significant associations persisted after adjustment for corresponding adulthood adiposity measure. CONCLUSION Childhood adiposity measures were associated with the increased risk of adulthood patellar cartilage defects and, to a lesser extent, BMLs, independent of adulthood adiposity measures. These results suggest that adiposity in childhood has long-term effects on patellar structural abnormalities in young adults.
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18
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Akhavan NS, Ormsbee L, Johnson SA, George KS, Foley EM, Elam ML, Ezzat-Zadeh Z, Panton LB, Arjmandi BH. Functionality in Middle-Aged and Older Overweight and Obese Individuals with Knee Osteoarthritis. Healthcare (Basel) 2018; 6:healthcare6030074. [PMID: 29973574 PMCID: PMC6165234 DOI: 10.3390/healthcare6030074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/27/2018] [Accepted: 06/30/2018] [Indexed: 12/15/2022] Open
Abstract
Patients with knee osteoarthritis (OA) suffer from immobility and pain. The objective of this cross-sectional study was to investigate the relationship between pain and functionality in middle-aged and older overweight and obese individuals with mild-to-moderate knee OA. Overall pattern, physical activity, and total energy expenditure (TEE) were assessed in 83 participants. The Western Ontario McMaster Universities Arthritis Index (WOMAC) was used to assess lower extremity pain and function. The six-minute walk test (6-MWT) and range of motion (ROM) were also assessed. Results indicated that age was inversely associated with body mass index (BMI) (r = 0.349) and total WOMAC scores (r = 0.247). BMI was positively associated with TEE (r = 0.430) and WOMAC scores (r = 0.268), while ROM was positively associated with the 6-MWT (r = 0.561) and negatively associated with WOMAC (r = 0.338) and pain scores (r = 0.222). Furthermore, women had significantly greater WOMAC scores (p = 0.046) than men. Older participants (≥65 years old) had significantly lower BMI (p = 0.002), and distance traveled during the 6-MWT (p = 0.013). Our findings indicate that older individuals in this population with knee OA had lower BMI, greater ROM, and less pain and stiffness and walked slower than middle-aged individuals. Women reported greater pain, stiffness, and reduced functionality, indicating that the manifestation of OA may vary due to gender.
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Affiliation(s)
- Neda S Akhavan
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), College of Human Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
| | - Lauren Ormsbee
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), College of Human Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
| | - Sarah A Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523-1571, USA.
| | - Kelli S George
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), College of Human Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
| | - Elizabeth M Foley
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), College of Human Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
| | - Marcus L Elam
- Department of Human Nutrition and Food Science, California State Polytechnic University, Pomona, CA 91768-2557, USA.
| | - Zahra Ezzat-Zadeh
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
| | - Lynn B Panton
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), College of Human Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
| | - Bahram H Arjmandi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), College of Human Sciences, Florida State University, Tallahassee, FL 32306-4310, USA.
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19
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Ezzat AM, Brussoni M, Whittaker JL, Emery CA. A qualitative investigation of the attitudes and beliefs about physical activity and post-traumatic osteoarthritis in young adults 3–10 years after an intra-articular knee injury. Phys Ther Sport 2018; 32:98-108. [DOI: 10.1016/j.ptsp.2018.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/06/2018] [Accepted: 05/02/2018] [Indexed: 01/18/2023]
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20
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Ezzat A, Whittaker J, Toomey C, Doyle-Baker P, Brussoni M, Emery C. Knee confidence in youth and young adults at risk of post-traumatic osteoarthritis 3–10 years following intra-articular knee injury. J Sci Med Sport 2018; 21:671-675. [DOI: 10.1016/j.jsams.2017.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 11/05/2017] [Accepted: 11/20/2017] [Indexed: 01/19/2023]
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21
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Culvenor AG, Øiestad BE, Hart HF, Stefanik JJ, Guermazi A, Crossley KM. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. Br J Sports Med 2018; 53:1268-1278. [PMID: 29886437 PMCID: PMC6837253 DOI: 10.1136/bjsports-2018-099257] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 11/04/2022]
Abstract
Background Knee MRI is increasingly used to inform clinical management. Features associated with osteoarthritis are often present in asymptomatic uninjured knees; however, the estimated prevalence varies substantially between studies. We performed a systematic review with meta-analysis to provide summary estimates of the prevalence of MRI features of osteoarthritis in asymptomatic uninjured knees. Methods We searched six electronic databases for studies reporting MRI osteoarthritis feature prevalence (ie, cartilage defects, meniscal tears, bone marrow lesions and osteophytes) in asymptomatic uninjured knees. Summary estimates were calculated using random-effects meta-analysis (and stratified by mean age: <40 vs ≥40 years). Meta-regression explored heterogeneity. Results We included 63 studies (5397 knees of 4751 adults). The overall pooled prevalence of cartilage defects was 24% (95% CI 15% to 34%) and meniscal tears was 10% (7% to 13%), with significantly higher prevalence with age: cartilage defect <40 years 11% (6%to 17%) and ≥40 years 43% (29% to 57%); meniscal tear <40 years 4% (2% to 7%) and ≥40 years 19% (13% to 26%). The overall pooled estimate of bone marrow lesions and osteophytes was 18% (12% to 24%) and 25% (14% to 38%), respectively, with prevalence of osteophytes (but not bone marrow lesions) increasing with age. Significant associations were found between prevalence estimates and MRI sequences used, physical activity, radiographic osteoarthritis and risk of bias. Conclusions Summary estimates of MRI osteoarthritis feature prevalence among asymptomatic uninjured knees were 4%–14% in adults aged <40 years to 19%–43% in adults ≥40 years. These imaging findings should be interpreted in the context of clinical presentations and considered in clinical decision-making.
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Affiliation(s)
- Adam G Culvenor
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria.,La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | | | - Harvi F Hart
- La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | - Joshua J Stefanik
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Ali Guermazi
- Department of Radiology, Quantitative Imaging Centre, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kay M Crossley
- La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
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22
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The relationship between body composition and knee osteoarthritis in postmenopausal women. Turk J Phys Med Rehabil 2018; 64:121-125. [PMID: 31453501 DOI: 10.5606/tftrd.2018.1496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/18/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives The aim of this study was to examine the relationship between the body composition measures and knee osteoarthritis (OA) in postmenopausal women to determine whether the fat mass or the lean mass was closely associated with knee OA. Patients and methods This retrospective, cross-sectional study included a total of 212 postmenopausal women (mean age 59.9±6.2 years; range, 46 to 76 years). Descriptive characteristics were recorded and height was measured using a stadiometer. Body weight, fat mass, and lean mass were estimated using bioelectrical impedance analysis. X-rays of the knees were obtained. Knee OA was radiographically diagnosed according to the Kellgren-Lawrence criteria. Based on the radiographic knee OA diagnosis the women were divided into two groups. Logistic regression analyses were used to examine the associations between the body composition measures and knee OA. Results Knee OA was present in 117 women. Body Mass Index, body weight, fat mass, and lean mass were all significantly associated with knee OA after adjusting for confounding factors such as age, height, and physical activity (p<0.001). When assessed together with lean mass in a multivariate regression model, fat mass was closely and significantly found to be related to knee OA, compared to lean mass (p<0.001, OR: 1.17). Furthermore the fat mass/lean mass ratio was positively associated with knee OA (p<0.001). Conclusion In postmenopausal women body weight was significantly and positively associated with knee OA and among the components that constitute body weight, fat mass was closely and significantly associated with knee OA compared to lean mass. This result suggests that the relationship between obesity and knee OA is mainly based on the fat mass, and supports the importance of systemic metabolic effects of adiposity in this relationship.
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Amano K, Huebner JL, Stabler TV, Tanaka M, McCulloch CE, Lobach I, Lane NE, Kraus VB, Benjamin C, Li X. Synovial Fluid Profile at the Time of Anterior Cruciate Ligament Reconstruction and Its Association With Cartilage Matrix Composition 3 Years After Surgery. Am J Sports Med 2018; 46:890-899. [PMID: 29364702 PMCID: PMC7263374 DOI: 10.1177/0363546517749834] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Anterior cruciate ligament tears can lead to posttraumatic osteoarthritis. In addition to biomechanical factors, changes in biochemical profiles within the knee joint after injury and anterior cruciate ligament reconstruction (ACLR) may play a role in accelerating joint degeneration. Hypothesis/Purpose: It was hypothesized that cartilage matrix composition after ACLR is associated with the degree of inflammatory response after initial injury. This study evaluated the association between the inflammatory response after injury-as indicated by cytokine, metalloproteinase, and cartilage degradation marker concentrations in synovial fluid-and articular cartilage degeneration, measured by T1ρ and T2 quantitative magnetic resonance imaging up to 3 years after ACLR. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Twenty-six subjects from a longitudinal cohort study who underwent ACLR at a mean 8.5 weeks after injury (range, 4-19 weeks) had synovial fluid aspirated at the time of surgery. Immunoassays quantified biomarkers in synovial fluid. T1ρ and T2 values of articular cartilage were calculated with magnetic resonance scans acquired prior to surgery and at 6 months and 1, 2, and 3 years after surgery. Pearson correlation coefficients were calculated among the various biomarkers. K-means clustering was used to group subjects with similar biomarker profiles. Generalized estimating equations were used to find the overall differences in T1ρ and T2 values throughout these first 3 years after surgery between the clusters while controlling for other factors. RESULTS Significant and strong correlations were observed between several cytokines (interleukin 6 [IL-6], IL-8, IL-10, and tumor necrosis factor α) and 2 matrix metalloproteinases (MMP-1 and MMP-3) ( P < .05). Moderate correlations were found among combinations of C-terminal crosslinked telopeptide type II collagen, N-terminal telopeptide, cartilage oligomeric matrix protein, and sulfated glycosaminoglycan ( P < .05). Two clusters were generated, 1 of which was characterized by lower concentrations of cytokines (IL-6, IL-8, IL-10, tumor necrosis factor α) and MMP-1 and MMP-3 and higher sulfated glycosaminoglycan. This cluster was associated with significantly higher T1ρ and T2 values in the medial tibial and patellar cartilage over the first 3 years after ACLR. CONCLUSION At the time of ACLR surgery, profiles of synovial fluid inflammatory cytokines, degradative enzymes, and cartilage breakdown products show promise as predictors of abnormal cartilage tissue integrity (increased T1ρ and T2 values) throughout the first 3 years after surgery. CLINICAL RELEVANCE The results suggest an intricate relationship between inflammation and cartilage turnover, which can in turn be influenced by timing after injury and patient factors.
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Affiliation(s)
- Keiko Amano
- Department of Orthopaedic Surgery, University of California, San Francisco, California, USA
| | - Janet L. Huebner
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Thomas V. Stabler
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Matthew Tanaka
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Iryna Lobach
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Nancy E. Lane
- Division of Rheumatology, UC Davis Health System, University of California, Davis, California, USA
| | - Virginia B. Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, School of Medicine, Duke University, Durham, North Carolina, USA
| | - C. Benjamin
- Department of Orthopaedic Surgery, University of California, San Francisco, California, USA.,Address correspondence to C. Benjamin Ma, MD, Department of Orthopaedic Surgery, University of California, San Francisco, 1500 Owens St, Rm 200, San Francisco, CA 94158, USA ()
| | - Xiaojuan Li
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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24
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Stout AC, Barbe MF, Eaton CB, Amin M, Al-Eid F, Price LL, Lu B, Lo GH, Zhang M, Pang J, McAlindon TE, Driban JB. Inflammation and glucose homeostasis are associated with specific structural features among adults without knee osteoarthritis: a cross-sectional study from the osteoarthritis initiative. BMC Musculoskelet Disord 2018; 19:1. [PMID: 29304778 PMCID: PMC5755424 DOI: 10.1186/s12891-017-1921-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/22/2017] [Indexed: 12/11/2022] Open
Abstract
Background Greater age and body mass index are strong risk factors for osteoarthritis (OA). Older and overweight individuals may be more susceptible to OA because these factors alter tissue turnover in menisci, articular cartilage, and bone via altered glucose homeostasis and inflammation. Understanding the role of inflammation and glucose homeostasis on structural features of early-stage OA may help identify therapeutic targets to delay or prevent the onset of OA among subsets of adults with these features. We examined if serum concentrations of glucose homeostasis (glucose, glycated serum protein [GSP]) or inflammation (C-reactive protein [CRP]) were associated with prevalent knee bone marrow lesions (BMLs) or effusion among adults without knee OA. Methods We conducted a cross-sectional study using baseline data from the Osteoarthritis Initiative. We selected participants who had no radiographic knee OA but were at high risk for knee OA. Blinded staff conducted assays for CRP, GSP, and glucose. Readers segmented BML volume and effusion using semi-automated programs. Our outcomes were prevalent BML (knee with a BML volume > 1 cm3) and effusion (knee with an effusion volume > 7.5 cm3). We used logistic regression models with CRP, GSP, or glucose concentrations as the predictors. We adjusted for age, sex, body mass index (BMI), and Physical Activity Scale for the Elderly (PASE) scores. Results We included 343 participants: mean age = 59 ± 9 years, BMI = 27.9 ± 4.5 kg/m2, PASE score = 171 ± 82, and 64% female. Only CRP was associated with BML prevalence (odds ratio [OR] = 1.43, 95% confidence interval [CI] = 1.09 to 1.87). For effusion, we found an interaction between BMI and CRP: only among adults with a BMI <25 kg/m2 was there a significant trend towards a positive association between CRP and effusion (OR = 1.40, 95% CI = 1.00 to 1.97). We detected a U-shaped relationship between GSP and effusion prevalence. Fasting glucose levels were not significantly associated with the presence of baseline effusion or BML. Conclusions Among individuals without knee OA, CRP may be related to the presence of BMLs and effusion among normal weight individuals. Abnormal GSP may be associated with effusion. Future studies should explore whether inflammation and glucose homeostasis are predictive of symptomatic knee OA.
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Affiliation(s)
- Alina C Stout
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Fatimah Al-Eid
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box #63, Boston, MA, 02111, USA.,Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA
| | - Bing Lu
- Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, 2002 Holcombe Blvd, Houston, TX, 77030, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA
| | - Ming Zhang
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Jincheng Pang
- Department of Electrical Engineering, Tufts University, 161 College Avenue, Medford, MA, 02155, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
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25
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Park HM, Kim HJ, Lee B, Kwon M, Jung SM, Lee SW, Park YB, Song JJ. Decreased muscle mass is independently associated with knee pain in female patients with radiographically mild osteoarthritis: a nationwide cross-sectional study (KNHANES 2010-2011). Clin Rheumatol 2017; 37:1333-1340. [PMID: 29243057 DOI: 10.1007/s10067-017-3942-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/15/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022]
Abstract
To evaluate the association between muscle mass and knee pain in relation to radiographic severity of knee osteoarthritis. We consulted nationwide health examination and survey records collected from 2010 to 2011 and extracted data regarding female patients aged > 50 years and diagnosed with knee osteoarthritis. Radiographic severity was assessed on plain radiographs using the Kellgren-Lawrence system, whereas appendicular skeletal mass was obtained from dual-energy X-ray absorptiometry data. We performed multivariate logistic regression to evaluate the association between knee pain and muscle mass index (appendicular skeletal muscle mass divided by body weight in percentile) in patient groups stratified by radiographic severity of knee osteoarthritis. Among 17,476 participants of the national survey, 2013 female knee osteoarthritis patients were identified and stratified by radiographic severity (grade ≤ 1, n = 1136; grade 2, n = 240; grade 3, n = 379; and grade 4, n = 258). For mild osteoarthritis (Kellgren-Lawrence grade 2), muscle mass index was significantly lower in patients with knee pain than in those without knee pain (24.9 ± 3.9 vs 26.5 ± 6.3%, P = 0.023), whereas no such difference was noted for severe osteoarthritis (Kellgren-Lawrence grade > 2). After adjusting for clinical variables by multivariate logistic regression, decreased muscle mass index remained significantly associated with knee pain in patients with mild osteoarthritis but not in those with severe osteoarthritis (regression coefficient 0.915, 95% confidence interval 0.854-0.981, P = 0.012). Lower muscle mass may be a risk factor for knee pain in patients with radiographically mild knee osteoarthritis but not in those with radiographically severe osteoarthritis.
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Affiliation(s)
- Hee Min Park
- Department of Internal Medicine, Division of Rheumatology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Ho Jae Kim
- Department of Internal Medicine, Division of Rheumatology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Byeori Lee
- Department of Internal Medicine, Division of Rheumatology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Minkyoung Kwon
- Department of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine and Science, 4500 San Pablo Road, Jacksonville, Florida, 32224, USA
| | - Seung Min Jung
- Department of Internal Medicine, Division of Rheumatology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Sang-Won Lee
- Department of Internal Medicine, Division of Rheumatology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Yong-Beom Park
- Department of Internal Medicine, Division of Rheumatology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jason Jungsik Song
- Department of Internal Medicine, Division of Rheumatology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. .,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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26
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Keng A, Sayre EC, Guermazi A, Nicolaou S, Esdaile JM, Thorne A, Singer J, Kopec JA, Cibere J. Association of body mass index with knee cartilage damage in an asymptomatic population-based study. BMC Musculoskelet Disord 2017; 18:517. [PMID: 29221481 PMCID: PMC5723095 DOI: 10.1186/s12891-017-1884-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/29/2017] [Indexed: 01/09/2023] Open
Abstract
Background Cartilage changes are an important early finding of osteoarthritis (OA), which can exist even before symptoms. Our objective was to determine the prevalence of knee cartilage damage on magnetic resonance imaging (MRI) in an asymptomatic population-based cross-sectional study and to evaluate the association of body mass index (BMI) with cartilage damage. Methods Subjects, aged 40-79 years, without knee pain (n = 73) were recruited as a random population sample and assessed for BMI (kg/m2), including current BMI (measured), past BMI at age 25 (self-reported) and change in BMI. Knee cartilage was scored semi-quantitatively (grades 0-4) on MRI. In primary analysis, cartilage damage was defined as ≥2 (at least moderate) and in a secondary analysis as ≥3 (severe). We also conducted a sensitivity analysis by dichotomizing current BMI as <25 vs. ≥25. Logistic regression was used to evaluate the association of each BMI variable with prevalent MRI-detected cartilage damage, adjusted for age and sex. Results Of 73 subjects, knee cartilage damage ≥2 and ≥3 was present in 65.4% and 28.7%, respectively. The median current BMI was 26.1, median past BMI 21.6, and median change in BMI was a gain of 2.8. For cartilage damage ≥2, current BMI had a non-statistically significant OR of 1.65 per 5 units (95% CI 0.93-2.92). For cartilage damage ≥3, current BMI showed a trend towards statistical significance with an OR of 1.70 per 5 units (95% CI 0.99-2.92). Past BMI and change in BMI were not significantly associated with cartilage damage. Current BMI ≥ 25 was statistically significantly associated with cartilage damage ≥2 (OR 3.04 (95% CI 1.10-8.42)), but not for ≥3 (OR 2.63 (95% CI 0.86-8.03)). Conclusions MRI-detected knee cartilage damage was highly prevalent in this asymptomatic population-based cohort. We report a trend towards significance of BMI with cartilage damage severity. Subjects with abnormal current BMI (≥25) had a 3-fold increased odds of cartilage damage ≥2, compared to those with normal BMI. This study lends support towards the role of obesity in the pathogenesis of knee cartilage damage at an asymptomatic stage of disease.
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Affiliation(s)
- Alvin Keng
- University of Toronto, Toronto, ON, Canada
| | - Eric C Sayre
- Arthritis Research Centre of Canada, Richmond, BC, Canada
| | - Ali Guermazi
- Section of Musculoskeletal Imaging, Boston University Medical Center, Boston, MA, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Savvakis Nicolaou
- Vancouver General Hospital, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - John M Esdaile
- Arthritis Research Centre of Canada, Richmond, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anona Thorne
- Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Joel Singer
- Canadian HIV Trials Network, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jacek A Kopec
- Arthritis Research Centre of Canada, Richmond, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jolanda Cibere
- Arthritis Research Centre of Canada, Richmond, BC, Canada. .,Department of Medicine, University of British Columbia, Vancouver, BC, Canada. .,Arthritis Research Canada Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC, V6X2C7, Canada.
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Jeanmaire C, Mazières B, Verrouil E, Bernard L, Guillemin F, Rat AC. Body composition and clinical symptoms in patients with hip or knee osteoarthritis: Results from the KHOALA cohort. Semin Arthritis Rheum 2017; 47:797-804. [PMID: 29224976 DOI: 10.1016/j.semarthrit.2017.10.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 09/26/2017] [Accepted: 10/17/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To analyze the associations between body composition, notably low lean mass, and clinical symptoms [pain, physical function, quality of life (QoL)] in patients with symptomatic hip and/or knee OA. METHODS Cross-sectional study using data from the 3-year follow-up visit of the Knee and Hip OsteoArthritis Long-term assessment (KHOALA) cohort. Skeletal muscle and fat mass were measured by dual X-ray absorptiometry (DXA). Fat mass index (FMI) was defined as total fat mass/height2. Appendicular lean mass was adjusted on body mass index (ALM/BMI), and low lean mass was defined according to the definition of FNIH Sarcopenia Project recommendations. Pain and function were measured by the WOMAC index and QoL by the SF-36. RESULTS In total, 358 patients underwent DXA (67% women, mean [SD] age 63.4 [8.4] years, mean BMI 29.5 [5.6]kg/m2). The visual analog scale (0-100) pain score was 38.0 [24.7] and 25.4% had hip and 74.6% knee OA. Low lean mass and ALM/BMI were associated with impaired QoL and WOMAC scores on bivariate analysis (all p ≤ 0.001) but not on multivariate analysis after adjustment for FMI. For patients with normal BMI, mean [SD] WOMAC scores were higher (greater impairment) with low lean mass than normal body composition (WOMAC function 33.4 [23.3] and 24.0 [17.4], p = 0.02), and mean SF-36 physical component score was lower (greater impairment) 40.3 [10.2] and (44.3 [8.4], p = 0.04). Among patients with obesity, low lean mass had no additional effect. CONCLUSION For patients with OA and normal BMI, QoL and function were more impaired for those with than without low lean mass. Conserving muscle mass in people with OA could have functional and antalgic benefits especially for those with normal BMI.
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Affiliation(s)
| | | | | | - Lorraine Bernard
- INSERM, CHRU Nancy, CIC 1433 Epidémiologie clinique, Nancy, F-54000, France
| | - Francis Guillemin
- INSERM, CHRU Nancy, CIC 1433 Epidémiologie clinique, Nancy, F-54000, France; Université de lorraine, EA 4360 Apemac, F-54500, Nancy, France
| | - Anne-Christine Rat
- CHRU Nancy, Rheumatology Department, F-54500, Nancy, France; Université de lorraine, EA 4360 Apemac, F-54500, Nancy, France.
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Neves AG, Kasawara KT, Godoy-Miranda AC, Oshika FH, Chaim EA, Surita FG. Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study. Clinics (Sao Paulo) 2017; 72:547-553. [PMID: 29069258 PMCID: PMC5629704 DOI: 10.6061/clinics/2017(09)05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/07/2017] [Accepted: 06/30/2017] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age. METHODS We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals. RESULTS Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity. CONCLUSIONS Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.
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Affiliation(s)
- Amanda Gonçalves Neves
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas – UNICAMP, Campinas, SP, BR
| | - Karina Tamy Kasawara
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas – UNICAMP, Campinas, SP, BR
| | - Ana Carolina Godoy-Miranda
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas – UNICAMP, Campinas, SP, BR
| | - Flávio Hideki Oshika
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas – UNICAMP, Campinas, SP, BR
| | - Elinton Adami Chaim
- Departamento de Cirurgia, Faculdade de Medicina, Universidade de Campinas, Campinas, SP, BR
| | - Fernanda Garanhani Surita
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas – UNICAMP, Campinas, SP, BR
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29
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Yousef AI, Akhtyamov IF. ARTHROPLASTY FEATURES IN OVERWEIGHT PATIENTS (REVIEW). TRAUMATOLOGY AND ORTHOPEDICS OF RUSSIA 2017. [DOI: 10.21823/2311-2905-2017-23-2-115-123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Gaunt T, Carey F, Cahir J, Toms A. Fluid signal changes around the knee on MRI are associated with increased volumes of subcutaneous fat: a case-control study. BMC Musculoskelet Disord 2016; 17:487. [PMID: 27881111 PMCID: PMC5121968 DOI: 10.1186/s12891-016-1345-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/18/2016] [Indexed: 11/12/2022] Open
Abstract
Background Fluid in the subcutaneous fat is a common finding anterior to the knee on MRI. This may be caused by chronic low-grade shearing injuries in patients who are overweight. The purpose of this study was to determine if there is a difference in the amount of subcutaneous fat around the knee between patients with these appearances and controls. Methods This was a retrospective case-control study. Following a sample size calculation on pilot data, eighteen sequential patients demonstrating hyper-intense subcutaneous signal changes around the knee on fat-saturated T2-weighted MRI were identified from PACS (18 females, mean age 45, range 31–62). Age and gender-matched patients without abnormal T2 MR signal changes were selected. Two observers independently drew regions of interest representing cross-sectional areas of bone and fat. The location of T2 signal hyper-intense lesions was characterized by consensus. Results Inter and intra-rater intraclass reproducibility was “excellent” (ICC > 0.8). The mean cross-sectional area of bone for patients with T2 hyper-intense lesions was 31.79cm2 (SD 2.57) and for controls 30.11cm2 (SD 3.20) which was not significantly different (p = 0.09). The median cross-sectional area of fat for the study group was 62.29cm2 (IQR 57.1–66.5) and for controls was 32.77cm2 (IQR 24.8–32.3) which was significantly different (p < 0.0001). Consensus agreement demonstrated all T2 hyper-intense lesions were anterior to the knee extensor mechanism. Conclusion Subcutaneous fluid around the knee is associated with an increased amount of subcutaneous fat, anterior to the knee extensor mechanism. This may be caused by shearing injuries in fat with reduced elasticity associated with metabolic syndrome.
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Affiliation(s)
- Trevor Gaunt
- Norwich Radiology Academy, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UB, UK.
| | - Frank Carey
- Norwich Radiology Academy, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UB, UK
| | - John Cahir
- Norwich Radiology Academy, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UB, UK
| | - Andoni Toms
- Norwich Radiology Academy, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UB, UK
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Mitra S, Fernandez-Del-Valle M, Hill JE. The role of MRI in understanding the underlying mechanisms in obesity associated diseases. Biochim Biophys Acta Mol Basis Dis 2016; 1863:1115-1131. [PMID: 27639834 DOI: 10.1016/j.bbadis.2016.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
Obesity and its possible association with diseases including diabetes and cardiovascular diseases have been studied for decades for its impact on healthcare. Recent studies clearly indicate the need for developing accurate and reproducible methodologies for assessing body fat content and distribution. Body fat distribution plays a significant role in developing an insight in the underlying mechanisms in which adipose tissue is linked with various diseases. Among imaging technologies including computerized axial tomography (CAT or CT), magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS), MRI and MRS seem to be the best emerging techniques and together are being considered as the gold standard for body fat content and distribution. This paper reviews studies up to the present time involving different methodologies of these two emerging technologies and presents the basic concepts of MRI and MRS with required novel image analysis techniques in accurate, quantitative, and direct assessment of body fat content and distribution. This article is part of a Special Issue entitled: Oxidative Stress and Mitochondrial Quality in Diabetes/Obesity and Critical Illness Spectrum of Diseases - edited by P. Hemachandra Reddy.
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Affiliation(s)
| | | | - Jason E Hill
- Texas Tech University, Lubbock, TX, United States
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Laskarin G, Persic V, Kukic SR, Massari D, Legovic A, Boban M, Miskulin R, Rogoznica M, Kehler T. Can pain intensity in osteoarthritis joint be indicator of the impairment of endothelial function? Med Hypotheses 2016; 94:15-9. [DOI: 10.1016/j.mehy.2016.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
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Antony B, Venn A, Cicuttini F, March L, Blizzard L, Dwyer T, Cross M, Jones G, Ding C. Association of Body Composition and Hormonal and Inflammatory Factors With Tibial Cartilage Volume and Sex Difference in Cartilage Volume in Young Adults. Arthritis Care Res (Hoboken) 2016; 68:517-25. [PMID: 26386243 DOI: 10.1002/acr.22715] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 08/11/2015] [Accepted: 08/18/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe the associations between body composition and hormonal and inflammatory factors measured 5 years prior and tibial cartilage volume in young adults, and to explore if these factors contribute to the sex difference in tibial cartilage volume. METHODS Subjects broadly representative of the young adult Australian population (n = 328, ages 31-41 years, 47.3% women) were selected. They underwent T1-weighted fat-suppressed magnetic resonance imaging (MRI) of their knees. Tibial cartilage volume was measured from MRI. Sex hormone binding globulin (SHBG) and testosterone in a subset of women and C-reactive protein (CRP) level and fibrinogen in both sexes were measured 5 years prior. Body mass index (BMI), fat mass, and lean mass were calculated from height, weight, and skinfolds. RESULTS In multivariable analyses, correlates of tibial cartilage volume included lean body mass (β = 26.4 mm(3) ; 95% confidence interval [95% CI] 13.6, 39.1), fat mass (β = -11.8 mm(3) ; 95% CI -22.2, -1.4), and fibrinogen (β = -146.4 mm(3) ; 95% CI -276.4, -16.4), but not BMI, testosterone, or CRP level. In women, SHBG was positively associated with tibial cartilage volume (β = 0.67 mm(3) ; 95% CI 0.14, 1.20) and Free Androgen Index was negatively associated with lateral tibial cartilage volume (β = -0.04 mm(3) ; 95% CI -0.07, 0.00). Men had 13% more tibial cartilage volume (500 mm(3) ) than women. The magnitude of this association decreased by 38%, 20%, and 37% after adjustment for lean body mass, fat mass, and fibrinogen, respectively. CONCLUSION Body composition, sex hormones, and fibrinogen correlate with knee cartilage volume in young adult life. Sex difference in knee cartilage volume is contributed largely by variations in body composition and/or fibrinogen.
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Affiliation(s)
- Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Lyn March
- Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Terence Dwyer
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Marita Cross
- Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, Tasmania, Hobart, Australia, and Monash University, Melbourne, Australia
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Kulkarni K, Karssiens T, Kumar V, Pandit H. Obesity and osteoarthritis. Maturitas 2016; 89:22-8. [DOI: 10.1016/j.maturitas.2016.04.006] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/08/2016] [Indexed: 01/23/2023]
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Teichtahl AJ, Urquhart DM, Wang Y, Wluka AE, O'Sullivan R, Jones G, Cicuttini FM. Modic changes in the lumbar spine and their association with body composition, fat distribution and intervertebral disc height - a 3.0 T-MRI study. BMC Musculoskelet Disord 2016; 17:92. [PMID: 26891686 PMCID: PMC4759726 DOI: 10.1186/s12891-016-0934-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vertebral endplate (Modic) abnormalities are important structural lesions in the spine, but their association with body composition and fat distribution have not been examined. Moreover, no study has examined whether Modic change are related to other structural features of low back pain, such as reduced intervertebral disc height. METHODS Seventy-two community-based individuals not selected for low back pain had lumbar vertebral Modic change and intervertebral disc height assessed from MRI. Dual energy x-ray absorptiometry measured body composition and fat distribution. RESULTS The predominance of Modic change was type 2. Modic change was associated with an increased fat mass index (OR 1.20, 95 % CI 1.01 to 1.43), and tended to be associated with a reduced fat-free mass index (OR 0.62, 95 % CI 0.37 to 1.03, p = 0.07). While an increased percentage of gynoid fat was associated with a reduced risk (OR 0.62, 95 % CI 0.43 to 0.89), an increased percentage of android fat was associated with an increased risk of Modic change (OR 2.11, 95 % CI 1.18 to 3.76). Modic change was also associated with reduced intervertebral disc height at L2/3, L4/5 and L5/S1 (OR range 1.4 to 1.8; all p ≤ 0.03). CONCLUSION Modic type 2 change is associated with reduced intervertebral disc height and an increased fat mass index. Whereas gynoid fat distribution protected against Modic type 2 change, an android pattern increased the risk of this lesion. Modic type 2 change, which histologically represent fat replacement, might have a metabolic component to its aetiology.
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Affiliation(s)
- Andrew J Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. .,Baker IDI Heart and Diabetes Institute, Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia.
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia.
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia.
| | - Richard O'Sullivan
- Healthcare Imaging Services, Epworth Hospital, Richmond, Melbourne, VIC, 3121, Australia. richard.o'.,Department of Medicine, Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia. richard.o'
| | - Graeme Jones
- Menzies Research Institute, Private bag 23, Hobart, TAS, 7000, Australia.
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia.
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Antony B, Venn A, Cicuttini F, March L, Blizzard L, Dwyer T, Halliday A, Cross M, Jones G, Ding C. Correlates of knee bone marrow lesions in younger adults. Arthritis Res Ther 2016; 18:31. [PMID: 26817452 PMCID: PMC4730612 DOI: 10.1186/s13075-016-0938-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 01/19/2016] [Indexed: 01/19/2023] Open
Abstract
Background Subchondral bone marrow lesions (BMLs) play a key role in the pathogenesis of osteoarthritis (OA) and are associated with pain and structural progression in knee OA. However, little is known about clinical significance and determinants of BMLs of the knee joint in younger adults. We aimed to describe the prevalence and environmental (physical activity), structural (cartilage defects, meniscal lesions) and clinical (pain, stiffness, physical dysfunction) correlates of BMLs in younger adults and to determine whether cholesterol levels measured 5 years prior were associated with current BMLs in young adults. Methods Subjects broadly representative of the Australian young adult population (n = 328, aged 31–41 years, female 48.7 %) underwent T1- and proton density-weighted fat-suppressed magnetic resonance imaging (MRI) in their dominant knee. BMLs, cartilage defects, meniscal lesions and cartilage volume were measured. Knee pain was assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Cholesterol levels including high-density lipoprotein (HDL) were assessed 5 years prior to MRI. Results The overall prevalence of BML was 17 % (grade 1: 10.7 %, grade 2: 4.3 %, grade 3: 1.8 %). BML was positively associated with increasing age and previous knee injury but not body mass index. Moderate physical activity (prevalence ratio (PR):0.93, 95 % CI: 0.87, 0.99) and HDL cholesterol (PR:0.36, 95 % CI: 0.15, 0.87) were negatively associated with BML, while vigorous activity (PR:1.02, 95 % CI: 1.01, 1.03) was positively associated with medial tibiofemoral BMLs. BMLs were associated with more severe total WOMAC knee pain (>5 vs ≤5, PR:1.05, 95 % CI: 1.02, 1.09) and WOMAC dysfunction (PR:1.75, 95 % CI: 1.07, 2.89), total knee cartilage defects (PR:2.65, 95 % CI: 1.47, 4.80) and total meniscal lesion score (PR:1.92, 95 % CI: 1.13, 3.28). Conclusions BMLs in young adults are associated with knee symptoms and knee structural lesions. Moderate physical activity and HDL cholesterol are beneficially associated with BMLs; in contrast, vigorous physical activity is weakly but positively associated with medial tibiofemoral BMLs. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-0938-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS 7000, Australia.
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS 7000, Australia.
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Lyn March
- Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS 7000, Australia.
| | - Terence Dwyer
- Murdoch Children's Research Institute, 50 Flemington Road, Melbourne, VIC, 3052, Australia.
| | - Andrew Halliday
- Department of Radiology, Royal Hobart Hospital, 48 Liverpool Street, Hobart, TAS, 7000, Australia.
| | - Marita Cross
- Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS 7000, Australia.
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS 7000, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
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Beckwée D, Vaes P, Shahabpour M, Muyldermans R, Rommers N, Bautmans I. The Influence of Joint Loading on Bone Marrow Lesions in the Knee: A Systematic Review With Meta-analysis. Am J Sports Med 2015; 43:3093-107. [PMID: 25634907 DOI: 10.1177/0363546514565092] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Bone marrow lesions (BMLs) are considered as predictors of pain, disability, and structural progression of knee osteoarthritis. The relationship between knee loading and BMLs is not yet completely understood. PURPOSE To summarize the available evidence regarding the relationship between joint loading and the prevalence and progression of BMLs in the tibiofemoral joint. STUDY DESIGN Meta-analysis. METHODS Three databases (PubMed, Web of Science, and The Cochrane Library) were systematically screened for studies encompassing BMLs and changes in knee loading. A methodological quality assessment was conducted, and a meta-analysis computing overall odds ratios (ORs) was performed where possible. RESULTS A total of 29 studies involving 7641 participants were included. Mechanical loading was categorized as body weight and composition, compartmental load, structural lesion, and physical activity. High compartmental loads and structural lesions increased the risk for BMLs (overall ORs ranging from 1.56 [95% CI, 1.13-2.15] to 8.2 [95% CI, 4.4-15.1]; P = .006). Body weight increased the risk for BMLs to a lesser extent (overall OR, 1.03; 95% CI, 1.01-1.05; P = .007). Contradictory results for the effect of physical activity on BMLs were found. CONCLUSION Augmented compartmental loads and structural lesions increased the risk of the presence or progression of BMLs. Body weight increased the risk for BMLs to a lesser extent. Contradictory results for the effect of physical activity on BMLs may be explained by a dose-response relationship, knee alignment, and structural lesions. CLINICAL RELEVANCE It has been shown that unloading the knee temporarily may induce beneficial effects on osteoarthritis-related structural changes. Therefore, an early recognition of BMLs in the aging athlete's knee may provide information to counter the onset and aggravation of symptomatic knee osteoarthritis by reducing the knee load.
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Affiliation(s)
- David Beckwée
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Vaes
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maryam Shahabpour
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ronald Muyldermans
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nikki Rommers
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ivan Bautmans
- Department of Frailty in Ageing Research, Vrije Universiteit Brussel, Brussels, Belgium
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Iizuka Y, Iizuka H, Mieda T, Tajika T, Yamamoto A, Ohsawa T, Sasaki T, Takagishi K. Association between neck and shoulder pain, back pain, low back pain and body composition parameters among the Japanese general population. BMC Musculoskelet Disord 2015; 16:333. [PMID: 26537689 PMCID: PMC4634147 DOI: 10.1186/s12891-015-0759-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/07/2015] [Indexed: 12/22/2022] Open
Abstract
Background Neck and shoulder pain, back pain and low back pain are common symptoms in Japanese subjects, and it is important to elucidate the pathology and associated factors of these pains due to their frequency and impact on the quality of life (QOL) and activities of daily living (ADL). The purpose of the present study was to investigate whether body composition is associated with these pains. Methods We collected the data of 273 Japanese subjects regarding the presence and the visual analogue scale (VAS) of neck and shoulder pain, back pain, low back pain and body composition parameters calculated using bioelectrical impedance analysis (BIA) technology. Furthermore, we investigated the association between these pains and the body composition using statistical methods. Results According to a multivariate analysis adjusted for age and gender, lower total body water ratio was significantly associated with the presence of neck and shoulder pain at present (P < 0.05); additionally, total body muscle mass (standardized β = −0.26, 95 % CI, −0.17 - -0.008, P < 0.05), total body water (standardized β = −0.27, 95 % CI, −0.23 - -0.04, P < 0.01), appendicular muscle mass (standardized β = −0.29, 95 % CI, −0.36 - -0.04, P < 0.05), and the appendicular muscle mass index (AMI) (standardized β = −0.24, 95 % CI, −1.18 - -0.20, P <0.01) were negatively correlated with the VAS of neck and shoulder pain, whereas no body composition parameters were significantly associated with back pain, low back pain at present and any type of chronic pain. Conclusions The present study demonstrated that some body composition parameters regarding body water and body muscle were associated or correlated with the presence or intensity of neck and shoulder pain.
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Affiliation(s)
- Yoichi Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Haku Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Tokue Mieda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Atsushi Yamamoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Takashi Ohsawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Tsuyoshi Sasaki
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Kenji Takagishi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
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Ertürk C, Altay MA, Sert C, Levent A, Yaptı M, Yüce K. The body composition of patients with knee osteoarthritis: relationship with clinical parameters and radiographic severity. Aging Clin Exp Res 2015; 27:673-9. [PMID: 25682213 DOI: 10.1007/s40520-015-0325-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 01/24/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS We investigated body composition in knee osteoarthritis (OA) patients and evaluated its relationship with clinical parameters and radiographic severity. METHODS Sixty-four patients with knee OA (52 females and 12 males with a mean age of 57.7 ± 8.6 years) and thirty healthy volunteers (20 females and 10 males with a mean age of 56.3 ± 9.5 years) were evaluated. Controls were selected among similar to demographic and hematologic characteristics of patients. Body compositions were assessed via bioelectrical impedance analysis (BIA). Each patient was clinically evaluated by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). In addition, radiographic severity was classified according to Kellgren-Lawrence's criteria. RESULTS Phase angle, body capacitance, resistance, reactance, lean body mass, and intracellular water values of the patients with knee OA were found to be significantly lower than those of the controls (p < 0.05). Furthermore, fat mass and extracellular water levels were significantly higher in the patients compared to the controls (p < 0.05). Lean body mass was inversely correlated with WOMAC score (r = -0.716, p < 0.001), whereas fat mass was moderately correlated with WOMAC score (r = 0.281, p < 0.05) in bivariate analysis. However, with respect to the body composition, there was no significant difference between early grades and late grades in the knee OA with patients (p > 0.05). CONCLUSION Body composition assessed using BIA might be associated with knee OA, and be a noninvasive tool for diagnosis of knee OA. However, body composition may not be predictive of the progression of knee OA.
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Affiliation(s)
- Cemil Ertürk
- Department of Orthopaedic Surgery, Harran University Faculty of Medicine, Yenisehir, 63100, Sanliurfa, Turkey.
| | - Mehmet Akif Altay
- Department of Orthopaedic Surgery, Harran University Faculty of Medicine, Yenisehir, 63100, Sanliurfa, Turkey
| | - Cemil Sert
- Department of Biophysics, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Ali Levent
- Department of Orthopaedic Surgery, Harran University Faculty of Medicine, Yenisehir, 63100, Sanliurfa, Turkey
| | - Metin Yaptı
- Department of Orthopaedic Surgery, Harran University Faculty of Medicine, Yenisehir, 63100, Sanliurfa, Turkey
| | - Kemal Yüce
- Department of Orthopaedic Surgery, Harran University Faculty of Medicine, Yenisehir, 63100, Sanliurfa, Turkey
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Brady SR, Mamuaya BB, Cicuttini F, Wluka AE, Wang Y, Hussain SM, Urquhart DM. Body Composition Is Associated With Multisite Lower Body Musculoskeletal Pain in a Community-Based Study. THE JOURNAL OF PAIN 2015; 16:700-6. [DOI: 10.1016/j.jpain.2015.04.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 03/19/2015] [Accepted: 04/17/2015] [Indexed: 12/23/2022]
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King LK, Henneicke H, Seibel MJ, March L, Anandacoomarasmy A. Association of adipokines and joint biomarkers with cartilage-modifying effects of weight loss in obese subjects. Osteoarthritis Cartilage 2015; 23:397-404. [PMID: 25481288 DOI: 10.1016/j.joca.2014.11.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 11/14/2014] [Accepted: 11/25/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To determine (1) the effects of weight loss in obese subjects on six adipokines and joint biomarkers; and (2) the relationship between changes in these markers with changes in cartilage outcomes. DESIGN Plasma levels of adiponectin, leptin, IL-6, COMP, MMP-3 and urine levels of CTX-II were measured at baseline and 12 months from 75 obese subjects enrolled in two weight-loss programs. Magnetic resonance imaging (MRI) was used to assess cartilage volume and thickness. Associations between weight loss, cartilage outcomes and markers were adjusted for age, gender, baseline BMI, presence of clinical knee OA, with and without weight loss percent. RESULTS Mean weight loss was 13.0 ± 9.5%. Greater weight loss percentage was associated with an increase in adiponectin (β = 0.019, 95% CI 0.012 to 0.026,) and a decrease in leptin (β = -1.09, 95% CI -1.37 to -0.82). Multiple regression analysis saw an increase in adiponectin associated with reduced loss of medial tibial cartilage volume (β = 14.4, CI 2.6 to 26.3) and medial femoral cartilage volume (β = 18.1, 95% CI 4.4 to 31.8). Decrease in leptin was associated with reduced loss of medial femoral volume (β = -4.1, 95% CI -6.8 to -1.4) and lateral femoral volume (β = -1.8, 95% CI -3.7 to 0.0). When weight loss percent was included in the model, only the relationships between COMP and cartilage volume remained statistically significant. CONCLUSIONS Adiponectin and leptin may be associated with cartilage loss. Further work will determine the relative contributions of metabolic and mechanical factors in the obesity-related joint changes.
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Affiliation(s)
- L K King
- Sydney Medical School, The University of Sydney, Australia.
| | - H Henneicke
- Bone Research Program, ANZAC Research Institute, The University of Sydney, Australia.
| | - M J Seibel
- Bone Research Program, ANZAC Research Institute, The University of Sydney, Australia.
| | - L March
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney, Australia; Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia.
| | - A Anandacoomarasmy
- Sydney Medical School, The University of Sydney, Australia; Department of Rheumatology, Concord Hospital, Sydney, Australia.
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Wang X, Hunter D, Xu J, Ding C. Metabolic triggered inflammation in osteoarthritis. Osteoarthritis Cartilage 2015; 23:22-30. [PMID: 25452156 DOI: 10.1016/j.joca.2014.10.002] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/23/2014] [Accepted: 10/06/2014] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is a common chronic joint disorder with a multifactorial etiology including genetic and environmental factors. Metabolic triggered inflammation, induced by nutrient overload and metabolic surplus, consists of components such as obesity, pro-inflammatory cytokines and adipokines, abnormal metabolites, acute phase proteins, vitamin D deficiency, and deregulated microRNAs that may play a role in OA pathophysiology. Obesity-related metabolic factors, especially adipokines, contribute to OA development by inducing pro-inflammatory cytokines and degradative enzymes, leading to cartilage matrix impairment and subchondral bone remodeling. Ectopic metabolite deposition and low-grade systemic inflammation can contribute to a toxic internal environment that exacerbates OA. Complement components highly expressed in osteoarthritic joints have also been proposed as causative factors. Vitamin D deficiency has been associated with obesity and is implicated to be associated with cartilage loss in OA. Metabolic microRNAs may explain the inflammatory link between obesity and OA. Therapies targeting metabolic-triggered inflammation and its components are anticipated to have potential for the treatment of OA.
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Affiliation(s)
- X Wang
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - D Hunter
- Institute of Bone and Joint Research, Kolling Institute and Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia
| | - J Xu
- Department of Rheumatology and Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, China
| | - C Ding
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia; Institute of Bone and Joint Research, Kolling Institute and Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia; Department of Rheumatology and Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, China.
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Amorim MR, Fonseca SFD, Arrieiro AN, Gomes WF, Lacerda ACR. Evaluation of clinical and radiographic measures and reliability of the quadriceps angle measurement in elderly women with knee osteoarthritis. FISIOTERAPIA EM MOVIMENTO 2014. [DOI: 10.1590/0103-5150.027.004.ao08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction Knees osteoarthritis (OA) is a complex degenerative disease with intra-articular changes affecting the amplitude of the quadriceps angle (Q). To measure this variable, it is necessary to use reliable protocols aiming at methodological reproducibility. The objective was to evaluate the intra-examiner and inter-examiner reliability of clinical and radiographic measures of the Q angle and to investigate the relationship between the degree of OA and the magnitude of this angle in the elderly. Materials and methods 23 volunteers had the Q angle measured by two evaluators at 48-h interval. Clinical measurements were collected by using the universal goniometer in the same position adopted in the radiographic examination. Results The intra-examiner reliability was good (0.722 to 0.763) for radiographic measurements and low (0.518 to 0.574) for clinical assessment, while inter-examiner reliability was moderate (0.634) for radiographic measurements and low (0.499) to the clinics. The correlation analysis between the radiographic values with the OA classification showed no correlation between them (p = 0.824 and r = -0.024). Conclusion Clinically, it is suggested that the radiographic examination is preferable to evaluate the Q angle of elderly women with knee osteoarthritis. Moreover, the magnitude of this angle did not correlate with the degree of impairment of OA in this population.
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Serebrakian AT, Poulos T, Liebl H, Joseph GB, Lai A, Nevitt MC, Lynch JA, McCulloch CE, Link TM. Weight loss over 48 months is associated with reduced progression of cartilage T2 relaxation time values: data from the osteoarthritis initiative. J Magn Reson Imaging 2014; 41:1272-1280. [PMID: 24700497 DOI: 10.1002/jmri.24630] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 02/20/2014] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess whether changes in knee cartilage MR-based T2 relaxation times are associated with weight loss in individuals with risk factors for knee osteoarthritis (OA) compared with controls with stable weight. MATERIALS AND METHODS One hundred twenty-seven individuals with risk factors for knee OA were studied: 62 subjects had a body mass index (BMI) decrease≥10% over 48 months and 65 controls had a BMI change <3%. Cartilage segmentation from five knee compartments at baseline and 48-month follow-up was performed, and T2 maps were generated. The association of change in T2 values over 48 months in the weight-loss group versus the control group was assessed using multiple linear regression models. RESULTS Weight loss was associated with significantly smaller increases in cartilage T2 in the medial femoral condyle (P = 0.035) and overall medial compartment (P = 0.006) compared with the controls. In a subgroup analysis comparing weight-loss subjects who were obese (BMI≥30 kg/m(2) ) and overweight (BMI 25-30 kg/m(2) ) at baseline, obesity was associated with smaller increases in cartilage T2 values in the medial femoral condyle (P = 0.022), lateral femoral condyle (P = 0.015), patella (P = 0.002), and globally across all compartments (P = 0.002). CONCLUSION A decrease in BMI of ≥ 10% was associated with a slower progression of T2 values in individuals with risk factors for OA, suggesting a beneficial impact of weight loss on cartilage matrix degeneration.
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Affiliation(s)
- Arman T Serebrakian
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Theresa Poulos
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Hans Liebl
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Gabby B Joseph
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Andrew Lai
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Thomas M Link
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
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Fillipas S, Tanamas SK, Davies-Tuck ML, Wluka AE, Wang Y, Holland AE, Cherry CL, Cicuttini F. The relationship between body composition and knee structure in patients with human immunodeficiency virus. Int J STD AIDS 2014; 26:133-8. [PMID: 24700199 DOI: 10.1177/0956462414531404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity is a risk factor for osteoarthritis. Antiretroviral therapy (ART)-treated HIV-infected patients are frequently affected by overweight and obesity, and may be at increased risk of osteoarthritis. BMI however is a measure which does not discriminate adipose from non-adipose body mass, or fat distribution, which may have different effects. This study aimed to examine relationships between body composition and knee cartilage volume, as assessed by magnetic resonance imaging in HIV infection. 35 ART-treated HIV-infected men aged 51.7 years (mean) 7.9 (SD) and 18 healthy men aged 49.5 years (mean) 6.4 (SD) participated. Cartilage volume was measured on magnetic resonance imaging of the dominant knee using validated methods. Body composition was measured using dual x-ray absorptiometry. HIV-infected participants had less total body and gynoid fat (kg) (p = 0.04 and p = 0.007, respectively) and more percent android fat mass and percent trunk fat mass (p = 0.001 and p < 0.001, respectively) than controls. In HIV-infected participants there was an inverse association between total body fat mass and average tibial cartilage volume (R = -8.01, 95% CI -15.66, -0.36). Also, in HIV-infected participants there was an inverse association between android fat mass and average cartilage volume (R = -90.91, 95% CI -158.66, -23.16). This preliminary study found that both total body and android fat mass were inversely related to average knee cartilage volume in ambulant, ART-treated HIV-infected adults. These findings are features of early knee osteoarthritis and this may be of future significance in HIV.
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Affiliation(s)
- S Fillipas
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia Alfred Hospital, Melbourne, Australia
| | - S K Tanamas
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - M L Davies-Tuck
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - A E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Y Wang
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - A E Holland
- Alfred Hospital, Melbourne, Australia La Trobe University, Bundoora, VIC, Australia
| | - C L Cherry
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia Alfred Hospital, Melbourne, Australia Burnet Institute, Melbourne, VIC, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia Alfred Hospital, Melbourne, Australia
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Mezhov V, Ciccutini FM, Hanna FS, Brennan SL, Wang YY, Urquhart DM, Wluka AE. Does obesity affect knee cartilage? A systematic review of magnetic resonance imaging data. Obes Rev 2014; 15:143-57. [PMID: 24118701 DOI: 10.1111/obr.12110] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/21/2013] [Accepted: 08/22/2013] [Indexed: 12/17/2022]
Abstract
There is increasing evidence for the effect of obesity on knee osteoarthritis (OA), although the association between obesity, particularly body composition, and knee osteoarthritis, using magnetic resonance imaging (MRI) to examine knee structure, has not been examined. We systematically evaluated the evidence for the relationship between obesity and knee cartilage assessed by MRI. We performed an electronic search of MEDLINE and EMBASE up to December 2012. Included studies investigated the association between obesity and the development and/or progression of knee cartilage changes using MRI. The studies were ranked according to their methodological score and best-evidence synthesis was performed to summarize the results Twenty-two studies were identified for inclusion, of which 7 were cross-sectional, 13 were longitudinal and 2 had both cross-sectional and longitudinal components. Seven cross-sectional and eight longitudinal studies were of high quality. Best-evidence synthesis showed consistent, yet limited evidence for a detrimental effect of body mass index (BMI) and fat mass on knee cartilage. This review identified a consistent detrimental effect of obesity, particularly related to elevated BMI and fat mass on cartilage defects. The strength of evidence was limited by the paucity of high-quality cohort studies examining this question. By further examining the mechanisms for these different effects, new strategies can be developed to prevent and treat knee OA.
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Affiliation(s)
- V Mezhov
- School of Rural Health, Monash University, Melbourne, Australia
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The role of fat mass and skeletal muscle mass in knee osteoarthritis is different for men and women: the NEO study. Osteoarthritis Cartilage 2014; 22:197-202. [PMID: 24333295 DOI: 10.1016/j.joca.2013.12.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 11/18/2013] [Accepted: 12/02/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate if the amount of fat mass (FM) or skeletal muscle mass (SMM) is more strongly associated with knee osteoarthritis (OA), in both men and women. METHODS The Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort aged 45-65 years, including 5313 participants (53% female, median body mass index (BMI) 29.9 kg/m(2)). FM (kg), fat percentage, SMM (kg) and skeletal muscle (SM) percentage were estimated using bioelectrical impedance analysis (BIA). Clinical OA was defined following the ACR criteria. Structural OA was defined based on magnetic resonance imaging (MRI) in 1142 participants. Logistic regression analyses were used to examine the associations of all body composition measures with clinical and structural knee OA per standard deviation (SD), stratified by sex and adjusted for age and height. RESULTS Clinical or structural OA was present in 25% and 14% of women and 12% and 13% of men, respectively. FM and fat percentage were positively associated with clinical knee OA in men and women. SMM was positively associated, while the SM percentage was negatively associated with clinical OA in both men and women. The FM/SMM ratio was positively associated with clinical OA. All determinants showed even stronger ORs for structural knee OA. In men, SMM was more strongly associated with knee OA as compared to FM whereas in women, FM was most strongly associated. CONCLUSION Especially a high FM/SMM ratio seems to be unfavorable in knee OA. In men, SMM is most strongly associated with knee OA whereas in women FM seems to be of most importance.
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48
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Salih S, Sutton P. Obesity, knee osteoarthritis and knee arthroplasty: a review. Sports Med Arthrosc Rehabil Ther Technol 2013; 5:25. [PMID: 24304704 PMCID: PMC3879025 DOI: 10.1186/2052-1847-5-25] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 11/24/2013] [Indexed: 12/22/2022]
Abstract
The incidence of obesity is rising worldwide. Obesity is a risk factor for developing osteoarthritis in the knee. Obesity and knee osteoarthritis are independently disabling conditions and in combination pose difficult therapeutic challenges. This review will discuss obesity, osteoarthritis, and the problems associated with knee osteoarthritis in an obese population. Treatment options including surgery and its success will be discussed.
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Affiliation(s)
- Saif Salih
- Department of Trauma and Orthopaedics, Northern General Hospital, Herries Rd, Sheffield S5 7 AU, UK.
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49
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Lim YZ, Wang Y, Wluka AE, Davies-Tuck ML, Hanna F, Urquhart DM, Cicuttini FM. Association of obesity and systemic factors with bone marrow lesions at the knee: a systematic review. Semin Arthritis Rheum 2013; 43:600-12. [PMID: 24287353 DOI: 10.1016/j.semarthrit.2013.10.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/17/2013] [Accepted: 10/22/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective of this study was to systematically review the literature to determine whether obesity and systemic factors, including age, gender, heritability, dietary factors, smoking, serum and urine biomarkers of cartilage or bone metabolism, bone-related factors, and medication, are associated with knee bone marrow lesions (BMLs) identified on magnetic resonance imaging in asymptomatic pre-osteoarthritis and osteoarthritis populations. METHODS Electronic searches of MEDLINE and EMBASE were performed from January 1, 1996 to September 30, 2012 using the following keywords: bone marrow lesion(s), bone marrow (o)edema, osteoarthritis, and knee. Studies examining obesity and non-biomechanical factors in relation to the presence, incidence, or change in BMLs were included. Two independent reviewers extracted data and assessed methodological quality of selected studies. Due to the heterogeneity of the studies, we performed a best evidence synthesis. RESULTS Among 30 studies, 17 were considered high quality. The study populations were heterogeneous in terms of symptoms and radiographic knee osteoarthritis. There was strong evidence for an association between serum lipids and BMLs and no association between age and BMLs. There was moderate evidence for a relationship between obesity and BMLs. There was limited evidence for gender, smoking, C-telopeptide of type I collagen, anti-bone-resorptive treatments, licofelone, and chondroitin sulfate. There was a paucity of evidence for heritability and conflicting evidence for dietary fatty acids. CONCLUSION There is strong evidence for serum lipids and moderate evidence for obesity as risk factors for knee BMLs. Given the role of BMLs in the pathogenesis of knee osteoarthritis, identification of modifiable risk factors of BMLs and therapeutic interventions targeting BMLs has the potential to reduce the burden of knee osteoarthritis.
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Affiliation(s)
- Yuan Z Lim
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria 3004, Australia
| | - Yuanyuan Wang
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria 3004, Australia
| | - Anita E Wluka
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria 3004, Australia
| | - Miranda L Davies-Tuck
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria 3004, Australia
| | - Fahad Hanna
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria 3004, Australia; School of Rural Health, Monash University, Victoria, Australia
| | - Donna M Urquhart
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria 3004, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria 3004, Australia.
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50
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Viester L, Verhagen EALM, Oude Hengel KM, Koppes LLJ, van der Beek AJ, Bongers PM. The relation between body mass index and musculoskeletal symptoms in the working population. BMC Musculoskelet Disord 2013; 14:238. [PMID: 23937768 PMCID: PMC3751130 DOI: 10.1186/1471-2474-14-238] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 07/30/2013] [Indexed: 12/19/2022] Open
Abstract
Background The primary aim of this study was to investigate the association between BMI and musculoskeletal symptoms in interaction with physical workload. In addition, it was aimed to obtain insight into whether overweight and obesity are associated with an increase in occurrence of symptoms and/or decrease in recovery from symptoms. Methods Based on a large working population sample (n = 44,793), using the data from The Netherlands Working Conditions Survey (NWCS), logistic regression analyses were carried out to investigate the association between BMI and musculoskeletal symptoms, with adjustment for potential confounders. Longitudinal data from the Netherlands Working Conditions Cohort Study (NWCCS) of 7,909 respondents was used for the second research aim (i.e., to investigate the transition in musculoskeletal symptoms). Results For high BMI an increased 12-month prevalence of musculoskeletal symptoms was found (overweight: OR 1.13, 95% CI: 1.08-1.19 and obesity: OR 1.28, 95% CI: 1.19-1.39). The association was modified by physical workload, with a stronger association for employees with low physical workload than for those with high physical workload. Obesity was related to developing musculoskeletal symptoms (OR 1.37, 95% CI: 1.05-1.79) and inversely related to recovery from symptoms (OR 0.76, 95% CI: 0.59-0.97). Conclusion BMI was associated with musculoskeletal symptoms, in particular symptoms of the lower extremity. Furthermore, the association differed for employees with high or low physical workload. Compared to employees with normal weight, obese employees had higher risk for developing symptoms as well as less recovery from symptoms. This study supports the role of biomechanical factors for the relationship between BMI and symptoms in the lower extremity.
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Affiliation(s)
- Laura Viester
- Department of Public and Occupational Health, the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
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