AB0871 OSTEOARTHRITIS IN OBESE PATIENTS

Abstract

Background:Obesity is a recognized risk factor for osteoarthritis (OA) of the knee joints, which is associated with increased biomechanical stress. However, the association of OA with metabolic syndrome is more multifaceted, since overweight and obese people have a similar increased risk of OA of the hand joints that do not carry weight, due to systemic factors.Objectives:To identify the features of the course of OA in overweight patients.Methods:52 patients with an established diagnosis of osteoarthritis were examined: women - 84.6%, men - 15.4%, average age - 60.9 ± 8.9 years (32 to 78 years). Clinical examination, calculation of body mass index (BMI), determination of the X-ray stage of OA according to the Kellgren and Lawrence system; ultrasound examination of the knee joints; assessment of the severity of pain according to visual analog scale (VAS); the index WOMAC was used to evaluate pain, stiffness and physical function. We evaluated the quality of life by EQ-5D.Results:The duration of OA was 8.75 [2.58; 26] years. The distribution of patients according to the X-ray stage of OA: I - 9.6%, II - 57.6%, III - 26.9%, IV - 5.9% of patients. The BMI range was from 21 to 43 kg/. A BMI up to 30 kg/ was found in 22 patients: 17.3% - normal weight, 25% - excess body weight. Thirty patients has BMI more than 30 kg/: I degree - 38.4%, II degree - 15.3%, III degree - 4%. Obese patients rated pain according to the VAS scale of 1.3 the score is more intensively than patients with a BMI <30 kg/m2(p <0.001). A detailed examination of each subsequent degree of obesity revealed a tendency to reduce the pain syndrome from 7.52 points at 1 degree of obesity to 5 points at 3 degrees of obesity (p <0.001). With increasing body weight, there was an increase in difficulties in daily activities according to the WOMAC (p <0.05). Reactive knee synovitis was detected in 25 (48%) patients. The incidence of synovitis in patients with a BMI <30 kg / m2is 27%, with a BMI> 30 kg / m2is 68%. Patients with obesity of 1stdegree had synovitis in 65%, 2nddegree - 75%, 3rddegree - 84% of cases (p <0.05). A high correlation between the x-ray stage of OA and BMI (r = 0.74; p <0.001) was revealed. According to the EQ-5D questionnaire, patients with the 1stdegree of obesity (2.31 ± 1.3) were very anxious, but the level of anxiety decreases in patients with 3rddegree of obesity (1.44 ± 0.9) and it’s equal to that in individuals with normal body weight (1.33 ± 0.8).Conclusion:The existence of obesity in patients with OA is associated with an increase in pain, a significant decrease in functional ability, a presence of reactive synovitis of the knee joints, aggravation of the X-ray stage of OA, and the appearance of anxiety and depression. However, with the further progression of obesity, the levels of anxiety for one’s condition decrease.