AB0972 Impact of obesity on clinical manifestations in patients with osteoarthritis of the knee

Abstract

ObjectivesTo determine the influence of obesity on clinical parameters in patients with knee osteoarthritis (OA) in comparison with patients with OA with normal body weight.MethodsOverall 72 patients with OA were studied, 28 (39.8%) male and 44 (61.1%) female; mean age was 51.3±7.5 years and the duration of disease was 11.2±5,3 years. The diagnosis of OA was made according to the ACR criteria. Anthropometric data were assessed by height, body weight, waist and hip circumference, body mass index (BMI). Clinical and instrumental studies of OA revealed monoarthrosis in 2 (2.8%), oligoarthrosis in 32 (44.4%) and polyosteoarthrosis in 38 (52.8%) patients. Visual analogue scale (VAS) in centimetres (cm) was used to assess pain, Lequesne and WOMAC indices were determined. Synovitis was documented on the basis of an ultrasound examination of the joints.Patients were divided into 2 groups according to BMI: BMI<24.9 kg/m2, n=22 (no obesity); BMI>30kg/m2, with signs of grade 1-2-3 obesity, n=50.ResultsOA patients with obesity had higher WOMAC and Lequesne index values than OA patients with normal weight (5.8±1.2 cm and 13.8±1.1 points versus 1.75±0.7 cm and 2.9±0.5 points, respectively, p<0.05). WOMAC parameters in overweight patients were significantly higher than in non-obese patients (31.2±5.9 vs. 9.7±2.7, respectively, p<0.05 for the above parameters).There was a direct correlation (p<0.05) between the severity of OA and increased BMI.Radiological changes of the joints in patients without obesity were stage I (60.6%) in 14 (60.6%), stage II in 7 (34.8%) and stage III in 1 (4.5%) patient.Grade I obesity was noted in 8 (16.0%), Grade II in 22 (44.0%), Grade III in 18 (36.0%), Grade IV in 2 (4.0%) patients. Inadequate joint function (NFS) grade I was in 16 (72.7%), II in 4 (18.2%), III in 2 (19.1%) patients with normal body weight, with NFS grade II (26 - 52%) and III (18-36%) predominating with obesity, grade I in 6 (12.0%). Synovitis was diagnosed in 37 (74.0%) with elevated BMI, significantly higher than in non-obese patients in 7 (31.8%). On the course: rapid progressive OA was seen more frequently in 11 obese patients (22. 0%) than in non-obese patients (4.5%); there was a direct correlation between the VAS pain index, Lequesne index and WOMAC index (r=0.5, p<0.05; r=0.4, p<0.05; r=0.45 p<0.05 respectively).ConclusionOverweight in patients with OA was associated with greater joint destruction and functional impairment of the joints, progressive course and pain syndrome, including secondary synovitis.Disclosure of InterestsNone declared