Abstract
Obesity is one of the most important risk factors of knee osteoarthritis (KOA), but its impact on clinical and functional consequences is less clear. The main objective of this cross-sectional study was to describe the relation between body mass index (BMI) and clinical expression of KOA. Participants with BMI ≥ 25 kg/m2 and KOA completed anonymous self-administered questionnaires. They were classified according to BMI in three groups: overweight (BMI 25–30 kg/m2), stage I obesity (BMI 30–35 kg/m2) and stage II/III obesity (BMI ≥ 35 kg/m2). The groups were compared in terms of pain, physical disability, level of physical activity (PA) and fears and beliefs concerning KOA. Among the 391 individuals included, 57.0% were overweight, 28.4% had stage I obesity and 14.6% had stage II/III obesity. Mean pain score on a 10-point visual analog scale was 4.3 (SD 2.4), 5.0 (SD 2.6) and 5.2 (SD 2.3) with overweight, stage I and stage II/III obesity, respectively (p = 0.0367). The mean WOMAC function score (out of 100) was 36.2 (SD 20.1), 39.5 (SD 21.4) and 45.6 (SD 18.4), respectively (p = 0.0409). The Knee Osteoarthritis Fears and Beliefs Questionnaire total score (KOFBEQ), daily activity score and physician score significantly differed among BMI groups (p = 0.0204, p = 0.0389 and p = 0.0413, respectively), and the PA level significantly differed (p = 0.0219). We found a dose–response relation between BMI and the clinical consequences of KOA. Strategies to treat KOA should differ by obesity severity. High PA level was associated with low BMI and contributes to preventing the clinical consequences of KOA.
Highlights
Obesity is one of the most important risk factors of knee osteoarthritis (KOA), but its impact on clinical and functional consequences is less clear
body mass index (BMI) was positively associated with increased risk of KOA defined by plain radiography and/or clinical symptoms (RR: 1.25, 95% CI: 1.17–1.35) and clinical surgery (RR: 1.54, 95% CI: 1.29–1.83)
The BMI groups did not differ in terms of renal failure, gastrointestinal bleeding, physical impairment limiting activity, or cardiovascular disease
Summary
Obesity is one of the most important risk factors of knee osteoarthritis (KOA), but its impact on clinical and functional consequences is less clear. Knee osteoarthritis (KOA) leads to knee pain and altered joint function, with socioeconomic consequences[2]. The Framingham study showed an association of decreased BMI by ≥2 units at 10 years before examination and 50% decreased risk of OA for women[6] In another cohort study[7], a weight loss of >10% could reduce the clinical consequences of OA, finding a dose–response association between weight loss and pain or articular function. Other studies of KOA suggest that being overweight or obese is associated with lower quality of life and higher risk of disability[15] and may affect knee joint impact rates and cause incremental pain[16]. Overweight and obesity are risk factors for pain in the global population[17]
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