Adiposity and hand osteoarthritis: the Netherlands Epidemiology of Obesity study

Abstract

IntroductionObesity, usually characterized by the body mass index (BMI), is a risk factor for hand osteoarthritis (OA). We investigated whether adipose tissue and abdominal fat distribution are associated with hand OA.MethodsThe Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort aged 45 to 65 years, including 5315 participants (53% women, median BMI 29.9 kg/m2). Fat percentage and fat mass (FM) (kg) were estimated using bioelectrical impedance analysis. The waist-to-hip ratio (WHR) was calculated. In 1721 participants, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (cm2) were assessed using abdominal MR imaging. Hand OA was defined according to the ACR criteria.Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association of fat percentage, FM, WHR, VAT and SAT with hand OA using logistic regression analyses per standard deviation, stratified by sex and adjusted for age.ResultsHand OA was present in 8% of men and 20% of women. Fat percentage was associated with hand OA in men (OR 1.34 (95% CI 1.11 to 1.61)) and women (OR 1.26 (1.05 to 1.51)), as was FM. WHR was associated with hand OA in men (OR 1.45 (1.13 to 1.85)), and to a lesser extent in women (OR 1.17 (1.00 to 1.36)). Subgroup analysis revealed that VAT was associated with hand OA in men (OR1.33 (1.01 to 1.75)). This association increased after additional adjustment for FM (OR 1.51 (1.13 to 2.03)).ConclusionsFat percentage, FM and WHR were associated with hand OA. VAT was associated with hand OA in men, suggesting involvement of visceral fat in hand OA.

State of the evidence

“…Some studies [45,46,49,64,66▪,97▪,102] have highlighted interactions among these risk factors (mostly surrounding sex differences in other osteoarthritis risk factors); given the multifactorial nature of osteoarthritis, future research should carefully consider these interrelationships. Also important is the existence of multiple known modifiable or preventable risk factors for osteoarthritis incidence and/or progression (e.g.…”

“…A Netherlands-based cohort study [45] found that percentage body fat, fat mass, and waist-to-hip ratio were all associated with hand osteoarthritis; visceral adipose tissue was associated with hand osteoarthritis in men only. The association of obesity with hip osteoarthritis has been weak and inconsistent across studies [11,12].…”

Osteoarthritis year in review 2015: clinical

“…Almost half of the association between elevated BMI and knee OA was explained by serum leptin level in the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly Boston Study (22). In the Netherlands Epidemiology of Obesity study, knee OA was associated with weight and fat-free mass, adjusting for metabolic factors, and hand OA was associated with the metabolic syndrome, adjusting for weight (23). In a study of patients undergoing total knee or hip replacement due to primary OA in Newfoundland, Canada, metabolomics analysis of synovial fluid samples demonstrated metabolically distinct subgroups (24).…”

Association of urinary metabolites with radiographic progression of knee osteoarthritis in overweight and obese adults: an exploratory study

“…In addition to knee OA, increased BMI is also associated with OA of the hips 7 and the hands 8, 9 . Data from the Netherlands Epidemiology of Obesity (NEO) study show that BMI and fat mass were associated with both knee 10 and hand OA 9 . The association of BMI and fat mass with hand OA in particular suggests that inflammatory and metabolic factors, rather than simply excessive joint loading, may be contributing to the higher risk of development of OA with obesity.…”