Associations between metabolic factors and radiographic knee osteoarthritis in early disease - a cross-sectional study of individuals with knee pain

Abstract

Objective Metabolic factors have been shown to be associated to severe radiographic knee osteoarthritis (RKOA). However, more knowledge is needed in early clinical knee osteoarthritis (KOA). The aim was to study associations between metabolic factors and radiographic knee osteoarthritis (OA) in individuals with knee pain. A second aim was to study associations between metabolic factors and RKOA in those with normal BMI and in those overweight/obese, respectively. Method This cross-sectional study included 282 individuals with knee pain (without cruciate ligament injury) and aged 30–67 years, and 70% women. Waist circumference, body mass index (BMI), proportion of fat and visceral fat area (VFA) were assessed. RKOA was defined as Ahlbäck grade 1 in at least one knee. Fasting blood samples were taken and triglycerides, cholesterol (total, low density lipoprotein (LDL) and high density lipoprotein (HDL)), C-reactive protein (CRP), glucose, HbA1C were analysed. Metabolic syndrome was defined in accordance with the International Diabetes Federation (IDF). Associations were analysed by logistic regression. Results Individuals with RKOA were older, had higher BMI, higher VFA, larger waist circumference and had increased total cholesterol, triglycerides and LDL-cholesterol, but not fasting glucose. There was no difference between the group with RKOA vs. non-radiographic group regarding the presence of metabolic syndrome. In a subgroup analysis of individuals with normal BMI (n = 126), those with RKOA had higher VFA, more central obesity, higher levels of CRP and total cholesterol, compared with individuals without RKOA. In individuals with obesity, age was the only outcome associated to RKOA. Conclusion There were clear associations between metabolic factors and RKOA in individuals with knee pain, also in those with normal BMI. In individuals with obesity age was the only variable associated to RKOA. Trial registration: clinicalTrials.gov Identifier: NCT04928170.

Baseline levels of circulating galectin-1 associated with radiographic hand but not radiographic knee osteoarthritis at a two-year follow-up

“…Thus, increased glycosylation of proteins provides a potential mechanism for the low-grade inflammation seen in hand OA. In this study, radiographic knee OA was associated with age and obesity, which has also been shown in previous studies [ 1 , 15 ].…”

Development of radiographic knee osteoarthritis and the associations to radiographic changes and baseline variables in individuals with knee pain: a 2-year longitudinal study

“…Decreasing BMI may prevent development or progression of KOA 39. Visceral fat, as a variable of central obesity, may be associated with pain and possibly also radiographic findings independent of BMI 45. A high VFA level is also considered as risk factor for development of type 2 diabetes,46 which is also associated to KOA 47.…”

“… 39 Visceral fat, as a variable of central obesity, may be associated with pain and possibly also radiographic findings independent of BMI. 45 A high VFA level is also considered as risk factor for development of type 2 diabetes, 46 which is also associated to KOA. 47 The threshold value considered as a raised and unhealthy VFA varies between studies.…”

Effects of Prolonged Fasting During Inpatient Multimodal Treatment on Pain and Functional Parameters in Knee and Hip Osteoarthritis: A Prospective Exploratory Observational Study

“…Furthermore, lipid metabolism is improved by fasting (60). Even in patients with normal BMI, metabolic factors have shown to be associated with disease severity (61). It seems that, apart from the above-mentioned systemic lowgrade inflammation associated with higher visceral fat, cholesterol metabolism (62,63) and adipokines (59, 61) play a pivotal role in disease progression as they activate diverse cartilage-degrading mechanisms.…”