Risk of Knee Osteoarthritis With Obesity, Sarcopenic Obesity, and Sarcopenia

Misra, Devyani; Fielding, Roger A.; Felson, David T.; Niu, Jingbo; Brown, Carrie; Nevitt, Michael C.; Lewis, Cora E.; Torner, James C.; Neogi, Tuhina

doi:10.1002/art.40692

Cited by 134 publications

(97 citation statements)

References 18 publications

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“…Sarcopenic obesity, which is characterized by the combination of obesity and sarcopenia (age-related muscle loss and physical dysfunction), is associated with a higher risk of radiographic knee OA, relative to individuals in the non-sarcopenia obesity group, demonstrated in a cross-sectional study based on 2893 individuals [ 82 ]. Interestingly, a recent longitudinal study based on 1653 patients showed an association between sarcopenic obese women and increased risk of radiographic knee OA, however this was not seen in men, suggesting that the effect of muscle dysfunction on obesity-related OA development may be related to gender [ 83 ].…”

Section: Mechanical Stress As a Key Pathological Factor In Obesity-rementioning

confidence: 99%

Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading

Chen

Zheng

et al. 2020

Journal of Orthopaedic Translation

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Summary Obesity-related osteoarthritis (OA) is a complex, multifactorial condition that can cause significant impact on patients’ quality of life. Whilst chronic inflammation, adipocytokines and metabolic factors are considered to be important pathogenic factors in obesity related OA, there has been limited investigation into the biomechanical impact of obesity on OA development. This review aims to demonstrate that mechanical factors are the major pathological cause of obesity-related OA. The effect of obesity on pathological changes to the osteochondral unit and surrounding connective tissues in OA is summarized, as well as the impact of obesity-related excessive and abnormal joint loading, concomitant joint malalignment and muscle weakness. An integrated therapeutic strategy based on this multi-factorial presentation is presented, to assist in the management of obesity related OA. The translational potential of this article Despite the high prevalence of obesity-related OA, there is no specific guideline available for obesity-related OA management. In this review, we demonstrated the pathological changes of obesity-related OA and summarized the impact of biomechanical factors by proposing a hypothetical model of obesity-related OA change. Therapeutic strategies based on adjusting abnormal mechanical effects are presented to assist in the management of obesity-related OA.

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Section: Mechanical Stress As a Key Pathological Factor In Obesity-rementioning

confidence: 99%

Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading

Chen

Zheng

et al. 2020

Journal of Orthopaedic Translation

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“…According to a 2016 data, there were 43.2 million men and 46.4 million women in China, and the number of obese people exceeded that of the USA, ranking first in the world [ 2 ]. As a health problem, obesity is more common in elderly people and is associated with many diseases, including osteoarthritis (OA) [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive value of adipose to muscle area ratio based on MRI at knee joint for postoperative functional outcomes in elderly osteoarthritis patients following total knee arthroplasty

et al. 2020

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Background The current research used a new index—adipose to muscle area ratio (AMR)—to measure fatness compared with body mass index (BMI) in elderly osteoarthritis (OA) patients following total knee arthroplasty. Our study aimed to test the relationship between the two indexes (AMR and BMI) and to examine whether AMR was a predictive factor of patient-reported outcome measures (PROMS) for elderly OA patients following total knee arthroplasty (TKA). Methods The retrospective data of 78 OA patients (older than 60 years) following TKA was included in our study. Clinical features of patients included age, BMI, sex, AMR, side of the implant, time of follow-up, complications, the Knee Society Score (KSS score), and the Hospital for Special Surgery knee score (HSS score). The area of adipose tissue and muscle tissue was measured on the cross section (supra-patella, midline of the patella, joint line of the knee) of the knee magnetic resonance imaging (MRI). AMR was calculated as the average of adipose to muscle area ratio at the three levels. The Pearson correlation analysis, simple linear regression, and multiple linear regression were used to study the relationship between BMI, AMR, and PROMS (KSS total-post score and HSS-post score) in the study. Results Of all patients, the mean (± standard deviations (SD)) of age was 67.78 ± 4.91 years. For BMI and AMR, the mean (± SD) were 26.90 ± 2.11 and 2.36 ± 0.69, respectively. In Pearson correlation analysis, BMI had a good correlation with AMR (r = 0.56, p = 0.000), and AMR (r = − 0.37, p = 0.001, HSS-post score; r = − 0.43, p = 0.000, KSS total-post score) had better correlations with PROMS postoperatively compared with BMI (r = − 0.27, p = 0.019, HSS-post score; r = − 0.33, p = 0.003, KSS total-post score). In multivariate linear regression analysis, AMR was negatively correlated with KSS total-post score as well as HSS-post score, while BMI was not. As for patients with complications, AMR values were between the 3rd quartile and 4th quartile of the AMR value in the entire study cohort. Conclusions In this study, the new obesity evaluation indicator—AMR, which was well related with BMI, was found to be a predictor of PROMS (KSS total-post score and HSS-post score) in elderly OA patients following TKA.

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“…Obesity may contribute to OA pathogenesis in two ways, by increasing joint load and mechanical wear of the joints, and by promoting systemic and local inflammation. Body composition studies demonstrated a direct association of obesity with the risk of knee OA, suggesting that weight loss strategies for knee OA should focus on reducing excess fat tissue [2,3]. Partial or full IFP resection has been used to reduce knee pain resulting from IFP inflammation and impingement during total knee arthroplasty [28].…”

Section: Adipokine Adiponectinmentioning

confidence: 99%

“…Obesity is a common metabolic syndrome caused by excess fat accumulation in the body due to disorders of fat metabolism. Previous research has demonstrated a strong association between knee OA and obesity [1][2][3][4][5]. Obesity not only causes increased weight bearing by the joint but also enhances adipokine production by the adipose tissue, thereby contributing to inflammatory or autoimmune diseases [6,7].…”

Section: Introductionmentioning

confidence: 99%

Adipokines: New Therapeutic Target for Osteoarthritis?

2019

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Purpose of the Review-Osteoarthritis (OA) is an aging-associated and injury-induced joint disease characterized by cartilage degradation, bone sclerosis, and persistent low-grade inflammation in the joint. Aging and injury are triggers of joint pathological changes mediated by pro-inflammatory factors, some of which are secreted by white adipose tissue. Adipokines including adiponectin, leptin, resistin, chemerin, IL-6, and TNF-α are major players not only during inflammation but also in metabolic regulation of joint cells including chondrocytes, osteoblasts, osteoclasts as well as mesenchymal stem cells. The purpose of this review is to summarize the signal transduction pathways of adipokines in the articular joint to provide new information on potential targets for intervention of OA. Recent Findings-The risk of knee osteoarthritis is associated with adipokine gene polymorphism. While the infrapatellar fat pad is a major source of adipokines in knee synovial fluid, adipocytes also accumulate in the bone marrow during aging and obesity. Adipokines can act as SASPs (senescence associated secretory phenotype factors) that participate in cellular senescence of chondrocytes, but they also regulate energy metabolism impacting bone remodeling. Thus, adipokines are closely related to the metabolic syndrome and degenerative pathological changes in cartilage and bone during OA. Summary-Modulating the effects of adipokines on different cell types in the intra-articular joint will be a promising new option for OA intervention.

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Risk of Knee Osteoarthritis With Obesity, Sarcopenic Obesity, and Sarcopenia

Cited by 134 publications

References 18 publications

Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading

Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading

Predictive value of adipose to muscle area ratio based on MRI at knee joint for postoperative functional outcomes in elderly osteoarthritis patients following total knee arthroplasty

Adipokines: New Therapeutic Target for Osteoarthritis?

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