The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: A cohort study in 1.2 million persons

Abstract

Objective. To investigate the effects of body mass index (BMI), height, and age on the risk of later total hip arthroplasty for primary osteoarthritis (OA).Methods. We matched screening data on body height and weight from 1,152,006 persons ages 18-67 years who attended a compulsory screening for tuberculosis in 1963-1975 with data from the Norwegian Arthroplasty Register for the years 1987-2003. We identified 28,425 total hip replacements because of primary OA.Results. We found dose-response associations between both height and BMI and later hip arthroplasty. The relative risk (RR) among men with a BMI >32 kg/m 2 versus a BMI of 20.5-21.9 kg/m 2 was 3.4 (95% confidence interval [95% CI] 2.9-4.0). The corresponding RR in women was 2.3 (95% CI 2.1-2.4). There was a decreasing trend in the RR with an increasing age at screening. Among men, the RR for an increase of 5 kg/m 2 in the BMI was 2.1 (95% CI 1.7-2.5) when measured at age <25 years and 1.5 (95% CI 1.3-1.7) when measured at ages 55-59 years. Among women, the corresponding RR values were 1.7 (95% CI 1.5-1.9) and 1.1 (95% CI 1.1-1.2). Conclusion.There was a strong dose-response association between BMI and later total arthroplasty for OA of the hip. Being overweight entailed the highest RR among young participants, and the participants who were overweight at a young age maintained an excess RR for arthroplasty throughout the followup period.

The causal role of smoking on the risk of hip or knee replacement due to primary osteoarthritis: a Mendelian randomisation analysis of the HUNT study

“…Another potential explanation is the indirect effect of smoking on lifestyle factors such as BMI. Increasing BMI is an established risk factor for OA and subsequent TJR 26,27 and there is evidence to suggest that smoking may lead to lower BMI 18,28,29 , which could mediate the effect of smoking on TJR 30 . However, the association of rs1051730 T alleles with TJR was only slightly attenuated after statistical adjustment for BMI.…”

Overview of the relationship between pain and obesity: What do we know? Where do we go next?

“…In the NHANES, where detailed arthritis examinations included X-rays and physical examinations, obesity was found to be significantly associated with OA of the hips in white women and nonwhite males only [43]. More recently, a large cohort study that matched BMI data from more than 1 million persons to a national arthroplasty register found a strong dose-response association between BMI and later total arthroplasty for hip OA in both males and females [50]. In particular, the study found that increased weight while young (compared with increased weight when older) had a greater affect on arthroplasty rates.…”

Patients With Hip Osteoarthritis Have a Phenotype With High Bone Mass and Low Lean Body Mass

“…However, there also are studies inferring that patients with OA have a general high bone mineral density (BMD) [4,9,12,13,17,24,29,30] and high BMI [17,29]. If this phenotype could be found in all patients with OA, independent of the affected joint, is unclear.…”