Weight Cycling and Knee Joint Degeneration in Individuals with Overweight or Obesity: Four‐Year Magnetic Resonance Imaging Data from the Osteoarthritis Initiative

Abstract

Objective The aim of this study was to investigate the associations between weight cycling and knee joint degeneration in individuals with overweight or obesity with different patterns of weight change over 4 years. Methods A total of 2,271 individuals from the Osteoarthritis Initiative database were assessed (case‐control study). Linear regression models using annual BMI measurements over 4 years were used to classify participants as weight cyclers or noncyclers. 3‐T magnetic resonance imaging was used to quantify knee cartilage transverse relaxation time (T2) and cartilage thickness annually over 4 years in all subjects. Whole‐Organ Magnetic Resonance Imaging Scores (WORMS) were obtained for cartilage, meniscus, and bone‐marrow abnormalities in 958 subjects at baseline and at the 4‐year follow‐up. The longitudinal differences in cartilage T2 and thickness between weight cyclers and noncyclers were assessed using general estimating equations, whereas the differences in WORMS outcomes were compared using general linear models. Results No significant differences in the rate of change of cartilage thickness or T2 were found between weight cyclers and noncyclers. However, increases in maximum cartilage WORMS (P = 0.0025) and bone‐marrow abnormalities (P = 0.04) were significantly greater in weight cyclers than in noncyclers. Conclusions Although participants’ intent for weight cycling in this study was unknown, weight cyclers had significantly greater increases in cartilage and bone‐marrow abnormalities over 4 years than noncyclers, independent of weight gain and loss.

Effects of Weight Change on Knee and Hip Radiographic Measurements and Pain Over Four Years: Data From the Osteoarthritis Initiative

“…The individuals in this study were selected as follows: of the 4,796 individuals included in the OAI, we included n = 4,239 who had at least 3 annual BMI measurements available over 6 years (necessary to determine whether an individual cycled between weight gain and weight loss, as described below). Of those, we excluded: 1) individuals with modest weight change (16) defined as 3–5% weight gain and 3–5% weight loss, 2) individuals with end‐stage OA (knee K/L grade 4 or hip JSN grade 3 in the medial and lateral sides) in both knees or both hips, 3) individuals with rheumatoid arthritis and other comorbid diseases that may impact weight change, and 4) individuals with weight cycling (17). Based on these criteria, a total of 2,752 individuals were included in this study (Figure 1).…”

Impact of Sustained Synovitis on Knee Joint Structural Degeneration: 4‐Year MRI Data from the Osteoarthritis Initiative

“…Bone marrow edema pattern (BMEP) was graded from 0 to 3 and cartilage lesions from 0 to 6 as previously described in each of six regions (patella, trochlea, medial/lateral femur, and medial/lateral tibia). The abnormalities of anterior and posterior cruciate, medial, and lateral collateral ligaments along with patellar, quadriceps, and popliteal tendons were graded from 0 to 4 20–22 . The maximum score was defined as the highest score for cartilage, medial, and lateral meniscus or BMEP.…”

“…The abnormalities of anterior and posterior cruciate, medial, and lateral collateral ligaments along with patellar, quadriceps, and popliteal tendons were graded from 0 to 4. [20][21][22] The maximum score was defined as the highest score for cartilage, medial, and lateral meniscus or BMEP.…”

Effects of Weight Change on Knee and Hip Radiographic Measurements and Pain Over 4 Years: Data From the Osteoarthritis Initiative

“…In addition, few studies have assessed the effects of both weight loss and weight gain on structural and symptomatic hip OA (14) The individuals in this study were selected as follows: of the 4796 individuals included in the OAI, we included n=4239 that had at least three (of five) annual BMI measurements available (necessary to determine if an individual cycled between weight gain and weight loss over 4 years, as described below). Of those, we excluded: (i) individuals with modest weight loss (16) defined as 3%-5% weight gain and 3%-5% weight loss (ii) individuals with end-stage OA (knee KL 4 or hip JSN grade 3 in the medial and lateral sides) in both knees or both hips, (iii) individuals with rheumatoid arthritis and other co-morbid diseases that may impact weight change (i.e., cardiac failure) and (iv) individuals with weight cycling (17). Based on these criteria, a total of 2752 individuals were included in this study (Figure 1).…”

“…We defined weight cycling as an RMSE value (19) in the top 10% of all RMSE values. Subjects with weight cycling were excluded from the study as they would not fall into a clear category of weight loss and weight gain, and weight cycling may independently affect OA knee degenerative outcomes (17).…”