Associations of Obesity and Weight Change with Onset and Progression of Radiographic Knee Osteoarthritis Public Deposited

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  • March 19, 2019
  • Abbate, Lauren M.
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Background: Obesity is a well-established risk factor for radiographic knee osteoarthritis (rKOA), but less is known about the relationships between fat distribution and weight change and rKOA. Though reduction in weight is one recommendation to reduce the incidence of rKOA, weight loss is difficult to achieve, and it is possible that weight maintenance is a more attainable goal for some individuals. Objectives: The relationships between anthropometric measures of obesity, including body mass index (BMI) and waist circumference (WC), and the development and progression of rKOA were determined. Weight maintenance was evaluated as an alternative to weight loss in the prevention of incident rKOA. Methods: Data were from 1,690 participants enrolled in the Johnston County Osteoarthritis Project, a population-based cohort of African-American and White men and women in Johnston County, NC. Anthropometric measures and radiographs were obtained at the first visit (T0) in 1990-1998 and assessments were repeated at the second visit (T1) in 1999-2003. Proportional hazards models, based on a Weibull distribution, were constructed to determine the associations between BMI and WC at T0 and the subsequent development and progression of rKOA at T1 among men and women. Second, the association between weight change and incident rKOA was determined. Results: In women, WC and BMI were strongly associated with the development rKOA, and WC appeared to offer no advantage in assessing risk. Both BMI and WC were associated with rKOA progression. In men, both BMI and WC were associated with incident rKOA, and among overweight men, WC but not BMI was associated with increased risk of rKOA. Weight loss but not weight maintenance was associated with a reduction in risk for the development of incident rKOA. Discussion: Increased BMI and WC are both associated with the development and progression of rKOA and, and using both measures to assess risk may be warranted, especially in men. Weight loss, but not weight maintenance, may be an effective strategy to reduce the risk of incident rKOA. Future studies should include measures of WC, especially in men, and interventions designed to promote weight loss should be considered for the prevention of rKOA.
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  • In Copyright
  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology."
  • Stevens, June Sheppa
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  • Chapel Hill, NC
  • Open access

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