Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose
Obesity is a well known risk factor for the development and progression of knee osteoarthritis (OA), and to a lesser extent of hip OA. However, types of obesity and body composition abnormalities could have different impact on OA severity. Body composition has rarely been studied in hip OA and has never been compared to knee OA.
The purpose of this study was to analyze the associations between body composition and sarcopenia and OA location and severity (clinical and structural), in patients with symptomatic hip and/or knee OA.
Methods
Skeletal muscle and fat mass were measured using dual X-ray absorptiometry (DXA) in a subset of patients of the Knee and Hip OsteoArthritis Long term assessment (KHOALA) cohort1.
Skeletal muscle mass index (SMI) was defined as appendicular skeletal muscle mass (ASM) / body weight. The SMI cutoff values used for sarcopenia were 26.8% for men and 21.0% for Women 2.
Pain and function were measured by WOMAC index and quality of life (QoL) by SF36. Structural severity was graded on X-Ray according to Kellgren and Lawrence‘s classification.
Percentages of patients in each group of body composition defined by presence or absence of obesity (BMI) ³ 30 kg/m2 )) and/or sarcopenia were compared in knee and/or hip OA.
We also compared severity of OA (Xrays grade, pain, function and quality of life) in each group of body composition.
Results
A DXA was performed in 381 patients among the 878 patients included in the cohort: women 254 (66.7%), mean (STD) age 63.6 (8.4), Hip OA 91 (23.9%), knee OA 267 (70.1), obesity 146 (38.8%), sarcopenia 105 (27.6%).
Associations between joint and OA severity according to body composition group are presented in table.
|
|
Normal body composition |
Non obese patients with sarcopenia |
Obese patients without sarcopenia |
Obese patients with sarcopenia |
|
||||
|
N=205 |
N=25 |
N=65 |
N=80 |
||||||
|
N |
(%) |
N |
(%) |
N |
(%) |
N |
(%) |
p |
|
|
Joint |
|||||||||
|
Hip |
66 |
(74.1) |
9 |
(10.1) |
5 |
(5.6) |
9 |
(10.1) |
<0.001 |
|
Knee |
127 |
(48.2) |
16 |
(6.1) |
55 |
(20.9) |
65 |
(24.7) |
|
|
Hip and knee |
12 |
(52.2) |
0 |
5 |
(21.7) |
6 |
(26.1) |
||
|
Kellgren stage |
|||||||||
|
2 |
103 |
(56.3) |
10 |
(5.5) |
31 |
(16.9) |
29 |
(15.8) |
0.05 |
|
3 |
48 |
(52.2) |
10 |
(10.9) |
14 |
(15.2) |
20 |
(21.7) |
|
|
4 |
34 |
(43.6) |
4 |
(5.1) |
18 |
(23.1) |
22 |
(28.2) |
|
|
SF36 PCS (mean (std)) |
44.3 (8.4) |
39.7 (9.1) |
38.7 (9.4) |
38.2 (9.1) |
<0.001 |
||||
|
SF36 MCS (mean (std)) |
48.1 (10.5) |
45.8 (10.7) |
46.2 (10.7) |
44.6 (11.7) |
0.09 |
||||
|
WOMAC Function (mean (std)) |
24.1 (17.3) |
36.2 (24.3) |
34.7 (21.5) |
35.9 (20.5) |
<0.001 |
||||
|
WOMAC Pain (mean (std)) |
27.0 (18.5) |
36.8 (25.7) |
38.7 (20.8) |
39.6 (22.1) |
<0.001 |
||||
WOMAC [0,100], 0=best, 100=worse), SF36 PCS: Physical component summary, MCS: Mental component summary, 0=worse, 100=best
Normal body composition was significantly more frequent in patients with hip than knee OA, but frequency of patients with sarcopenia was not different in hip or knee OA.
Normal body composition seemed to decrease in more severe Kellgren stages but the associations did not reach statistical significance.
Physical component summary score was higher and pain score lower in patients with normal body composition than in patients with obesity. In patients with normal BMI, scores did not differ with or without sarcopenia.
Function score was lower in patients with normal body composition than in other patients. No difference was found between obese patients with or without sarcopenia. No difference was found between patients with sarcopenia and normal BMI and obese patients.
Conclusion
Impact of OA on pain, function and QoL was not different between obese patients and patients with sarcopenia and normal BMI. Impact of OA was worse in obese patients with or without sarcopenia than in patients with normal body composition.
Guillemin F et al. Joint Bone Spine. 2012
Lee S et al. Arthritis and Rheumatism
Disclosure:
C. Jeanmaire,
None;
I. Chary-Valkenaere,
None;
D. Loeuille,
None;
L. Bernard,
None;
A. C. Rat,,
None.
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