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Abstract Number: 2352

Obesity-Related Systemic Inflammation and Knee Synovitis

Devyani Misra1, Tuhina Neogi2, Michael C. Nevitt3, James Torner4, Cora E. Lewis5 and David T. Felson6, 1Medicine, Section of, BUSM, Boston, MA, 2Clinical Epidemiology, BUSM, Boston, MA, 3Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, 4University of Iowa, UIowa, Iowa City, IA, 5University of Alabama Birmingham, Birmingham, AL, 6Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Inflammation, Knee, obesity, osteoarthritis and synovitis

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Session Information

Date: Tuesday, November 15, 2016

Session Title: Osteoarthritis – Clinical Aspects - Poster II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Obesity, a major risk factor for knee osteoarthritis (OA), is a state of systemic inflammation through elaboration of adipokines (pro and anti-inflammatory cytokines) from adipose tissue. Whether degree of adiposity or systemic level of pro-inflammatory adipokines is associated with presence of local inflammation (synovitis) in knee OA is not known. Thus, in this study, we evaluated the cross-sectional association between total body fat mass and serum leptin (a proinflammatory adipokine) level to the presence of synovitis of the knee on MRI in community-dwelling older adults, with and without knee OA.

Methods: We included participants from the Multicenter Osteoarthritis (MOST) study, which has whole body Dual Energy X-ray (DXA) for assessment of fat mass, serum leptin assay and knee MRI (fat-suppressed (FS) fast spin-echo intermediate-weighted (IW) sequences) for evaluation of synovitis available. Sex-specific tertiles were created for total body fat mass and serum leptin from baseline visit. Person-level synovitis was defined by WORMS score >=1 on knee MRI from the same visit separately at 3 specific sites: 1) Infrapatellar fat pad; 2) Intercondylar; and 3) whole knee Effusion. A sum score of synovitis was calculated by adding the scores at the above sites. To assess the relation of fat mass tertiles and serum leptin tertiles to knee synovitis, we performed logistic regression for the site specific synovitis and linear regression for sum of synovitis score, adjusting for age, sex, education, physical activity, smoking status and body weight (proxy for loading effect). Analyses were repeated, stratified by the presence of radiographic knee OA (Kellegren-Lawrence grade ≥2) status.

Results: Among 2871 subjects, 1015 subjects developed synovitis (162 infrapatellar, 419 intercondylar and 462 effusion). We did not find an association between tertiles of fat mass or serum leptin with site specific synovitis or sum of synovitis scores (Table 1). Results did not change when stratified by radiographic knee OA.

Conclusion: Our results suggest that presence of knee synovitis may not be associated with obesity-related systemic inflammation.  However, as our study is limited by power, larger studies are needed to comprehensively study this relation between obesity-related systemic inflammation and synovitis in knee OA as it may provide insight into the pathogenesis of knee OA.

Table 1 : Association of tertiles of absolute body fat mass and serum leptin with site specific synovitis

Sex-specific total body fat mass

tertiles

n/N

Crude OR

Adjusted* OR

(95% CI)

Infrapatellar fat pad synovitis

Tertile 1 (lowest)

61/957

1.50

0.64 (0.32-1.27)

Tertile 2

59/949

1.46

0.92 (0.56-1.54)

Tertile 3 (ref)

42/965

1.0

1.0

Intercondylar synovitis

Tertile 1 (lowest)

155/887

1.61

1.01 (0.64-1.60)

Tertile 2

158/903

1.61

1.26 (0.89-1.77)

Tertile 3 (ref)

106/910

1.0

1.0

Effusion synovitis

Tertile 1 (lowest)

137/853

1.10

0.66 (0.43-1.04)

Tertile 2

155/851

1.26

0.99 (0.71-1.38)

Tertile 3 (ref)

134/881

1.0

1.0

Sex-specific serum  leptin tertiles

Infrapatellar fat pad synovitis

Tertile 1 (lowest)

10/220

0.66

0.74 (0.27-2.00)

Tertile 2

13/221

0.87

1.97 (0.43-2.22)

Tertile 3 (ref)

15/224

1.0

1.0

Intercondylar synovitis

Tertile 1 (lowest)

43/194

1.54

1.67 (0.89-3.12)

Tertile 2

31/210

0.93

1.01 (0.57-1.80)

Tertile 3 (ref)

33/211

1.0

1.0

Effusion synovitis

Tertile 1 (lowest)

24/187

0.49

0.73 (0.38-1.42)

Tertile 2

28/163

0.57

0.75 (0.46-1.33)

Tertile 3 (ref)

46/199

1.0

1.0

*Age, sex, education, smoking, physical activity (physical activity scale for elders) and body weight

Disclosure: D. Misra, None; T. Neogi, None; M. C. Nevitt, None; J. Torner, None; C. E. Lewis, None; D. T. Felson, zimmer knee creations, 5.

To cite this abstract in AMA style:

Misra D, Neogi T, Nevitt MC, Torner J, Lewis CE, Felson DT. Obesity-Related Systemic Inflammation and Knee Synovitis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/obesity-related-systemic-inflammation-and-knee-synovitis/. Accessed December 16, 2019.
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