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Clin Rheumatol. 2016 Apr;35(4):1071-6. doi: 10.1007/s10067-015-3152-2. Epub 2015 Dec 21.

Overweight older adults, particularly after an injury, are at high risk for accelerated knee osteoarthritis: data from the Osteoarthritis Initiative.

Author information

1
Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA. jeffrey.driban@tufts.edu.
2
Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA.
3
Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.
4
Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA.
5
The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 02111, USA.
6
Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA.
7
Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA.
8
Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA.
9
Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.

Abstract

We explored whether age and body mass index (BMI) can help identify a subset of individuals who are at high risk for accelerated knee osteoarthritis (AKOA) compared with common knee osteoarthritis (KOA). In the Osteoarthritis Initiative, a multicenter observational cohort study of KOA (n = 4796), we studied participants without KOA at baseline (Kellgren-Lawrence (KL) <2). Participants could have one of three outcomes: (1) AKOA, ≥1 knee progressed to end-stage KOA within 48 months; (2) common KOA, ≥1 knee increased in radiographic scoring within 48 months (excluding those with AKOA); and (3) no KOA, no change in KL grade in either knee. After verifying an interaction between age, BMI, and recent knee injury, we determined if we could identify a specific subset of individuals at high risk for AKOA instead of KOA. First, we reviewed three-dimensional graphs with age, BMI, and probability of AKOA versus KOA on the axes. We then conducted a logistic regression with AKOA as the outcome and age-BMI groups as the predictor. In our main analyses, we found that older individuals with a BMI <35 kg/m(2) were more likely to develop AKOA than common KOA (n = 64; mean [SD] BMI = 27.3 [3.1] kg/m(2); odds ratio = 3.47, 95 % confidence interval = 1.70 to 7.10), especially if they had a recent knee injury. While older age and greater BMI are independently associated with AKOA, we found that older individuals who had a higher BMI, particularly if they have an injury, were more likely to develop AKOA than common KOA.

KEYWORDS:

Age; Body mass index; Injuries; Knee; Osteoarthritis

PMID:
26686368
PMCID:
PMC4811718
DOI:
10.1007/s10067-015-3152-2
[Indexed for MEDLINE]
Free PMC Article

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