Obesity as a Metabolic Pathway in Knee OA

April 5, 2016

Obesity may have an independent effect on the risk of knee osteoarthritis through both metabolic pathways and mechanical loading, physicians report at the OARSI 2016 World Congress.

Obesity may have an independent effect on the risk of knee osteoarthritis through both metabolic pathways and mechanical loading, physicians report at the OARSI 2016 World Congress held in Amsterdam this month.

This was the conclusion of one of two OARSI studies that looked into whether it’s possible to discover how obesity leads to knee osteoarthritis and whether losing weight can relieve pressure on knee joints.

On April 1, Boston University School of Medicine’s Devyani Misra M.D., presented “Obesity, Sarcopenic Obesity or Sarcopenia: Which is a Greater Risk for Knee OA?,” and Wake Forest University’s Stephen Messier, Ph.D., delivered “Does Long-Term Intensive Diet and Exercise Reduce the Biomechanical Burden in Overweight and Obese Adults with Knee Osteoarthritis? The Intensive Diet and Exercise for Arthritis (IDEA) Trail.” The first discussed the association of body composition to knee osteoarthritis risk, and the second discussed how combining diet and exercise can alleviate pressure. [[{"type":"media","view_mode":"media_crop","fid":"47323","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_4998842077025","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5557","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":" ","typeof":"foaf:Image"}}]]

In Misra’s study, 2,787 patients were divided into four categories: 14 percent obese non-sarcopenic, 4 percent sarcopenic-obese, 17 percent sarcopenic non-obese, and 65 percent non-sarcopenic non-obese. Three hundred fifty five and 154 subjects developed incident ROA and incident SOA, respectively. Obesity and sarcopenic-obesity patients had a more than twofold increase in the risk of incident ROA. Sarcopenia had no increased risk.

Results indicate adipose tissue may have an independent effort on knee OA risk through metabolic pathways beyond solely mechanical effects.

“Even after accounting for mechanical loading (adjusting for body weight), adiposity defined by body composition was associated with increased risk of knee OA. No such association was noted for sarcopenia,” the researchers wrote.

In the second study, after 18 months, participants experienced weight loss - 2.0 percent (exercise), 9.5 percent (diet), and 11.4 percent (exercise and diet), respectively. Exercise included low-to-moderate intensity walking and resistance training three days a week.

Results from the first study indicate adipose tissue may have an independent effect on knee OA risk through metabolic pathways beyond solely mechanical effects. The second study showed a reduction in joint pressure could play a significant role in improving clinical outcomes and slowing disease.

 

References:

“Obesity, Sarcopenic Obesity or Sarcopenia:  Which is a greater risk for knee OA?” Devyani Misra, April 1, OARSI 2016.

“Does Long-Term Intensive Diet and Exercise Reduce the Biomechanical Burden in Overweight and Obese Adults with Knee Osteoarthritis? The Intensive Diet and Exercise for Arthritis (IDEA) Trial," Stephen Messier, Ph.D., abstract 66, April 1, OARSI 2016.