Weight gain may be linked to development of knee OA in overweight patients
medwireNews: Overweight and obese women who gain weight over a 2.5-year period are more likely to experience progression of knee joint synovitis than those who maintain a stable bodyweight, research suggests.
The study included 347 women aged 50–60 years with a BMI of at least 27 kg/m2 who participated in the PROOF trial. None of the women had clinical osteoarthritis (OA) at baseline, but 31% reported having knee pain in the previous year, and 17–59% had cartilage defects in various compartments of the knee joint.
Marieke Landsmeer (Erasmus University Medical Center, Rotterdam, the Netherlands) and colleagues categorized participants according to changes in bodyweight over 2.5 years of follow-up, and used magnetic resonance imaging to analyze the progression of various OA structural features in the different subgroups.
In all, 12.4% of participants gained an average of 8.6 kg during follow-up, while 74.9% maintained a stable bodyweight, and 12.7% lost an average of 9.0 kg.
The researchers found that 18% of women in the weight gain group experienced progression of synovitis – defined as at least slight distension of the joint capsule and/or at least mild hyperintensity in Hoffa’s fat pad – from baseline to the 2.5-year follow-up, compared with 7% of women in the stable weight group, translating into a significant 2.9-fold increased risk after adjustment for factors including baseline BMI, mild knee symptoms, and injury.
“The larger increase in synovitis in the weight gain subgroup is an important finding, since synovitis is seen as a characteristic feature in OA onset,” say the researchers.
They add that participants in the weight loss group had numerically lower rates of synovitis progression than those in the weight gain group (9 vs 18%), but the difference did not reach statistical significance.
Landsmeer and team note that women in the weight loss group had a mean BMI of 26.3 kg/m2 at the age of 40 years and 33.1 kg/m2 at study baseline (mean age 55 years), and therefore these women had a “high weight exposure time” of at least 15 years.
“The effect of prolonged exposure to high BMI on development of knee OA has been previously described,” and “more extreme weight loss” than that observed in the PROOF study “might be necessary to minimize the articular damage in those women with prolonged high weight exposure,” they explain.
The study authors also demonstrated that participants who gained weight had numerically higher rates of patellofemoral bone marrow lesions and cartilage defects than those in the stable weight group, while those who lost weight had numerically lower rates, but these differences did not reach statistical significance.
And the team concludes in Osteoarthritis and Cartilage: “Whether weight loss or at least the prevention of weight gain, is able to prevent (progression of) structural knee OA, remains a key topic for further research.”
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