BACKGROUND Metabolic as well as mechanical stress of increased adiposity is known to play important roles in osteoarthritis. This study aimed to analyze the association between knee osteoarthritis and four body size phenotypes defined by the presence or absence of metabolic abnormality and obesity. ...
BACKGROUND Metabolic as well as mechanical stress of increased adiposity is known to play important roles in osteoarthritis. This study aimed to analyze the association between knee osteoarthritis and four body size phenotypes defined by the presence or absence of metabolic abnormality and obesity. MEHODS This was a cross-sectional study using data from 1,549 female participants of the Fifth Korean National Health And Nutrition Examination Survey. Knee osteoarthritis was defined as a Kellgren-Lawrence grade of ≥2. Metabolically abnormal state was defined as presence of more than one abnormality among five metabolic risk factors: waist circumference ≥80 cm, triglyceride ≥ 150 mg/dL, high density lipoprotein cholesterol (HDL-cholesterol) <50 mg/dL, systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 85 mmHg, and fasting glucose ≥ 100 mg/dL. Obesity was defined as a body mass index ≥ 27.5. Participants were grouped into one of the four body size phenotypes based on the presence or absence of metabolic abnormality and obesity: metabolically healthy normal weight (MHNW), metabolically abnormal normal weight (MANW), metabolically healthy obesity (MHO), metabolically abnormal obesity (MAO). RESULTS The distribution of each body size phenotype was as follows: MHNW 54.7%, MANW 30.7%, MHO 4.3%, MAO 10.3%. Compared to MHNW, MANW and MAO were characterized by significantly higher age, BMI, waist circumference, Serum triglyceride, fasting serum glucose, and significantly lower HDL-cholesterol. Prevalence of knee osteoarthritis was higher in MANW(51.6%) than in MHNW(36.2%), and in MAO(69.4%) than in MHO(56.1%) . In multivariable analysis, the association between symptomatic knee osteoarthritis and the body size phenotypes was as follows (OR [95% CI]): MHNW 1.00 (reference), MANW 1.54 (1.15 ? 2.07), MHO 1.61 (0.83 ? 3.13), MAO 3.47 (2.35 ? 5.14). CONCLUSIONS MANW and MAO were more closely associated with knee osteoarthritis than were metabolically healthy counterparts in the same BMI categories. In the absence of metabolic abnormality, there was no difference in the association with symptomatic knee osteoarthritis between obese and non-obese groups. The results suggest that the risk of osteoarthritis may be more heterogeneous than predicted by BMI alone.
BACKGROUND Metabolic as well as mechanical stress of increased adiposity is known to play important roles in osteoarthritis. This study aimed to analyze the association between knee osteoarthritis and four body size phenotypes defined by the presence or absence of metabolic abnormality and obesity. MEHODS This was a cross-sectional study using data from 1,549 female participants of the Fifth Korean National Health And Nutrition Examination Survey. Knee osteoarthritis was defined as a Kellgren-Lawrence grade of ≥2. Metabolically abnormal state was defined as presence of more than one abnormality among five metabolic risk factors: waist circumference ≥80 cm, triglyceride ≥ 150 mg/dL, high density lipoprotein cholesterol (HDL-cholesterol) <50 mg/dL, systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 85 mmHg, and fasting glucose ≥ 100 mg/dL. Obesity was defined as a body mass index ≥ 27.5. Participants were grouped into one of the four body size phenotypes based on the presence or absence of metabolic abnormality and obesity: metabolically healthy normal weight (MHNW), metabolically abnormal normal weight (MANW), metabolically healthy obesity (MHO), metabolically abnormal obesity (MAO). RESULTS The distribution of each body size phenotype was as follows: MHNW 54.7%, MANW 30.7%, MHO 4.3%, MAO 10.3%. Compared to MHNW, MANW and MAO were characterized by significantly higher age, BMI, waist circumference, Serum triglyceride, fasting serum glucose, and significantly lower HDL-cholesterol. Prevalence of knee osteoarthritis was higher in MANW(51.6%) than in MHNW(36.2%), and in MAO(69.4%) than in MHO(56.1%) . In multivariable analysis, the association between symptomatic knee osteoarthritis and the body size phenotypes was as follows (OR [95% CI]): MHNW 1.00 (reference), MANW 1.54 (1.15 ? 2.07), MHO 1.61 (0.83 ? 3.13), MAO 3.47 (2.35 ? 5.14). CONCLUSIONS MANW and MAO were more closely associated with knee osteoarthritis than were metabolically healthy counterparts in the same BMI categories. In the absence of metabolic abnormality, there was no difference in the association with symptomatic knee osteoarthritis between obese and non-obese groups. The results suggest that the risk of osteoarthritis may be more heterogeneous than predicted by BMI alone.
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