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The impact of obesity on the musculoskeletal system

Abstract

Obesity is associated with a range of disabling musculoskeletal conditions in adults. As the prevalence of obesity increases, the societal burden of these chronic musculosketelal conditions, in terms of disability, health-related quality of life, and health-care costs, also increases. Research exploring the nature and strength of the associations between obesity and musculoskeletal conditions is accumulating, providing a better understanding of underlying mechanisms. Weight reduction is important in ameliorating some of the manifestations of musculoskeletal disease and improving function.

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References

  1. World Health Organisation. 2006, http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/.

  2. Australia's Health. 2004 Australian Institute of Health and Welfare 2004. AIHW Cat.No. AUS-44.

  3. McTigue K, Larson JC, Valoski A, Burke G, Kotchen J, Lewis CE et al. Mortality and cardiac and vascular outcomes in extremely obese women. JAMA 2006; 296: 79–86.

    Article  CAS  PubMed  Google Scholar 

  4. Penm E, Dixon T, Bhatia K . Health expenditure for arthritis and musculoskeletal conditions in Australia, 2000-01. Australian Institute of Health and Welfare 2006; Bulletin no. 46 (catalogue no. AUS 83).

  5. Australian Institute of Health and Welfare. The AIHW analysis of the 2003 ABS National Survey of Disability, Ageing and Carers 2003.

  6. Australia's Health 2006. Australian Institute of Health and Welfare 2006;. AIHW Cat. No. AUS-73: 88.

  7. Kortt M, Baldry J . The association between musculoskeletal disorders and obesity. Aust Health Rev 2002; 25: 207–214.

    Article  PubMed  Google Scholar 

  8. National Center for Chronic Disease Prevention and Health Promotion. Arthritis related statistics 2006. Division of Adult and Community Health, Health Care and Aging Studies Branch 2006.

  9. Amin AK, Sales JD, Benkel IJ . Obesity and total knee and hip replacement. Curr Ortho 2006; 20: 216–221.

    Article  Google Scholar 

  10. Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF . Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med 1988; 109: 18–24.

    Article  CAS  PubMed  Google Scholar 

  11. Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ . Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med 1992; 116: 535–539.

    Article  CAS  PubMed  Google Scholar 

  12. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P et al. Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum 1997; 40: 728–733.

    Article  CAS  PubMed  Google Scholar 

  13. Hart DJ, Doyle DV, Spector TD . Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford Study. Arthritis Rheum 1999; 42: 17–24.

    Article  CAS  PubMed  Google Scholar 

  14. Davis MA, Ettinger WH, Neuhaus JM . The role of metabolic factors and blood pressure in the association of obesity with osteoarthritis of the knee. J Rheumatol 1988; 15: 1827–1832.

    CAS  PubMed  Google Scholar 

  15. Hochberg MC, Lethbridge-Cejku M, Scott Jr WW, Reichle R, Plato CC, Tobin JD . The association of body weight, body fatness and body fat distribution with osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging. J Rheumatol 1995; 22: 488–493.

    CAS  PubMed  Google Scholar 

  16. Bagge E, Bjelle A, Eden S, Svanborg A . Factors associated with radiographic osteoarthritis: results from the population study 70-year-old people in Goteborg. J Rheumatol 1991; 18: 1218–1222.

    CAS  PubMed  Google Scholar 

  17. Spector TD, Hart DJ, Doyle DV . Incidence and progression of osteoarthritis in women with unilateral knee disease in the general population: the effect of obesity. Ann Rheum Dis 1994; 53: 565–568.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Cicuttini FM, Spector T, Baker J . Risk factors for osteoarthritis in the tibiofemoral and patellofemoral joints of the knee. J Rheumatol 1997; 24: 1164–1167.

    CAS  PubMed  Google Scholar 

  19. Cicuttini FM, Baker JR, Spector TD . The association of obesity with osteoarthritis of the hand and knee in women: a twin study. J Rheumatol 1996; 23: 1221–1226.

    CAS  PubMed  Google Scholar 

  20. Anderson JJ, Felson DT . Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol 1988; 128: 179–189.

    Article  CAS  PubMed  Google Scholar 

  21. Schouten JS, van den Ouweland FA, Valkenburg HA . A 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee. Ann Rheum Dis 1992; 51: 932–937.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Ledingham J, Regan M, Jones A, Doherty M . Factors affecting radiographic progression of knee osteoarthritis. Ann Rheum Dis 1995; 54: 53–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Dougados M, Gueguen A, Nguyen M, Thiesce A, Listrat V, Jacob L et al. Longitudinal radiologic evaluation of osteoarthritis of the knee. J Rheumatol 1992; 19: 378–384.

    CAS  PubMed  Google Scholar 

  24. Hart DJ, Spector TD . The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. J Rheumatol 1993; 20: 331–335.

    CAS  PubMed  Google Scholar 

  25. Chang MT, Lane NE, Hietpas J, Felson DT, Zhu Y, Sharma L et al. Obesity, gender, and in men, prior knee injuries are associated with incident symptomatic knee OA (SxKOA) in a high risk cohort: The Multicenter Osteoarthritis Study (MOST). ACR Annual Scientific Meeting 2006. abstract: presentation number: 116.

  26. Andriacchi TP, Mundermann A . The role of ambulatory mechanics in the initiation and progression of knee osteoarthritis. Curr Opin Rheumatol 2006; 18: 514–518.

    Article  PubMed  Google Scholar 

  27. Manek NJ, Hart D, Spector TD, MacGregor AJ . The association of body mass index and osteoarthritis of the knee joint: an examination of genetic and environmental influences. Arthritis Rheum 2003; 48: 1024–1029.

    Article  PubMed  Google Scholar 

  28. Cimen OB, Incel NA, Yapici Y, Apaydin D, Erdogan C . Obesity related measurements and joint space width in patients with knee osteoarthritis. Ups J Med Sci 2004; 109: 159–164.

    Article  PubMed  Google Scholar 

  29. Szoeke C, Dennerstein L, Guthrie J, Clark M, Cicuttini F . The relationship between prospectively assessed body weight and physical activity and prevalence of radiological knee osteoarthritis in postmenopausal women. J Rheumatol 2006; 33: 1835–1840.

    PubMed  Google Scholar 

  30. Sharma L, Lou C, Cahue S, Dunlop DD . The mechanism of the effect of obesity in knee osteoarthritis: the mediating role of malalignment. Arthritis Rheum 2000; 43: 568–575.

    Article  CAS  PubMed  Google Scholar 

  31. Felson DT, Goggins J, Niu J, Zhang Y, Hunter DJ . The effect of body weight on progression of knee osteoarthritis is dependent on alignment. Arthritis Rheum 2004; 50: 3904–3909.

    Article  PubMed  Google Scholar 

  32. Jordan JM, Luta G, Stabler T, Renner JB, Dragomir AD, Vilim V et al. Ethnic and sex differences in serum levels of cartilage oligomeric matrix protein: the Johnston County Osteoarthritis Project. Arthritis Rheum 2003; 48: 675–681.

    Article  CAS  PubMed  Google Scholar 

  33. Mouritzen U, Christgau S, Lehmann HJ, Tanko LB, Christiansen C . Cartilage turnover assessed with a newly developed assay measuring collagen type II degradation products: influence of age, sex, menopause, hormone replacement therapy, and body mass index. Ann Rheum Dis 2003; 62: 332–336.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Cicuttini FM, Teichtahl AJ, Wluka AE, Davis S, Strauss BJ, Ebeling PR . The relationship between body composition and knee cartilage volume in healthy, middle-aged subjects. Arthritis Rheum 2005; 52: 461–467.

    Article  PubMed  Google Scholar 

  35. Wluka AE, Wang Y, Giles GG, English DR, Cicuttini FM . Muscle mass explains the gender difference in knee cartilage volume. ACR Annual Scientific Meeting 2006. abstract: presentation number: 258.

  36. Hunter DJ, Zhang Y, Niu J, Goodpaster BH, Harris TB, Kwoh K et al. Muscle mass predicts patellofemoral osteoarthritis (PF OA) progression. ACR Annual Scientific Meeting 2006. abstract: presentation number: 2090.

  37. Amin S, Baker K, Niu J, Clancy M, Goggins J, Guermazi A et al. Quadriceps strength and its relation to cartilage loss in knee osteoarthritis. ACR Annual Scientific Meeting 2006. abstract: presentation number: 2092.

  38. Ding C, Cicuttini F, Scott F, Cooley H, Jones G . Knee structural alteration and BMI: a cross-sectional study. Obes Res 2005; 13: 350–361.

    Article  PubMed  Google Scholar 

  39. Baker P, Coggon D, Reading I, Barrett D, McLaren M, Cooper C . Sports injury, occupational physical activity, joint laxity, and meniscal damage. J Rheumatol 2002; 29: 557–563.

    PubMed  Google Scholar 

  40. Tepper S, Hochberg MC . Factors associated with hip osteoarthritis: data from the First National Health and Nutrition Examination Survey (NHANES-I). Am J Epidemiol 1993; 137: 1081–1088.

    Article  CAS  PubMed  Google Scholar 

  41. Lievense AM, Bierma-Zeinstra SM, Verhagen AP, van Baar ME, Verhaar JA, Koes BW . Influence of obesity on the development of osteoarthritis of the hip: a systematic review. Rheumatology (Oxford) 2002; 41: 1155–1162.

    Article  CAS  Google Scholar 

  42. Carman WJ, Sowers M, Hawthorne VM, Weissfeld LA . Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. Am J Epidemiol 1994; 139: 119–129.

    Article  CAS  PubMed  Google Scholar 

  43. van Saase JL, Vandenbroucke JP, van Romunde LK, Valkenburg HA . Osteoarthritis and obesity in the general population. A relationship calling for an explanation. J Rheumatol 1988; 15: 1152–1158.

    CAS  PubMed  Google Scholar 

  44. Davis MA, Neuhaus JM, Ettinger WH, Mueller WH . Body fat distribution and osteoarthritis. Am J Epidemiol 1990; 132: 701–707.

    Article  CAS  PubMed  Google Scholar 

  45. Hochberg MC, Lethbridge-Cejku M, Plato CC, Wigley FM, Tobin JD . Factors associated with osteoarthritis of the hand in males: data from the Baltimore Longitudinal Study of Aging. Am J Epidemiol 1991; 134: 1121–1127.

    Article  CAS  PubMed  Google Scholar 

  46. Hochberg MC, Lethbridge-Cejku M, Scott Jr WW, Plato CC, Tobin JD . Obesity and osteoarthritis of the hands in women. Osteoarthritis Cartilage 1993; 1: 129–135.

    Article  CAS  PubMed  Google Scholar 

  47. Sayer AA, Poole J, Cox V, Kuh D, Hardy R, Wadsworth M et al. Weight from birth to 53 years: a longitudinal study of the influence on clinical hand osteoarthritis. Arthritis Rheum 2003; 48: 1030–1033.

    Article  PubMed  Google Scholar 

  48. Haara MM, Heliovaara M, Kroger H, Arokoski JP, Manninen P, Karkkainen A et al. Osteoarthritis in the carpometacarpal joint of the thumb. Prevalence and associations with disability and mortality. J Bone Joint Surg Am 2004; 86-A: 1452–1457.

    Article  Google Scholar 

  49. Dahaghin S, Bierma-Zeinstra SM, Koes BW, Hazes JM, Pols HA . Do metabolic factors add to the effect of overweight on hand osteoarthritis? The Rotterdam Study. Ann Rheum Dis 2007; 66: 916–920.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Loeser RF . Systemic and local regulation of articular cartilage metabolism: where does leptin fit in the puzzle? Arthritis Rheum 2003; 48: 3009–3012.

    Article  CAS  PubMed  Google Scholar 

  51. Dumond H, Presle N, Terlain B, Mainard D, Loeuille D, Netter P et al. Evidence for a key role of leptin in osteoarthritis. Arthritis Rheum 2003; 48: 3118–3129.

    Article  CAS  PubMed  Google Scholar 

  52. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman BN, Aliabadi P et al. The incidence and natural history of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 1995; 38: 1500–1505.

    Article  CAS  PubMed  Google Scholar 

  53. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000; 43: 1905–1915.

    Article  Google Scholar 

  54. Pendleton A, Arden N, Dougados M, Doherty M, Bannwarth B, Bijlsma JW et al. EULAR recommendations for the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2000; 59: 936–944.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C . Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord 2001; 25: 622–627.

    Article  CAS  PubMed  Google Scholar 

  56. Toda Y . The effect of energy restriction, walking, and exercise on lower extremity lean body mass in obese women with osteoarthritis of the knee. J Orthop Sci 2001; 6: 148–154.

    Article  CAS  PubMed  Google Scholar 

  57. Messier SP, Loeser RF, Mitchell MN, Valle G, Morgan TP, Rejeski WJ et al. Exercise and weight loss in obese older adults with knee osteoarthritis: a preliminary study. J Am Geriatr Soc 2000; 48: 1062–1072.

    Article  CAS  PubMed  Google Scholar 

  58. Huang MH, Chen CH, Chen TW, Weng MC, Wang WT, Wang YL . The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity. Arthritis Care Res 2000; 13: 398–405.

    Article  CAS  PubMed  Google Scholar 

  59. Rejeski WJ, Focht BC, Messier SP, Morgan T, Pahor M, Penninx B . Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol 2002; 21: 419–426.

    Article  PubMed  Google Scholar 

  60. Messier SP, Gutekunst DJ, Davis C, DeVita P . Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum 2005; 52: 2026–2032.

    Article  PubMed  Google Scholar 

  61. Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA . Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum 2004; 50: 1501–1510.

    Article  PubMed  Google Scholar 

  62. Christensen R, Astrup A, Bliddal H . Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial. Osteoarthritis Cartilage 2005; 13: 20–27.

    Article  CAS  PubMed  Google Scholar 

  63. Miller GD, Nicklas BJ, Davis CC, Ambrosius WT, Loeser RF, Messier SP . Is serum leptin related to physical function and is it modifiable through weight loss and exercise in older adults with knee osteoarthritis? Int J Obes Relat Metab Disord 2004; 28: 1383–1390.

    Article  CAS  PubMed  Google Scholar 

  64. Australia's Health 2006. Australian Institute of Health and Welfare 2006;. AIHW Cat. No. AUS-73:374-375.

  65. Spicer DD, Pomeroy DL, Badenhausen WE, Schaper Jr LA, Curry JI, Suthers KE et al. Body mass index as a predictor of outcome in total knee replacement. Int Orthop 2001; 25: 246–249.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Mont MA, Mathur SK, Krackow KA, Loewy JW, Hungerford DS . Cementless total knee arthroplasty in obese patients. A comparison with a matched control group. J Arthroplasty 1996; 11: 153–156.

    Article  CAS  PubMed  Google Scholar 

  67. Soballe K, Christensen F, Luxhoj T . Hip replacement in obese patients. Acta Orthop Scand 1987; 58: 223–225.

    Article  CAS  PubMed  Google Scholar 

  68. Callaghan JJ, Albright JC, Goetz DD, Olejniczak JP, Johnston RC . Charnley total hip arthroplasty with cement. Minimum twenty-five-year follow-up. J Bone Joint Surg Am 2000; 82: 487–497.

    Article  CAS  PubMed  Google Scholar 

  69. Wendelboe AM, Hegmann KT, Biggs JJ, Cox CM, Portmann AJ, Gildea JH et al. Relationships between body mass indices and surgical replacements of knee and hip joints. Am J Prev Med 2003; 25: 290–295.

    Article  PubMed  Google Scholar 

  70. Benjamin J, Tucker T, Ballesteros P . Is obesity a contraindication to bilateral total knee arthroplasties under one anesthetic? Clin Orthop Relat Res 2001; 392: 190–195.

    Article  Google Scholar 

  71. Berend KR, Lombardi Jr AV, Mallory TH, Adams JB, Groseth KL . Early failure of minimally invasive unicompartmental knee arthroplasty is associated with obesity. Clin Orthop Relat Res 2005; 440: 60–66.

    Article  PubMed  Google Scholar 

  72. Spahn G, Kirschbaum S, Kahl E . Factors that influence high tibial osteotomy results in patients with medial gonarthritis: a score to predict the results. Osteoarthritis Cartilage 2006; 14: 190–195.

    Article  CAS  PubMed  Google Scholar 

  73. Harrison MM, Morrell J, Hopman WM . Influence of obesity on outcome after knee arthroscopy. Arthroscopy 2004; 20: 691–695.

    Article  PubMed  Google Scholar 

  74. van Tulder M, Koes B . Chronic low back pain. Am Fam Physician 2006; 74: 1577–1579.

    PubMed  Google Scholar 

  75. Kwon MA, Shim WS, Kim MH, Gwak MS, Hahm TS, Kim GS et al. A correlation between low back pain and associated factors: a study involving 772 patients who had undergone general physical examination. J Korean Med Sci 2006; 21: 1086–1091.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Vindigni D, Walker BF, Jamison JR, Da Costa C, Parkinson L, Blunden S . Low back pain risk factors in a large rural Australian Aboriginal community. An opportunity for managing co-morbidities? Chiropr Osteopat 2005; 13: 21.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Bener A, Alwash R, Gaber T, Lovasz G . Obesity and low back pain. Coll Antropol 2003; 27: 95–104.

    PubMed  Google Scholar 

  78. Yip YB, Ho SC, Chan SG . Tall stature, overweight and the prevalence of low back pain in Chinese middle-aged women. Int J Obes Relat Metab Disord 2001; 25: 887–892.

    Article  CAS  PubMed  Google Scholar 

  79. Han TS, Schouten JS, Lean ME, Seidell JC . The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord 1997; 21: 600–607.

    Article  CAS  PubMed  Google Scholar 

  80. Mirtz TA, Greene L . Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropr Osteopat 2005; 13: 2.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Fanuele JC, Abdu WA, Hanscom B, Weinstein JN . Association between obesity and functional status in patients with spine disease. Spine 2002; 27: 306–312.

    Article  PubMed  Google Scholar 

  82. Fransen M, Woodward M, Norton R, Coggan C, Dawe M, Sheridan N . Risk factors associated with the transition from acute to chronic occupational back pain. Spine 2002; 27: 92–98.

    Article  PubMed  Google Scholar 

  83. Melissas J, Kontakis G, Volakakis E, Tsepetis T, Alegakis A, Hadjipavlou A . The effect of surgical weight reduction on functional status in morbidly obese patients with low back pain. Obes Surg 2005; 15: 378–381.

    Article  PubMed  Google Scholar 

  84. Melissas J, Volakakis E, Hadjipavlou A . Low-back pain in morbidly obese patients and the effect of weight loss following surgery. Obes Surg 2003; 13: 389–393.

    Article  PubMed  Google Scholar 

  85. Liuke M, Solovieva S, Lamminen A, Luoma K, Leino-Arjas P, Luukkonen R et al. Disc degeneration of the lumbar spine in relation to overweight. Int J Obes (Lond) 2005; 29: 903–908.

    Article  CAS  Google Scholar 

  86. Fassett DR, Schmidt MH . Spinal epidural lipomatosis: a review of its causes and recommendations for treatment. Neurosurg Focus 2004; 16: E11.

    PubMed  Google Scholar 

  87. Yamakawa K, Tsai CK, Haig AJ, Miner JA, Harris MJ . Relationship between ambulation and obesity in older persons with and without low back pain. Int J Obes Relat Metab Disord 2004; 28: 137–143.

    Article  CAS  PubMed  Google Scholar 

  88. Bejia I, Younes M, Zrour S, Touzi M, Bergaoui N . Factors predicting outcomes of mechanical sciatica: a review of 1092 cases. Joint Bone Spine 2004; 71: 567–571.

    Article  PubMed  Google Scholar 

  89. Yang SH, Wu CC, Chen PQ . Postoperative meralgia paresthetica after posterior spine surgery: incidence, risk factors, and clinical outcomes. Spine 2005; 30: E547–E550.

    Article  PubMed  Google Scholar 

  90. Gepstein R, Shabat S, Arinzon ZH, Berner Y, Catz A, Folman Y . Does obesity affect the results of lumbar decompressive spinal surgery in the elderly? Clin Orthop Relat Res 2004; 426: 138–144.

    Article  Google Scholar 

  91. Smythe HA LG . Diffuse idiopathic skeletal hyperostosis. In: Klippel JH (ed). Rheumatology. Mosby: London, 1998. pp 8.10.1–6.

    Google Scholar 

  92. Denko CW, Boja B, Moskowitz RW . Growth promoting peptides in osteoarthritis and diffuse idiopathic skeletal hyperostosis—insulin, insulin-like growth factor-I, growth hormone. J Rheumatol 1994; 21: 1725–1730.

    CAS  PubMed  Google Scholar 

  93. Mader R, Dubenski N, Lavi I . Morbidity and mortality of hospitalized patients with diffuse idiopathic skeletal hyperostosis. Rheumatol Int 2005; 26: 132–136.

    Article  CAS  PubMed  Google Scholar 

  94. Shirakura Y, Sugiyama T, Tanaka H, Taguchi T, Kawai S . Hyperleptinemia in female patients with ossification of spinal ligaments. Biochem Biophys Res Commun 2000; 267: 752–755.

    Article  CAS  PubMed  Google Scholar 

  95. Hills AP, Hennig EM, Byrne NM, Steele JR . The biomechanics of adiposity—structural and functional limitations of obesity and implications for movement. Obes Rev 2002; 3: 35–43.

    Article  CAS  PubMed  Google Scholar 

  96. Sharma L . Local factors in osteoarthritis. Curr Opin Rheumatol 2001; 13: 441–446.

    Article  CAS  PubMed  Google Scholar 

  97. Van Boerum DH, Sangeorzan BJ . Biomechanics and pathophysiology of flat foot. Foot Ankle Clin 2003; 8: 419–430.

    Article  PubMed  Google Scholar 

  98. Birtane M, Tuna H . The evaluation of plantar pressure distribution in obese and non-obese adults. Clin Biomech (Bristol, Avon) 2004; 19: 1055–1059.

    Article  Google Scholar 

  99. Gravante G, Russo G, Pomara F, Ridola C . Comparison of ground reaction forces between obese and control young adults during quiet standing on a baropodometric platform. Clin Biomech (Bristol, Avon) 2003; 18: 780–782.

    Article  CAS  Google Scholar 

  100. Wearing SC, Hills AP, Byrne NM, Hennig EM, McDonald M . The arch index: a measure of flat or fat feet? Foot Ankle Int 2004; 25: 575–581.

    Article  PubMed  Google Scholar 

  101. Messier SP . Osteoarthritis of the knee and associated factors of age and obesity: effects on gait. Med Sci Sports Exerc 1994; 26: 1446–1452.

    CAS  PubMed  Google Scholar 

  102. Syed IY, Davis BL . Obesity and osteoarthritis of the knee: hypotheses concerning the relationship between ground reaction forces and quadriceps fatigue in long-duration walking. Med Hypotheses 2000; 54: 182–185.

    Article  CAS  PubMed  Google Scholar 

  103. Maffiuletti NA, Agosti F, Proietti M, Riva D, Resnik M, Lafortuna CL et al. Postural instability of extremely obese individuals improves after a body weight reduction program entailing specific balance training. J Endocrinol Invest 2005; 28: 2–7.

    Article  CAS  PubMed  Google Scholar 

  104. Jadelis K, Miller ME, Ettinger Jr WH, Messier SP . Strength, balance, and the modifying effects of obesity and knee pain: results from the Observational Arthritis Study in Seniors (oasis). J Am Geriatr Soc 2001; 49: 884–891.

    Article  CAS  PubMed  Google Scholar 

  105. Hulens M, Vansant G, Claessens AL, Lysens R, Muls E . Predictors of 6-minute walk test results in lean, obese and morbidly obese women. Scand J Med Sci Sports 2003; 13: 98–105.

    Article  CAS  PubMed  Google Scholar 

  106. Walker-Bone KE, Palmer KT, Reading I, Cooper C . Soft-tissue rheumatic disorders of the neck and upper limb: prevalence and risk factors. Semin Arthritis Rheum 2003; 33: 185–203.

    Article  PubMed  Google Scholar 

  107. Werner RA, Franzblau A, Gell N, Ulin SS, Armstrong TJ . A longitudinal study of industrial and clerical workers: predictors of upper extremity tendonitis. J Occup Rehabil 2005; 15: 37–46.

    Article  PubMed  Google Scholar 

  108. Descatha A, Leclerc A, Chastang JF, Roquelaure Y . Incidence of ulnar nerve entrapment at the elbow in repetitive work. Scand J Work Environ Health 2004; 30: 234–240.

    Article  PubMed  Google Scholar 

  109. Hooper MM, Stellato TA, Hallowell PT, Seitz BA, Moskowitz RW . Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery. Int J Obes (Lond) 2007; 31: 114–120.

    Article  CAS  Google Scholar 

  110. Geoghegan JM, Clark DI, Bainbridge LC, Smith C, Hubbard R . Risk factors in carpal tunnel syndrome. J Hand Surg [Br] 2004; 29: 315–320.

    Article  CAS  Google Scholar 

  111. Bland JD . The relationship of obesity, age, and carpal tunnel syndrome: more complex than was thought? Muscle Nerve 2005; 32: 527–532.

    Article  PubMed  Google Scholar 

  112. Becker J, Nora DB, Gomes I, Stringari FF, Seitensus R, Panosso JS et al. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clin Neurophysiol 2002; 113: 1429–1434.

    Article  PubMed  Google Scholar 

  113. Wendelboe AM, Hegmann KT, Gren LH, Alder SC, White Jr GL, Lyon JL . Associations between body-mass index and surgery for rotator cuff tendinitis. J Bone Joint Surg Am 2004; 86-A: 743–747.

    Article  Google Scholar 

  114. Riddle DL, Pulisic M, Pidcoe P, Johnson RE . Risk factors for Plantar fasciitis: a matched case–control study. J Bone Joint Surg Am 2003; 85-A: 872–877.

    Article  Google Scholar 

  115. Irving DB, Cook JL, Young MA, Menz HB . Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case–control study. BMC Musculoskelet Disord 2007; 8: 41.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Messier SP, Pittala KA . Etiologic factors associated with selected running injuries. Med Sci Sports Exerc 1988; 20: 501–505.

    Article  CAS  PubMed  Google Scholar 

  117. Cohen SP, Narvaez JC, Lebovits AH, Stojanovic MP . Corticosteroid injections for trochanteric bursitis: is fluoroscopy necessary? A pilot study. Br J Anaesth 2005; 94: 100–106.

    Article  CAS  PubMed  Google Scholar 

  118. Nguyen TV, Kelly PJ, Sambrook PN, Gilbert C, Pocock NA, Eisman JA . Lifestyle factors and bone density in the elderly: implications for osteoporosis prevention. J Bone Miner Res 1994; 9: 1339–1346.

    Article  CAS  PubMed  Google Scholar 

  119. Bauer DC, Browner WS, Cauley JA, Orwoll ES, Scott JC, Black DM et al. Factors associated with appendicular bone mass in older women. The Study of Osteoporotic Fractures Research Group. Ann Intern Med 1993; 118: 657–665.

    Article  CAS  PubMed  Google Scholar 

  120. Kroger H, Tuppurainen M, Honkanen R, Alhava E, Saarikoski S . Bone mineral density and risk factors for osteoporosis—a population-based study of 1600 perimenopausal women. Calcif Tissue Int 1994; 55: 1–7.

    Article  CAS  PubMed  Google Scholar 

  121. Pluijm SM, Visser M, Smit JH, Popp-Snijders C, Roos JC, Lips P . Determinants of bone mineral density in older men and women: body composition as mediator. J Bone Miner Res 2001; 16: 2142–2151.

    Article  CAS  PubMed  Google Scholar 

  122. Felson DT, Zhang Y, Hannan MT, Anderson JJ . Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res 1993; 8: 567–573.

    Article  CAS  PubMed  Google Scholar 

  123. Edelstein SL, Barrett-Connor E . Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 1993; 138: 160–169.

    Article  CAS  PubMed  Google Scholar 

  124. Liel Y, Edwards J, Shary J, Spicer KM, Gordon L, Bell NH . The effects of race and body habitus on bone mineral density of the radius, hip, and spine in premenopausal women. J Clin Endocrinol Metab 1988; 66: 1247–1250.

    Article  CAS  PubMed  Google Scholar 

  125. Halioua L, Anderson JJ . Age and anthropometric determinants of radial bone mass in premenopausal Caucasian women: a cross-sectional study. Osteoporos Int 1990; 1: 50–55.

    Article  CAS  PubMed  Google Scholar 

  126. Dawson-Hughes B, Shipp C, Sadowski L, Dallal G . Bone density of the radius, spine, and hip in relation to percent of ideal body weight in postmenopausal women. Calcif Tissue Int 1987; 40: 310–314.

    Article  CAS  PubMed  Google Scholar 

  127. Ribot C, Tremollieres F, Pouilles JM, Louvet JP, Guiraud R . Influence of the menopause and aging on spinal density in French women. Bone Miner 1988; 5: 89–97.

    Article  CAS  PubMed  Google Scholar 

  128. Lenchik L, Register TC, Hsu FC, Lohman K, Nicklas BJ, Freedman BI et al. Adiponectin as a novel determinant of bone mineral density and visceral fat. Bone 2003; 33: 646–651.

    Article  CAS  PubMed  Google Scholar 

  129. Reid IR . Relationships among body mass, its components, and bone. Bone 2002; 31: 547–555.

    Article  CAS  PubMed  Google Scholar 

  130. Makovey J, Naganathan V, Sambrook P . Gender differences in relationships between body composition components, their distribution and bone mineral density: a cross-sectional opposite sex twin study. Osteoporos Int 2005; 16: 1495–1505.

    Article  PubMed  Google Scholar 

  131. Zhao LJ, Liu YJ, Hamilton J, Recker RR, Deng HW . Interventions decreasing obesity risk tend to be beneficial for decreasing risk to osteoporosis: a challenge to the current dogma. International Osteoporosis Foundation World Congress 2006. abstract: P152SU.

  132. Kato I, Toniolo P, Zeleniuch-Jacquotte A, Shore RE, Koenig KL, Akhmedkhanov A et al. Diet, smoking and anthropometric indices and postmenopausal bone fractures: a prospective study. Int J Epidemiol 2000; 29: 85–92.

    Article  CAS  PubMed  Google Scholar 

  133. Mattila VM, Jormanainen V, Sahi T, Pihlajamaki H . An association between socioeconomic, health and health behavioural indicators and fractures in young adult males. Osteoporos Int 2007; June 13 [E-pub ahead of print].

  134. Nguyen TV, Sambrook PN, Eisman JA . Bone loss, physical activity, and weight change in elderly women: the Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res 1998; 13: 1458–1467.

    Article  CAS  PubMed  Google Scholar 

  135. Ensrud KE, Lewis CE, Lambert LC, Taylor BC, Fink HA, Barrett-Connor E et al. Endogenous sex steroids, weight change and rates of hip bone loss in older men: the MrOS study. Osteoporos Int 2006; 17: 1329–1336.

    Article  CAS  PubMed  Google Scholar 

  136. Tothill P . Dual-energy x-ray absorptiometry measurements of total-body bone mineral during weight change. J Clin Densitom 2005; 8: 31–38.

    Article  PubMed  Google Scholar 

  137. Riedt CS, Cifuentes M, Stahl T, Chowdhury HA, Schlussel Y, Shapses SA . Overweight postmenopausal women lose bone with moderate weight reduction and 1 g/day calcium intake. J Bone Miner Res 2005; 20: 455–463.

    Article  CAS  PubMed  Google Scholar 

  138. Villareal DT, Fontana L, Weiss EP, Racette SB, Steger-May K, Schechtman KB et al. Bone mineral density response to caloric restriction-induced weight loss or exercise-induced weight loss: a randomized controlled trial. Arch Intern Med 2006; 166: 2502–2510.

    Article  PubMed  Google Scholar 

  139. Hogan SL . The effects of weight loss on calcium and bone. Crit Care Nurs Q 2005; 28: 269–275.

    Article  PubMed  Google Scholar 

  140. Lips P . Vitamin D physiology. Prog Biophys Mol Biol 2006; 92: 4–8.

    Article  CAS  PubMed  Google Scholar 

  141. Saag KG, Choi H . Epidemiology, risk factors, and lifestyle modifications for gout. Arthritis Res Ther 2006; 8 (Suppl 1): S2.

    Article  PubMed  PubMed Central  Google Scholar 

  142. Roubenoff R, Klag MJ, Mead LA, Liang KY, Seidler AJ, Hochberg MC . Incidence and risk factors for gout in white men. JAMA 1991; 266: 3004–3007.

    Article  CAS  PubMed  Google Scholar 

  143. Takahashi S, Yamamoto T, Tsutsumi Z, Moriwaki Y, Yamakita J, Higashino K . Close correlation between visceral fat accumulation and uric acid metabolism in healthy men. Metabolism 1997; 46: 1162–1165.

    Article  CAS  PubMed  Google Scholar 

  144. Thompson D, Lettich L, Takeshita J . Fibromyalgia: an overview. Curr Psychiatry Rep 2003; 5: 211–217.

    Article  PubMed  Google Scholar 

  145. Shapiro JR, Anderson DA, Danoff-Burg S . A pilot study of the effects of behavioral weight loss treatment on fibromyalgia symptoms. J Psychosom Res 2005; 59: 275–282.

    Article  PubMed  Google Scholar 

  146. Symmons DP . Looking back: rheumatoid arthritis—aetiology, occurrence and mortality. Rheumatology (Oxford) 2005; 44 (Suppl 4): iv14–iv17.

    Article  Google Scholar 

  147. Symmons DP, Bankhead CR, Harrison BJ, Brennan P, Barrett EM, Scott DG et al. Blood transfusion, smoking, and obesity as risk factors for the development of rheumatoid arthritis: results from a primary care-based incident case–control study in Norfolk, England. Arthritis Rheum 1997; 40: 1955–1961.

    Article  CAS  PubMed  Google Scholar 

  148. Voigt LF, Koepsell TD, Nelson JL, Dugowson CE, Daling JR . Smoking, obesity, alcohol consumption, and the risk of rheumatoid arthritis. Epidemiology 1994; 5: 525–532.

    CAS  PubMed  Google Scholar 

  149. Cerhan JR, Saag KG, Criswell LA, Merlino LA, Mikuls TR . Blood transfusion, alcohol use, and anthropometric risk factors for rheumatoid arthritis in older women. J Rheumatol 2002; 29: 246–254.

    PubMed  Google Scholar 

  150. Escalante A, Haas RW, del R I . Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation. Arch Intern Med 2005; 165: 1624–1629.

    Article  PubMed  Google Scholar 

  151. Garcia-Poma A, Segami MI, Terrazas HN, Ugarte MF, Rhor EA, Mora CS et al. Independent association between obesity and impaired quality of life in patients with rheumatoid arthritis. ACR Annual Scientific Meeting 2006. abstract: presentation number: 123.

  152. Otero M, Lago R, Gomez R, Lago F, Dieguez C, Gomez-Reino JJ et al. Changes in plasma levels of fat-derived hormones adiponectin, leptin, resistin and visfatin in patients with rheumatoid arthritis. Ann Rheum Dis 2006; 65: 1198–1201.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  153. Qazi UM, Petri M . Autoantibodies, low complement and obesity predict pre-eclampsia in SLE: a case–control study. ACR Annual Scientific Meeting 2006. abstract: presentation number: 552.

  154. Utset TO, Laughlin J, Schmitz A . Obesity in systemic lupus erythematosus. ACR Annual Scientific Meeting 2006. abstract: presentation number: 593.

  155. Harle P, Pongratz G, Weidler C, Buttner R, Scholmerich J, Straub RH . Possible role of leptin in hypoandrogenicity in patients with systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis 2004; 63: 809–816.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  156. Verbrugge LM, Gates DM, Ike RW . Risk factors for disability among US adults with arthritis. J Clin Epidemiol 1991; 44: 167–182.

    Article  CAS  PubMed  Google Scholar 

  157. Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM et al. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 2000; 133: 635–646.

    Article  CAS  PubMed  Google Scholar 

  158. Visser M, Langlois J, Guralnik JM, Cauley JA, Kronmal RA, Robbins J et al. High body fatness, but not low fat-free mass, predicts disability in older men and women: the Cardiovascular Health Study. Am J Clin Nutr 1998; 68: 584–590.

    Article  CAS  PubMed  Google Scholar 

  159. Okoro CA, Hootman JM, Strine TW, Balluz LS, Mokdad AH . Disability, arthritis, and body weight among adults 45 years and older. Obes Res 2004; 12: 854–861.

    Article  PubMed  Google Scholar 

  160. Jordan JM, Luta G, Renner JB, Linder GF, Dragomir A, Hochberg MC et al. Self-reported functional status in osteoarthritis of the knee in a rural southern community: the role of sociodemographic factors, obesity, and knee pain. Arthritis Care Res 1996; 9: 273–278.

    Article  CAS  PubMed  Google Scholar 

  161. Weil E, Wachterman M, McCarthy EP, Davis RB, O'Day B, Iezzoni LI et al. Obesity among adults with disabling conditions. JAMA 2002; 288: 1265–1268.

    Article  PubMed  Google Scholar 

  162. Focht BC, Rejeski WJ, Ambrosius WT, Katula JA, Messier SP . Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum 2005; 53: 659–665.

    Article  PubMed  Google Scholar 

  163. Leroux I, Dionne CE, Bourbonnais R, Brisson C . Prevalence of musculoskeletal activity limitation and associated factors among adults in the general population in the 1998 Quebec Health Survey. J Rheumatol 2005; 32: 1794–1804.

    PubMed  Google Scholar 

  164. Adamson J, Ebrahim S, Dieppe P, Hunt K . Prevalence and risk factors for joint pain among men and women in the West of Scotland Twenty-07 study. Ann Rheum Dis 2006; 65: 520–524.

    Article  CAS  PubMed  Google Scholar 

  165. Tsuritani I, Honda R, Noborisaka Y, Ishida M, Ishizaki M, Yamada Y . Impact of obesity on musculoskeletal pain and difficulty of daily movements in Japanese middle-aged women. Maturitas 2002; 42: 23–30.

    Article  PubMed  Google Scholar 

  166. Aoyagi K, Ross PD, Okano K, Hayashi T, Moji K, Kusano Y et al. Association of body mass index with joint pain among community-dwelling women in Japan. Aging Clin Exp Res 2002; 14: 378–381.

    Article  PubMed  Google Scholar 

  167. Andersen RE, Crespo CJ, Bartlett SJ, Bathon JM, Fontaine KR . Relationship between body weight gain and significant knee, hip, and back pain in older Americans. Obes Res 2003; 11: 1159–1162.

    Article  PubMed  Google Scholar 

  168. Marchesini G, Natale S, Tiraferri F, Tartaglia A, Moscatiello S, Marchesini RL et al. The burden of obesity on everyday life: a role for osteoarticular and respiratory diseases. Diabetes Nutr Metab 2003; 16: 284–290.

    CAS  PubMed  Google Scholar 

  169. Jinks C, Jordan K, Croft P . Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain 2002; 100: 55–64.

    Article  PubMed  Google Scholar 

  170. Heo M, Allison DB, Faith MS, Zhu S, Fontaine KR . Obesity and quality of life: mediating effects of pain and comorbidities. Obes Res 2003; 11: 209–216.

    Article  PubMed  Google Scholar 

  171. Australia's Health 2006. Australian Institute of Health and Welfare 2006. AIHW Cat.No. AUS-73:27.

  172. Hulens M, Vansant G, Lysens R, Claessens AL, Muls E . Exercise capacity in lean versus obese women. Scand J Med Sci Sports 2001; 11: 305–309.

    Article  CAS  PubMed  Google Scholar 

  173. Larsson UE . Influence of weight loss on pain, perceived disability and observed functional limitations in obese women. Int J Obes Relat Metab Disord 2004; 28: 269–277.

    Article  PubMed  Google Scholar 

  174. Christensen R, Bartels EM, Astrup A, Bliddal H . The effect of weight reduction in obese patients diagnosed with knee osteoarthritis (OA): a systematic review and meta-analysis. EULAR Annual Scientific Meeting 2006. abstract: presentation number: OP0194.

  175. Blaum CS, Xue QL, Michelon E, Semba RD, Fried LP . The association between obesity and the frailty syndrome in older women: the Women's Health and Aging Studies. J Am Geriatr Soc 2005; 53: 927–934.

    Article  PubMed  Google Scholar 

  176. Villareal DT, Banks M, Siener C, Sinacore DR, Klein S . Physical frailty and body composition in obese elderly men and women. Obes Res 2004; 12: 913–920.

    Article  PubMed  Google Scholar 

  177. Borowiak E, Kostka T . Predictors of quality of life in older people living at home and in institutions. Aging Clin Exp Res 2004; 16: 212–220.

    Article  PubMed  Google Scholar 

  178. The economic costs of obesity. Access Economics Australia 2006; http://www.accesseconomics.com.au/publicationsreports.

  179. Hartman E, Oude Vrielink HH, Huirne RB, Metz JH . Risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers: a case–control study. Am J Ind Med 2006; 49: 204–214.

    Article  PubMed  Google Scholar 

  180. Peltonen M, Lindroos AK, Torgerson JS . Musculoskeletal pain in the obese: a comparison with a general population and long-term changes after conventional and surgical obesity treatment. Pain 2003; 104: 549–557.

    Article  PubMed  Google Scholar 

  181. Counterweight Project Team. The impact of obesity on drug prescribing in primary care. Br J Gen Pract 2005; 55: 743–749.

    PubMed Central  Google Scholar 

  182. Elimimian JU, Smith PA, Iluore A . Musculoskeletal disorders and the consumption of disability products. Health Mark Q 1999; 17: 83–98.

    Article  CAS  PubMed  Google Scholar 

  183. Manninen P, Riihimaki H, Heliovaara M, Makela P . Overweight, gender and knee osteoarthritis. Int J Obes Relat Metab Disord 1996; 20: 595–597.

    CAS  PubMed  Google Scholar 

  184. Mansson NO, Eriksson KF, Israelsson B, Ranstam J, Melander A, Rastam L . Body mass index and disability pension in middle-aged men—non-linear relations. Int J Epidemiol 1996; 25: 80–85.

    Article  CAS  PubMed  Google Scholar 

  185. Baird IM . Obesity and insurance risk: the insurance industry's viewpoint. Pharmacoeconomics 1994; 5 (Suppl 1): 62–65.

    Article  CAS  PubMed  Google Scholar 

  186. Gallagher S . Obesity and the aging adult: ideas for promoting patient safety and preventing caregiver injury. Clin Geriatr Med 2005; 21: 757–765.

    Article  PubMed  Google Scholar 

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Acknowledgements

Ananthila Anandacoomarasamy holds a National Health and Medical Research Council Medical Postgraduate Research Scholarship (ID number 402901).

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Anandacoomarasamy, A., Caterson, I., Sambrook, P. et al. The impact of obesity on the musculoskeletal system. Int J Obes 32, 211–222 (2008). https://doi.org/10.1038/sj.ijo.0803715

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Keywords

  • musculoskeletal
  • arthritis
  • disability
  • function

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