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Body fat is associated with increased and lean mass with decreased knee cartilage loss in older adults: a prospective cohort study

Abstract

Objective:

To determine the associations between body composition at baseline and knee cartilage loss over 2.9 years in older adults.

Methods:

A total of 395 randomly selected subjects (mean 62 years, range 51–81, 50% female) were studied at baseline and 2.9 years later. T1-weighted fat-suppressed magnetic resonance imaging of the right knee was performed to determine knee cartilage volume and tibial bone area at baseline and follow-up. Height, weight and radiographic osteoarthritis were measured by standard protocols at baseline. Fat mass and lean mass were measured by dual-energy X-ray absorptiometry at baseline.

Results:

Tibial cartilage volume decreased by 2.0–2.7% per annum. In multivariable analysis, annual change in medial cartilage volume was negatively and significantly associated with body mass index (β: −0.14% per kg m−2, 95% confidence interval (CI): −0.25%, −0.02%), percentage total body fat (β: −0.19% per %, 95% CI: −0.30%, −0.07%) and percentage trunk fat (β: −0.10% per %, 95% CI: −0.19%, −0.02%), and positively associated with percentage lean mass (β: 0.20% per %, 95% CI: 0.08%, 0.32%). Change in lateral tibial cartilage volume was also significantly associated with percentage total body fat (β: −0.11% per %, 95% CI: −0.21%, −0.001%) and total lean mass (β: 0.13% per kg, 95% CI: 0.04%, 0.22%). These were independent of sex and age even though both were also significant predictors.

Conclusions:

Body fat adversely affects tibial cartilage loss over time, whereas lean mass is protective. Strategies aimed at reducing body fat but increasing lean mass may reduce knee cartilage loss in older people.

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References

  1. 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  Google Scholar 

  2. 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  Google Scholar 

  3. Ding C, Cicuttini F, Scott F, Cooley H, Jones G . Association between age and knee structural change: a cross sectional MRI based study. Ann Rheum Dis 2005; 64: 549–555.

    Article  CAS  Google Scholar 

  4. Ding C, Cicuttini F, Blizzard L, Scott F, Jones G . A longitudinal study of the effect of sex and age on rate of change in knee cartilage volume in adults. Rheumatology 2007; 46: 273–279.

    Article  Google Scholar 

  5. 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  Google Scholar 

  6. 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  Google Scholar 

  7. 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  Google Scholar 

  8. Richette P, Poitou C, Garnero P, Vicaut E, Bouillot JL, Lacorte JM et al. Benefits of massive weight loss on symptoms, systemic inflammation and cartilage turnover in obese patients with knee osteoarthritis. Ann Rheum Dis 2011; 70: 139–144.

    Article  CAS  Google Scholar 

  9. Ding C, Cicuttini F, Scott F, Boon C, Jones G . Association of prevalent and incident knee cartilage defects with loss of tibial and patellar cartilage: A longitudinal study. Arthritis Rheum 2005; 52: 3918–3927.

    Article  Google Scholar 

  10. Ding C, Cicuttini F, Blizzard L, Jones G . Smoking interacts with family history with regard to knee cartilage loss and cartilage defect development. Arthritis Rheum 2007; 56: 1521–1528.

    Article  Google Scholar 

  11. Wluka AE, Stuckey S, Snaddon J, Cicuttini FM . The determinants of change in tibial cartilage volume in osteoarthritic knees. Arthritis Rheum 2002; 46: 2065–2072.

    Article  Google Scholar 

  12. Cicuttini F, Wluka A, Wang Y, Stuckey S . The determinants of change in patella cartilage volume in osteoarthritic knees. J Rheumatol 2002; 29: 2615–2619.

    PubMed  Google Scholar 

  13. Antony B, Ding C, Stannus O, Cicuttini F, Jones G . Association of baseline knee bone size, cartilage volume, and body mass index with knee cartilage loss over time: a longitudinal study in younger or middle-aged adults. J Rheumatol 2011; 38: 1973–1980.

    Article  Google Scholar 

  14. Ding C, Cicuttini F, Scott F, Cooley H, Boon C, Jones G . Natural history of knee cartilage defects and factors affecting change. Arch Intern Med 2006; 166: 651–658.

    Article  Google Scholar 

  15. 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  Google Scholar 

  16. Teichtahl AJ, Wang Y, Wluka AE, Cicuttini FM . Obesity and knee osteoarthritis: new insights provided by body composition studies. Obesity 2008; 16: 232–240.

    Article  Google Scholar 

  17. Altman RD, Hochberg M, Murphy WA, Wolfe F, Lequesne M . Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage 1995; 3: 3–70.

    PubMed  Google Scholar 

  18. Jones G, Ding C, Scott F, Glisson M, Cicuttini F . Early radiographic osteoarthritis is associated with substantial changes in cartilage volume and tibial bone surface area in both males and females. Osteoarthritis Cartilage 2004; 12: 169–174.

    Article  CAS  Google Scholar 

  19. Jones G, Glisson M, Hynes K, Cicuttini F . Sex and site differences in cartilage development: a possible explanation for variations in knee osteoarthritis in later life. Arthritis Rheum 2000; 43: 2543–2549.

    Article  CAS  Google Scholar 

  20. Ding C, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G . Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study. Arthritis Rheum 2009; 60: 1381–1389.

    Article  Google Scholar 

  21. Raynauld JP, Martel-Pelletier J, Berthiaume MJ, Beaudoin G, Choquette D, Haraoui B et al. Long term evaluation of disease progression through the quantitative magnetic resonance imaging of symptomatic knee osteoarthritis patients: correlation with clinical symptoms and radiographic changes. Arthritis Res Ther 2006; 8: R21.

    Article  Google Scholar 

  22. Wluka AE, Wolfe R, Davis SR, Stuckey S, Cicuttini FM . Tibial cartilage volume change in healthy postmenopausal women: a longitudinal study. Ann Rheum Dis 2004; 63: 444–449.

    Article  CAS  Google Scholar 

  23. Hanna F, Ebeling PR, Wang Y, O'Sullivan R, Davis S, Wluka AE et al. Factors influencing longitudinal change in knee cartilage volume measured from magnetic resonance imaging in healthy men. Ann Rheum Dis 2005; 64: 1038–1042.

    Article  CAS  Google Scholar 

  24. Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J et al. Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes 2008; 32: 959–966.

    Article  CAS  Google Scholar 

  25. Wang Y, Wluka AE, English DR, Teichtahl AJ, Giles GG, O’Sullivan R et al. Body composition and knee cartilage properties in healthy, community-based adults. Ann Rheum Dis 2007; 66: 1244–1248.

    Article  Google Scholar 

  26. Teichtahl AJ, Wluka AE, Wang Y, Hanna F, English DR, Giles GG et al. Obesity and adiposity are associated with the rate of patella cartilage volume loss over 2 years in adults without knee osteoarthritis. Ann Rheum Dis 2009; 68: 909–913.

    Article  CAS  Google Scholar 

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Acknowledgements

Special thanks go to the subjects who made this study possible. The role of C Boon and P Boon in collecting the data is gratefully acknowledged. We would like to thank Dr G Zhai, Mr R Warren and Ms S Wei for MRI readings, and Drs V Srikanth and H Cooley for radiographic assessment. C Ding is a recipient of NHMRC Clinical Career Development Award and G Jones is a recipient of NHMRC Practitioner Fellowship. This work was supported by the National Health and Medical Research Council of Australia; Australian Research Council Future Fellowship; Tasmanian Community Fund; Arthritis Foundation of Australia; University of Tasmania Grant-Institutional Research Scheme and Rising Star Programme.

Author contributions

All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be submitted for publication. A/Prof Ding had full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study conception and design: Ding, Jones, Cicuttini. Acquisition of data: Ding, Stannus, Antony. Analysis and interpretation of data: Ding, Stannus, Antony, Jones.

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Correspondence to C Ding.

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Ding, C., Stannus, O., Cicuttini, F. et al. Body fat is associated with increased and lean mass with decreased knee cartilage loss in older adults: a prospective cohort study. Int J Obes 37, 822–827 (2013). https://doi.org/10.1038/ijo.2012.136

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  • DOI: https://doi.org/10.1038/ijo.2012.136

Keywords

  • cartilage volume
  • body fat
  • lean mass
  • osteoarthritis

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