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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



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


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.


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.


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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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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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).

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  • cartilage volume
  • body fat
  • lean mass
  • osteoarthritis

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