Abstract
Objective: To examine the effect of weight changes between 20 and 50 years of age on the risk of severe knee osteoarthritis (OA) requiring arthroplasty.
Subjects and methods: Cases were 55–75 year old men and women (n = 220) having had knee arthroplasty for primary osteoarthritis at the Kuopio University Hospital in 1992–93. Controls (n = 415) were randomly selected from the population of Kuopio Province. Weight at the age of 20, 30, 40, and 50 years was collected retrospectively with a postal questionnaire.
Results: After adjustment for age, sex, history of physical workload, recreational physical activity, and previous knee injury, weight gain resulting to a shift from normal body mass index (BMI ⩽25 kg/m2) to overweight (BMI >25 kg/m2) was associated with a higher relative risk of knee OA requiring arthroplasty than persistent overweight from 20–50 years of age, compared with those with normal relative weight during the corresponding age period. The odds ratios (OR) were 3.07 (95% confidence interval 1.87 to 5.05) for those with normal weight at the age of 20 years and overweight at two or three of the ages 30, 40 or 50 years, 3.15 (1.85 to 5.36) for those with overweight from the age of 30 years, and 2.37 (1.21 to 4.62) for those with overweight from the age of 20 years, respectively.
Conclusion: In adult life, a shift from normal to overweight may carry a higher risk for knee OA requiring arthroplasty than does constant overweight.
Full Text
The Full Text of this article is available as a PDF (59.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson J. J., Felson D. T. 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 Jul;128(1):179–189. doi: 10.1093/oxfordjournals.aje.a114939. [DOI] [PubMed] [Google Scholar]
- Cicuttini F. M., Spector T. D. Genetics of osteoarthritis. Ann Rheum Dis. 1996 Sep;55(9):665–667. doi: 10.1136/ard.55.9.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cicuttini F. M., Spector T., Baker J. Risk factors for osteoarthritis in the tibiofemoral and patellofemoral joints of the knee. J Rheumatol. 1997 Jun;24(6):1164–1167. [PubMed] [Google Scholar]
- Coggon D., Reading I., Croft P., McLaren M., Barrett D., Cooper C. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001 May;25(5):622–627. doi: 10.1038/sj.ijo.0801585. [DOI] [PubMed] [Google Scholar]
- Cooper C., McAlindon T., Coggon D., Egger P., Dieppe P. Occupational activity and osteoarthritis of the knee. Ann Rheum Dis. 1994 Feb;53(2):90–93. doi: 10.1136/ard.53.2.90. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooper C., McAlindon T., Snow S., Vines K., Young P., Kirwan J., Dieppe P. Mechanical and constitutional risk factors for symptomatic knee osteoarthritis: differences between medial tibiofemoral and patellofemoral disease. J Rheumatol. 1994 Feb;21(2):307–313. [PubMed] [Google Scholar]
- Cooper C. Occupational activity and the risk of osteoarthritis. J Rheumatol Suppl. 1995 Feb;43:10–12. [PubMed] [Google Scholar]
- Cooper C., Snow S., McAlindon T. E., Kellingray S., Stuart B., Coggon D., Dieppe P. A. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000 May;43(5):995–1000. doi: 10.1002/1529-0131(200005)43:5<995::AID-ANR6>3.0.CO;2-1. [DOI] [PubMed] [Google Scholar]
- Creamer P., Lethbridge-Cejku M., Hochberg M. C. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford) 2000 May;39(5):490–496. doi: 10.1093/rheumatology/39.5.490. [DOI] [PubMed] [Google Scholar]
- Davis M. A., Ettinger W. H., Neuhaus J. M., Cho S. A., Hauck W. W. The association of knee injury and obesity with unilateral and bilateral osteoarthritis of the knee. Am J Epidemiol. 1989 Aug;130(2):278–288. doi: 10.1093/oxfordjournals.aje.a115334. [DOI] [PubMed] [Google Scholar]
- Davis M. A., Ettinger W. H., Neuhaus J. M. Obesity and osteoarthritis of the knee: evidence from the National Health and Nutrition Examination Survey (NHANES I). Semin Arthritis Rheum. 1990 Dec;20(3 Suppl 1):34–41. doi: 10.1016/0049-0172(90)90045-h. [DOI] [PubMed] [Google Scholar]
- Davis M. A., Ettinger W. H., Neuhaus J. M. The role of metabolic factors and blood pressure in the association of obesity with osteoarthritis of the knee. J Rheumatol. 1988 Dec;15(12):1827–1832. [PubMed] [Google Scholar]
- Ettinger W. H., Davis M. A., Neuhaus J. M., Mallon K. P. Long-term physical functioning in persons with knee osteoarthritis from NHANES. I: Effects of comorbid medical conditions. J Clin Epidemiol. 1994 Jul;47(7):809–815. doi: 10.1016/0895-4356(94)90178-3. [DOI] [PubMed] [Google Scholar]
- Felson D. T., Anderson J. J., Naimark A., Walker A. M., Meenan R. F. Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med. 1988 Jul 1;109(1):18–24. doi: 10.7326/0003-4819-109-1-18. [DOI] [PubMed] [Google Scholar]
- Felson D. T., Chaisson C. E. Understanding the relationship between body weight and osteoarthritis. Baillieres Clin Rheumatol. 1997 Nov;11(4):671–681. doi: 10.1016/s0950-3579(97)80003-9. [DOI] [PubMed] [Google Scholar]
- Felson D. T. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1988;10:1–28. doi: 10.1093/oxfordjournals.epirev.a036019. [DOI] [PubMed] [Google Scholar]
- Felson D. T., Hannan M. T., Naimark A., Berkeley J., Gordon G., Wilson P. W., Anderson J. Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. J Rheumatol. 1991 Oct;18(10):1587–1592. [PubMed] [Google Scholar]
- Felson D. T. Preventing knee and hip osteoarthritis. Bull Rheum Dis. 1998 Nov;47(7):1–4. [PubMed] [Google Scholar]
- Felson D. T., Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum. 1998 Aug;41(8):1343–1355. doi: 10.1002/1529-0131(199808)41:8<1343::AID-ART3>3.0.CO;2-9. [DOI] [PubMed] [Google Scholar]
- Felson D. T., Zhang Y., Anthony J. M., Naimark A., Anderson J. J. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med. 1992 Apr 1;116(7):535–539. doi: 10.7326/0003-4819-116-7-535. [DOI] [PubMed] [Google Scholar]
- Gelber A. C., Hochberg M. C., Mead L. A., Wang N. Y., Wigley F. M., Klag M. J. Body mass index in young men and the risk of subsequent knee and hip osteoarthritis. Am J Med. 1999 Dec;107(6):542–548. doi: 10.1016/s0002-9343(99)00292-2. [DOI] [PubMed] [Google Scholar]
- Haara M. M., Manninen P., Kröger H., Arokoski J. P. A., Kärkkäinen A., Knekt P., Aromaa A., Heliövaara M. Osteoarthritis of finger joints in Finns aged 30 or over: prevalence, determinants, and association with mortality. Ann Rheum Dis. 2003 Feb;62(2):151–158. doi: 10.1136/ard.62.2.151. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hart D. J., Doyle D. V., Spector T. D. Association between metabolic factors and knee osteoarthritis in women: the Chingford Study. J Rheumatol. 1995 Jun;22(6):1118–1123. [PubMed] [Google Scholar]
- Hart D. J., Spector T. D. The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. J Rheumatol. 1993 Feb;20(2):331–335. [PubMed] [Google Scholar]
- Hartz A. J., Fischer M. E., Bril G., Kelber S., Rupley D., Jr, Oken B., Rimm A. A. The association of obesity with joint pain and osteoarthritis in the HANES data. J Chronic Dis. 1986;39(4):311–319. doi: 10.1016/0021-9681(86)90053-6. [DOI] [PubMed] [Google Scholar]
- Hochberg M. C., Lethbridge-Cejku M., Scott W. W., Jr, Reichle R., Plato C. C., Tobin J. D. 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 Mar;22(3):488–493. [PubMed] [Google Scholar]
- Jensen C. H., Rofail S. Knee injury and obesity in patients undergoing total knee replacement: a retrospective study in 115 patients. J Orthop Sci. 1999;4(1):5–7. doi: 10.1007/s007760050066. [DOI] [PubMed] [Google Scholar]
- Jensen L. K., Eenberg W. Occupation as a risk factor for knee disorders. Scand J Work Environ Health. 1996 Jun;22(3):165–175. doi: 10.5271/sjweh.127. [DOI] [PubMed] [Google Scholar]
- Jordan J. M., Luta G., Renner J. B., Linder G. F., Dragomir A., Hochberg M. C., Fryer J. G. 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 Aug;9(4):273–278. doi: 10.1002/1529-0131(199608)9:4<273::aid-anr1790090412>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
- Kivimäki J., Riihimäki H., Hänninen K. Knee disorders in carpet and floor layers and painters. Scand J Work Environ Health. 1992 Oct;18(5):310–316. [PubMed] [Google Scholar]
- Kohatsu N. D., Schurman D. J. Risk factors for the development of osteoarthrosis of the knee. Clin Orthop Relat Res. 1990 Dec;(261):242–246. [PubMed] [Google Scholar]
- Lippiello L., Walsh T., Fienhold M. The association of lipid abnormalities with tissue pathology in human osteoarthritic articular cartilage. Metabolism. 1991 Jun;40(6):571–576. doi: 10.1016/0026-0495(91)90046-y. [DOI] [PubMed] [Google Scholar]
- Manninen P., Riihimaki H., Heliovaara M., Suomalainen O. Physical exercise and risk of severe knee osteoarthritis requiring arthroplasty. Rheumatology (Oxford) 2001 Apr;40(4):432–437. doi: 10.1093/rheumatology/40.4.432. [DOI] [PubMed] [Google Scholar]
- Manninen P., Riihimäki H., Heliövaara M., Mäkelä P. Overweight, gender and knee osteoarthritis. Int J Obes Relat Metab Disord. 1996 Jun;20(6):595–597. [PubMed] [Google Scholar]
- Manninen Pirjo, Heliövaara Markku, Riihimäki Hilkka, Suoma-Iainen Olavi. Physical workload and the risk of severe knee osteoarthritis. Scand J Work Environ Health. 2002 Feb;28(1):25–32. doi: 10.5271/sjweh.643. [DOI] [PubMed] [Google Scholar]
- Martin K., Lethbridge-Cejku M., Muller D. C., Elahi D., Andres R., Tobin J. D., Hochberg M. C. Metabolic correlates of obesity and radiographic features of knee osteoarthritis: data from the Baltimore Longitudinal Study of Aging. J Rheumatol. 1997 Apr;24(4):702–707. [PubMed] [Google Scholar]
- Mäkelä M., Heliövaara M., Sievers K., Knekt P., Maatela J., Aromaa A. Musculoskeletal disorders as determinants of disability in Finns aged 30 years or more. J Clin Epidemiol. 1993 Jun;46(6):549–559. doi: 10.1016/0895-4356(93)90128-n. [DOI] [PubMed] [Google Scholar]
- Paavolainen P., Hämäläinen M., Mustonen H., Slätis P. Registration of arthroplasties in Finland. A nationwide prospective project. Acta Orthop Scand Suppl. 1991;241:27–30. doi: 10.3109/17453679109155101. [DOI] [PubMed] [Google Scholar]
- Palta M., Prineas R. J., Berman R., Hannan P. Comparison of self-reported and measured height and weight. Am J Epidemiol. 1982 Feb;115(2):223–230. doi: 10.1093/oxfordjournals.aje.a113294. [DOI] [PubMed] [Google Scholar]
- Philbin E. F., Ries M. D., Groff G. D., Sheesley K. A., French T. S., Pearson T. A. Osteoarthritis as a determinant of an adverse coronary heart disease risk profile. J Cardiovasc Risk. 1996 Dec;3(6):529–533. [PubMed] [Google Scholar]
- Rhoads G. G., Kagan A. The relation of coronary disease, stroke, and mortality to weight in youth and in middle age. Lancet. 1983 Mar 5;1(8323):492–495. doi: 10.1016/s0140-6736(83)92189-x. [DOI] [PubMed] [Google Scholar]
- Sandmark H., Hogstedt C., Lewold S., Vingård E. Osteoarthrosis of the knee in men and women in association with overweight, smoking, and hormone therapy. Ann Rheum Dis. 1999 Mar;58(3):151–155. doi: 10.1136/ard.58.3.151. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sharma L., Lou C., Cahue S., Dunlop D. D. The mechanism of the effect of obesity in knee osteoarthritis: the mediating role of malalignment. Arthritis Rheum. 2000 Mar;43(3):568–575. doi: 10.1002/1529-0131(200003)43:3<568::AID-ANR13>3.0.CO;2-E. [DOI] [PubMed] [Google Scholar]
- Silveri F., Brecciaroli D., Argentati F., Cervini C. Serum levels of insulin in overweight patients with osteoarthritis of the knee. J Rheumatol. 1994 Oct;21(10):1899–1902. [PubMed] [Google Scholar]
- Sowers M. Epidemiology of risk factors for osteoarthritis: systemic factors. Curr Opin Rheumatol. 2001 Sep;13(5):447–451. doi: 10.1097/00002281-200109000-00018. [DOI] [PubMed] [Google Scholar]
- Spector T. D., Cicuttini F., Baker J., Loughlin J., Hart D. Genetic influences on osteoarthritis in women: a twin study. BMJ. 1996 Apr 13;312(7036):940–943. doi: 10.1136/bmj.312.7036.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spector T. D., Hart D. J., Doyle D. V. Incidence and progression of osteoarthritis in women with unilateral knee disease in the general population: the effect of obesity. Ann Rheum Dis. 1994 Sep;53(9):565–568. doi: 10.1136/ard.53.9.565. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stewart A. L. The reliability and validity of self-reported weight and height. J Chronic Dis. 1982;35(4):295–309. doi: 10.1016/0021-9681(82)90085-6. [DOI] [PubMed] [Google Scholar]
- Stunkard A. J., Albaum J. M. The accuracy of self-reported weights. Am J Clin Nutr. 1981 Aug;34(8):1593–1599. doi: 10.1093/ajcn/34.8.1593. [DOI] [PubMed] [Google Scholar]
- Stürmer T., Günther K. P., Brenner H. Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. J Clin Epidemiol. 2000 Mar 1;53(3):307–313. doi: 10.1016/s0895-4356(99)00162-6. [DOI] [PubMed] [Google Scholar]