title: Overweight older adults, particularly after an injury, are at high risk for accelerated knee osteoarthritis: data from the Osteoarthritis Initiative.
abstract: We explored whether age and body mass index (BMI) can help identify a subset of individuals who are at high risk for accelerated knee osteoarthritis (AKOA) compared with common knee osteoarthritis (KOA). In the Osteoarthritis Initiative, a multicenter observational cohort study of KOA (n = 4796), we studied participants without KOA at baseline (Kellgren-Lawrence (KL) <2). Participants could have one of three outcomes: (1) AKOA, ≥1 knee progressed to end-stage KOA within 48 months; (2) common KOA, ≥1 knee increased in radiographic scoring within 48 months (excluding those with AKOA); and (3) no KOA, no change in KL grade in either knee. After verifying an interaction between age, BMI, and recent knee injury, we determined if we could identify a specific subset of individuals at high risk for AKOA instead of KOA. First, we reviewed three-dimensional graphs with age, BMI, and probability of AKOA versus KOA on the axes. We then conducted a logistic regression with AKOA as the outcome and age-BMI groups as the predictor. In our main analyses, we found that older individuals with a BMI <35 kg/m(2) were more likely to develop AKOA than common KOA (n = 64; mean [SD] BMI = 27.3 [3.1] kg/m(2); odds ratio = 3.47, 95 % confidence interval = 1.70 to 7.10), especially if they had a recent knee injury. While older age and greater BMI are independently associated with AKOA, we found that older individuals who had a higher BMI, particularly if they have an injury, were more likely to develop AKOA than common KOA.
authors.affiliation: Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA. jeffrey.driban@tufts.edu.
authors.forename: Jeffrey B
authors.identifier: http://orcid.org/0000-0001-6098-4273
authors.initials: JB
authors.lastname: Driban
authors.affiliation: Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.affiliation: Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.|Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA.
authors.forename: Grace H
authors.initials: GH
authors.lastname: Lo
authors.affiliation: The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 02111, USA.|Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA.
authors.forename: Lori Lyn
authors.initials: LL
authors.lastname: Price
authors.affiliation: Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA.
authors.forename: Bing
authors.initials: B
authors.lastname: Lu
authors.affiliation: Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Barbe
authors.affiliation: Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: McAlindon
mesh_terms: D000367:Age Factors; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D003625:Data Collection; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050177:Overweight / Q000150:complications*; D012307:Risk Factors; D057566:Self Report; D016896:Treatment Outcome
keywords: Age; Body mass index; Injuries; Knee; Osteoarthritis