Association of Visceral Adiposity With Pain but Not Structural Osteoarthritis

Abstract

ObjectiveOsteoarthritis (OA) and pain are both made more severe by low‐grade inflammation. This study was undertaken to examine whether visceral fat, a major source of inflammatory cytokines and adipokines, is associated with an increased risk of knee OA or musculoskeletal pain.MethodsSubjects in the Multicenter Osteoarthritis Study cohort, who were age 50–79 years and had or were at high risk of knee OA, underwent whole‐body dual x‐ray absorptiometry (DXA) at baseline. At baseline, 30 months, and 60 months radiographs and magnetic resonance images (MRIs) of the knees were obtained, and patients were asked to score the severity of their knee pain and to identify sites of joint pain using a body homunculus. Baseline DXA scans were used to measure total body fat and visceral and subcutaneous fat in the torso. The association of fat depot size with structural outcomes (incident radiographic OA and cartilage loss and synovitis on MRI) and with pain outcomes (worsening knee pain, number of painful joints, and widespread pain) was assessed. Regression analyses were adjusted for age, sex, race, education level, smoking status, physical activity, body mass index (BMI), and depressive symptoms.ResultsOf the 2,961 participants at baseline, 60.7% were women. The mean age was 62.5 years and mean BMI was 30.5 kg/m2. After adjustment for covariates, no fat measures were associated with any structural outcomes. However, total and visceral, but not subcutaneous, fat were positively associated with worsening knee pain (P = 0.0005 for total fat and P = 0.007 for visceral fat) and widespread pain (P = 0.001 for total fat and P = 0.02 for visceral fat), and the amount of visceral fat was associated with the number of painful joints (P = 0.07).ConclusionOur findings indicate that visceral fat is associated with an increased risk of musculoskeletal and widespread pain.

Association of Serum Low‐Density Lipoprotein, High‐Density Lipoprotein, and Total Cholesterol With Development of Knee Osteoarthritis

“…In addition, we examined quartiles of cholesterol, HDL, and LDL to see if high (or low) levels affected risk of disease. Last, we added visceral adiposity (21) as a covariate in our analysis to see if the relationships of lipids with OA outcomes were altered. Analyses were carried out using SAS, version 9.4.…”

Inflammatory and Immune Protein Pathways Possible Mechanisms for Pain Following Walking in Knee Osteoarthritis

“…It is possible that BMI influenced the significant proteins. Adiposity contributes to inflammation, and visceral adiposity has been linked to greater local and widespread pain in KOA (Li et al, 2020). However, our findings are consistent with those in other samples of KOA demonstrating proteins in the complement system, fibrinogen alpha chain, and other inflammatory proteins are part of a set of proteins found in osteoarthritis specifically, regardless of BMI (Gobezie & Lee, 2012).…”

Protein Changes After 6 weeks of Walking and the Relationship to Pain in Adults with Knee Osteoarthritis

“…The differences in BMI between our healthy and control groups may have influenced the significant proteins found, particularly with regard to inflammation. Adiposity is a known contributor to inflammation and recently considered a contributor to pain in osteoarthritis (Li et al, 2020; Urban & Little, 2018). However, the differential proteins found in our sample are consistent with those in other samples of KOA that include differential proteins in the complement system, fibrinogen alpha chain, and other inflammatory proteins which are part of a set of proteins found in osteoarthritis specifically, regardless of BMI (Gobezie & Lee, 2012).…”