Associations Between Obesity With Low Muscle Mass and Physical Function in Patients With End-Stage Knee Osteoarthritis

Abstract

Objective: To investigate the prevalence of obesity with low muscle mass and its impact on physical function, quality of life (QOL) and pain in patients with end-stage knee osteoarthritis over 65 years old. Methods: In this cross-sectional study, we assessed a total of 562 patients. After separating the group into males and females, we divided patients into 4 further groups: normal BMI with normal muscle mass, obesity with normal muscle mass, normal BMI with low muscle mass and obesity with low muscle mass. All patients completed stair climbing test (SCT), 6-minute walk test, timed up and go test (TUG), instrumental gait analysis, Western Ontario McMaster Universities Osteoarthritis Index, VAS, and EuroQOL 5 dimensions questionnaire. Results: Obesity with low muscle mass was diagnosed in 6 males subjects (7.8%) and 9 female subjects (1.9%). Patients with obesity and low muscle mass performed the SCT-ascent and descent significantly slower than other body composition groups in both males and females. TUG in males and gait speed in females were also significantly slower in the obesity with low muscle mass group. Stepwise multiple linear regression analysis revealed that in males, obesity with low muscle mass was significantly predictive of SCT ascent (β = 0.409, p < 0.001), SCT-descent (β = 0.405, p < 0.001), and TUG (β = 0.283, p = 0.009), and in females, obesity with low muscle mass was significantly predictive of SCT-ascent (β = 0.231, p < 0.001), SCT-descent (β = 0.183, p < 0.001), and gait speed (β=-0.129, p = 0.004). Conclusions: This study confirms that the combination of obesity and low muscle mass is associated with impaired physical function in patients with end-stage knee osteoarthritis.

The Relationship Between Sarcopenic Obesity and Knee Osteoarthritis: The SARCOB Study

“… 27 - 29 The combination of sarcopenia and obesity (i.e., sarcopenic obesity) is associated with impaired physical function and quality of life in patients with advanced knee OA. 30 Nonetheless, this shows compelling evidence that sarcopenia and/or obesity is present in knee OA but poorly recognized/not recognized at all as sarcopenic obesity. This is very important to consider while assessing one of the abovementioned disorders.…”

Sarcopenia and Sarcopenic Obesity and Osteoarthritis: A Discussion among Muscles, Fat, Bones, and Aging

“…The longitudinal study by Kim and colleagues [ 32 ] found that an increase in visceral fat mass resulted in a decrease in skeletal muscle mass, which demonstrates the synergistic action of the two clinical entities, sarcopenia and obesity. Thus, sarcopenic obesity may have a greater effect on metabolic disorders; cardiovascular disease; increased risk of osteopenia, osteoporosis, fractures and falls; and mortality than either sarcopenia or obesity separately [ 33 ].…”

Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study

“…Low muscle mass as well as high body fat become evident with disease progression of KOA [24,90], sarcopenic obesity becomes prevalent at late stage of KOA. The overall sarcopenic obesity prevalence at end-stage KOA has been estimated to be 2.7−17.2% for the elder population in Asia [26,31,91] and 2.6−9.4% in other areas worldwide [27,32], regardless of sex, age, and identification criteria of sarcopenic obesity. In this study cohort, 59 out of 587 (10.1%) patients with moderate or severe KOA were classified as having sarcopenic obesity, which agrees with previous results.…”

“…In addition to obesity, low muscle mass (i.e., sarcopenia) has been given as a risk factor for KOA and its disease progression [22][23][24]. Notably, the obese older individuals with KOA who are classified as having sarcopenia (i.e., sarcopenic obesity) may suffer potential risks of physical decline and disability [25][26][27]. Sarcopenic obesity is a condition referring to the coexistence of sarcopenia and obesity and threatens physical health in elderly populations [28], with an overall global prevalence of 11% in older adults [29].…”