Body mass index and hand osteoarthritis susceptibility: an updated meta‐analysis

Abstract

Aim: Numerous epidemiologic studies have evaluated the association between overweight and hand osteoarthritis; However, the existing results are inconsistent.Methods: Systematic searches were performed and reference lists from the retrieved trials were searched. This meta-analysis and meta-regression was executed to identify all English-language articles that quantitatively assess the strength of associations between body mass index and hand osteoarthritis risk. Study-specific incremental estimates were standardized to determine the risk associated with a 5 kg/m 2 increase in body mass index. We conducted the study according to the guidelines for the meta-analysis of observational studies in epidemiology.Results: Of the 21 studies included, 13 were cross-sectional studies, three were case control studies and five were cohort studies. The pooled summary estimates were 1.10 (95%CI: 0.98-1.24) with no significant difference (P = 0.09). Subgroup analysis shows that body mass index was positively associated with hand osteoarthritis in cross-sectional studies (1.05 [95%CI: 1.02-1.08] P < 0.01), while with no significant difference was found in case-control studies (1.28 [95%CI: 0.87-1.88]) and in cohort studies (1.06 [95%CI: 0.71-1.58]) (P = 0.21 and P = 0.77, respectively). A weak but significant effect on radiographic hand osteoarthritis risk was found. The summary estimates were 1.06 (95%CI: 1.02-1.10) in studies defined by radiography and 1.25 (95%CI: 1.06-1.49) by radiography and clinically (P < 0 .01 and P = 0.01, respectively).Conclusion: It appears that increased body mass index contributes to a positively moderate effect on susceptibility to hand osteoarthritis, as defined radiographically and/or radiographically and clinically. The effects vary by study design and osteoarthritis definition.

The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

“…Tendinopathy has also been linked with dietary fats, adiposity and inflammation [ 80 , 81 ], highlighting that obesity may not necessarily be only related to excessive load. Clearly elevated body fat is linked with structural changes and pain in multiple regions and may explain the known link between elevated BMI and osteoarthritis in non-weight-bearing joints such as the hands [ 15 ]. Future work to investigate if there is a true discordance between fat mass and fat-free mass may help strengthen the notion that body composition is more meaningful measure of risk for musculoskeletal pain.…”

“…The BMI is not a good measure of adiposity (body fatness) as it does not account for age or gender differences [ 13 ]. Furthermore, given the association between BMI-defined obesity and musculoskeletal pain extends to both weight-bearing [ 14 ] and non-weight-bearing joints [ 15 ], it follows that the mechanism underpinning this relationship may extend beyond excessive mechanical loading alone, which is implied with the BMI. Fat mass index (FMI) is a more relevant measure in having or predicting pain [ 16 ], suggesting the type of tissue is important.…”

Changes in foot pain, structure and function following bariatric surgery

“…Musculoskeletal pain has a bidirectional relationship with both obesity [ 11 ] and depression [ 12 ], while depression and obesity also amplify each other [ 13 ]. These relationships, however, are not limited to weight-bearing joints with a known association between elevated BMI and symptomatic hand osteoarthritis [ 14 ], suggesting that metabolic mechanisms, including systemic inflammation [ 15 ], may underpin the relationship between obesity and joint pain [ 16 ]. Whilst these relationships exist in the general population, it is particularly pertinent in bariatric surgery candidates, who are over-represented amongst those complaining of musculoskeletal pain [ 17 ]; with foot and ankle pain prevalence cited as 34–50% [ 18 , 19 ].…”

Approche phénotypique de l’arthrose : le cas de l’arthrose associée au syndrome métabolique

“…L'obésité est un facteur de risque important d'arthrose, surtout de gonarthrose, mais aussi de coxarthrose et, dans une moindre mesure d'arthrose des mains [4,5]. L'association non fortuite entre obésité et maladies métaboliques intégrée au sein du syndrome métabolique a conduit à la recherche d'association entre le syndrome métabolique et l'arthrose.…”