Does body mass index mediate the relationship between socioeconomic position and incident osteoarthritis?

Witkam, Rozemarijn; Gwinnutt, James M; Selby, David A; Cooper, Rachel; Humphreys, Jennifer; Verstappen, Suzanne

doi:10.1016/j.semarthrit.2022.152063

Cited by 2 publications

(1 citation statement)

References 37 publications

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“…The relationship between lower SEP and worse disease progression may be mediated by obesity. Obesity is a well-known risk factor for the development of OA ( 14 ), and a recent prospective study indicated that body mass index (BMI) mediates the relationship between lower SEP and incident OA at any site ( 15 ). Although there is conflicting evidence about the relationship between obesity and radiographic progression of knee OA ( 16 – 18 ), recent systematic reviews indicated a strong association between BMI and symptomatic progression measured by pain and function ( 18 ), and weight loss resulted in symptomatic improvements (i.e., pain and function) in people with knee OA ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

The association between lower socioeconomic position and functional limitations is partially mediated by obesity in older adults with symptomatic knee osteoarthritis: Findings from the English Longitudinal Study of Ageing

Witkam

Verstappen

Gwinnutt

et al. 2022

Front. Public Health

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ObjectiveTo assess the longitudinal associations of socioeconomic position (SEP) with functional limitations and knee joint replacement surgery (JRS) in people with symptomatic knee osteoarthritis (OA), and whether body mass index (BMI) mediated these relationships.MethodsData came from the English Longitudinal Study of Ageing, a national longitudinal panel study of adults aged ≥50 years. A total of 1,499 participants (62.3% female; mean age 66.5 (standard deviation (SD) 9.4) years; 47.4% obese) self-reporting an OA diagnosis and knee pain, with at least one BMI measurement were included. Mixed effect models estimated longitudinal associations of each SEP variable (education, occupation, income, wealth and deprivation index) and obesity (BMI ≥30.0 kg/m2) with repeated measures of functional limitations. Cox regression analyses estimated associations between SEP indicators and obesity at baseline and risk of knee JRS at follow-up. Structural equation modeling estimated any mediating effects of BMI on these relationships.ResultsLower SEP and obesity at baseline were associated with increased odds of functional limitations in people with knee OA [e.g., difficulty walking 100 yards: no qualification vs. degree adjOR 4.33 (95% CI 2.20, 8.55) and obesity vs. no obesity adjOR 3.06 (95% CI 2.14, 4.37); similar associations were found for the other SEP indicators]. A small proportion of the association between lower SEP and functional limitations could be explained by BMI (6.2–12.5%). Those with lower income, lower wealth and higher deprivation were less likely to have knee JRS [e.g., adjHR most vs. least deprived 0.37 (95% CI 0.19, 0.73)]; however, no clear association was found for education and occupation. Obesity was associated with increased hazards of having knee JRS [adjHR 1.87 (95% CI 1.32, 2.66)]. As the direction of the associations for SEP and obesity with knee JRS were in opposite directions, no mediation analyses were performed.ConclusionsLower SEP was associated with increased odds of functional limitations but lower hazards of knee JRS among people with knee OA, potentially indicating underutilization of JRS in those with lower SEP. Obesity partially mediated the relationship between lower SEP and increased odds of functional limitations, suggesting adiposity as a potential interventional target.

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Section: Introductionmentioning

confidence: 99%

The association between lower socioeconomic position and functional limitations is partially mediated by obesity in older adults with symptomatic knee osteoarthritis: Findings from the English Longitudinal Study of Ageing

Witkam

Verstappen

Gwinnutt

et al. 2022

Front. Public Health

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The burden of osteoarthritis due to high Body Mass Index in Iran from 1990 to 2019

Darbandi

Shadmani

Miryan

et al. 2023

Sci Rep

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High BMI related burden of knee and hip osteoarthritis (OA) is on a significant rise worldwide. OA not only causes joint pain and stiffness, but it also leads to disability. This study investigated the trend and burden of OA attributable to high body mass index (BMI) in Iran. The age-standardized disability-adjusted life years (DALYs) rates of knee and hip OA due to high BMI, were estimated using data from the Global Burden of Disease 2019. We evaluated DALYs rate trend of high BMI related OA by sex and age in span of 30 years from 1990–2019 across the 31 provinces of Iran. The age-standardized prevalence trend of OA in the knee and hip showed an increase from 1990 to 2019. In 2019 there were 29.92 (95% CI: 10.98–64.92) and 42.50 (95% CI: 16.32–97.37) DALYs/100,000 related to OA from high BMI in men and women, respectively. 2019 saw the greatest DALYs/100,000 rate in the 65–79 age group. From 2005 to 2019, men and women saw DALYs/100,000 rate changes of 24.87 and 17.43 percent, respectively. The burden of knee OA was significantly higher than that of hip OA. DALYs rate of OA due to high BMI was found to be positively associated with the Socio-demographic Index (SDI). The burden of knee and hip OA due to high BMI has increased significantly in recent years in Iran among all age groups of both men and women. It is recommended that health policymakers develop weight control strategies to reduce the burden of OA and implement them at the national level.

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Does body mass index mediate the relationship between socioeconomic position and incident osteoarthritis?

Cited by 2 publications

References 37 publications

The association between lower socioeconomic position and functional limitations is partially mediated by obesity in older adults with symptomatic knee osteoarthritis: Findings from the English Longitudinal Study of Ageing

The association between lower socioeconomic position and functional limitations is partially mediated by obesity in older adults with symptomatic knee osteoarthritis: Findings from the English Longitudinal Study of Ageing

The burden of osteoarthritis due to high Body Mass Index in Iran from 1990 to 2019

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