Low Skeletal Muscle Mass in the Lower Limbs Is Independently Associated to Knee Osteoarthritis

Abstract

ObjectivesIt has been reported that low skeletal muscle mass correlates with knee osteoarthritis in obese individuals. This study aimed to investigate whether lower limb skeletal muscle mass is independently associated with knee osteoarthritis in the general population.Materials and MethodsThis cross-sectional study used public data from the Fourth and Fifth Korean National Health and Nutrition Examination Survey. Subjects included 4924 community-dwelling adults aged ≥50 years (821 subjects with knee osteoarthritis and 4,103 controls). Skeletal muscle mass index (SMI) was calculated from the appendicular skeletal muscle mass measured by dual energy X-ray absorptiometry. Independent effects of total and lower limb SMI values on knee osteoarthritis were determined using odds ratios (OR) adjusted for age, sex, obesity, total femur bone mineral density, serum vitamin D level, diabetes mellitus status, and physical activity on multivariate logistic regression analysis.ResultsThe adjusted logistic regression model revealed that older age, female sex, and obesity were significantly associated with knee osteoarthritis. A higher serum vitamin D level was also positively correlated with knee osteoarthritis (OR, 1.015; 95% CI, 1.003–1.027; P = 0.010). Although total SMI was not significantly associated with knee osteoarthritis (OR, 0.976; 95% CI, 0.946–1.007; P = 0.127), a low lower limb SMI had an independent effect on knee osteoarthritis (OR, 0.941; 95% CI, 0.900–0.983; P = 0.006).ConclusionsLow skeletal muscle mass in the lower limbs but not in the whole body was independently associated with knee osteoarthritis.

The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review

“…No clear cut-off for defining weakness Dynapenic obesity group (“obese and weak” phenotype) had higher pain and poorer physical function compared to “minimal joint disease”, “strong muscle”, and “non-obese and weak” phenotypes. Lee et al [ 63 ], 2016 To investigate association between lower limb muscle mass and knee OA Cross-sectional Korean population (KNHANES) age ≥ 50 years, n = 821 with knee OA (K/L grade ≥ 2), ( n = 821), and control group without knee OA ( n = 4103) BMI ≥27.5 kg/m 2 DXA ASM/weight, 2SD below the mean in sex-matched young reference group (< 29.5% in men, < 23.2% in women) Secondary analysis of population survey data. No assessment of muscle strength or function SO prevalence was 5.2% in knee OA group compared to 1.8% in control group.…”

“…Ten of the eleven studies were cross-sectional [ 60 – 69 ], and one longitudinal [ 59 ]. Four studies (36.4%) were secondary analyses of the Korea National Health and Nutrition Examination Survey (KNHANES) population cohort [ 61 , 63 , 64 , 68 ], two (18.2%) were secondary analyses of the North American Osteoarthritis Initiative (OAI) population cohort [ 59 , 62 ], one (9%) was a secondary analysis of the French Knee and Hip OsteoArthritis Long-term Assessment (KHOALA) cohort [ 69 ], and the remaining four (36.4%) were independent studies with cohorts from Korea [ 60 ], Thailand [ 65 ], Japan [ 67 ] and the Netherlands [ 66 ]. Eight studies focused on osteoarthritis of the knee joint [ 59 , 61 – 65 , 67 , 68 ], with two additional studies examining both knee and hip [ 60 , 69 ], and one solely on hip osteoarthritis [ 66 ].…”

Skeletal Muscle Wasting and Its Relationship With Osteoarthritis: a Mini-Review of Mechanisms and Current Interventions

“…Though, it should be noted that this study classified sarcopenia as the sum of absolute muscle mass of upper and lower limbs. However, findings from a previous study suggest that skeletal muscle mass of the lower limbs shows a higher correlation with knee OA than that of the lower and upper limbs combined [ 18 ]. Therefore, a statistical association between the risk of knee OA and sarcopenia may be observed, if the assessment of skeletal muscle mass focuses on the lower limbs.…”

Relationships between Spinal Sarcopenia and Spinal Sagittal Balance in Older Women

“…Healthy community-dwelling older ( ≥ 65 years) women who could independently walk more than 100 m were consecutively enrolled in a single center from July 2018 to December 2018. Participants who had experienced the following were excluded: (1) low back pain with moderate severity (numeric rating scale 5 and over); (2) history of any type of lumbar spine surgery; (3) history of hip fracture surgery and arthroplasty of the hip or knee; (4) disorders of the central nervous system such as stroke, parkinsonism, or spinal cord injury; (5) communication disorder such as severe hearing loss; (6) musculoskeletal conditions affecting physical function such as limb amputation; (7) long-term use of corticosteroids due to inflammatory disease; (8) malignancy requiring treatment within 5 years; and (9) other medical conditions requiring active treatment; additionally, individuals who refused to participate in the study were also excluded.…”

“…A cross-sectional study of 821 subjects with knee osteoarthritis and 4,103 controls showed that low skeletal muscle mass in the lower limbs was correlated with the presence of knee osteoarthritis, whereas whole-body skeletal muscle mass was not. 2) The authors suggested the need for limb-specific muscle mass examinations to assess the effects of skeletal muscles on a specific joint. Therefore, regional measurements should be performed to evaluate the outcome of sarcopenia in focal areas.…”