Osteoarthritis and cartilage · 2026
Does fat mass contribute to knee osteoarthritis risk beyond weight itself? Data from the Multicenter Osteoarthritis Study.
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Godziuk K, Tilley S, LaValley M, Kiel D P, Nevitt M C, Lewis C E, Torner J C, Neogi T
Аннотация
OBJECTIVE: We examined the extent to which fat mass may contribute to the risk of incident radiographic knee osteoarthritis (ROA) beyond body weight alone.
METHODS: Participants from the Multicenter Osteoarthritis (MOST) Study with DXA body composition and no ROA in ≥1 knee at baseline were included. Incident ROA (KL grade ≥2 or knee replacement) was assessed at 7 years. We created sex-specific weight categories (<70,70-79.9,80-89.9, ≥90 kg in females, <90,90-99.9, ≥100 kg in males), computed % fat mass quartiles, and then evaluated the relation between quartiles (lowest as referent) to risk of ROA in each weight category. We then scaled and standardized % fat mass in a combined model to assess the overall relationship between relative fat mass and ROA risk.
RESULTS: We included 1611 individuals (60% female, mean age 61.7 years, BMI 29.6 kg/m2, 2646 knees). Incident ROA developed in 27.6% of knees after 7 years. In females only, risk for ROA increased in those with the highest % fat mass relative to lowest in their weight category (Q4 vs Q1, RR 1.29, 95% CI 1.02, 1.64). Spline analyses identified a J- or U-shaped pattern of % fat mass on incident ROA in females and males, with predicted probabilities only differing by 10-20% across the fat mass percentiles.
CONCLUSIONS: A higher relative fat mass did not influence increased risk of incident ROA in males, but there was a potential threshold effect in females. Overall, total body mass (weight) appears to be driving risk for ROA rather than a distinct influence of relative fat mass.
METHODS: Participants from the Multicenter Osteoarthritis (MOST) Study with DXA body composition and no ROA in ≥1 knee at baseline were included. Incident ROA (KL grade ≥2 or knee replacement) was assessed at 7 years. We created sex-specific weight categories (<70,70-79.9,80-89.9, ≥90 kg in females, <90,90-99.9, ≥100 kg in males), computed % fat mass quartiles, and then evaluated the relation between quartiles (lowest as referent) to risk of ROA in each weight category. We then scaled and standardized % fat mass in a combined model to assess the overall relationship between relative fat mass and ROA risk.
RESULTS: We included 1611 individuals (60% female, mean age 61.7 years, BMI 29.6 kg/m2, 2646 knees). Incident ROA developed in 27.6% of knees after 7 years. In females only, risk for ROA increased in those with the highest % fat mass relative to lowest in their weight category (Q4 vs Q1, RR 1.29, 95% CI 1.02, 1.64). Spline analyses identified a J- or U-shaped pattern of % fat mass on incident ROA in females and males, with predicted probabilities only differing by 10-20% across the fat mass percentiles.
CONCLUSIONS: A higher relative fat mass did not influence increased risk of incident ROA in males, but there was a potential threshold effect in females. Overall, total body mass (weight) appears to be driving risk for ROA rather than a distinct influence of relative fat mass.