Main Article Content

Abstract

Background: Obesity is a major risk factor for knee osteoarthritis. The relationship between obesity and OA may not be simply due to a mechanical factor. Evidences suggest that metabolic factors related to body fat play important roles, but the specific type of fat that contributes to OA is unclear. The objective of this study was to examine the possible correlation between body fat distribution with knee OA.

Methods: This study was a cross sectional study of OA patients with obesity visiting the Rheumatology and Geriatric-Internal Medicine clinics at Cipto Mangunkusumo Hospital between January-March 2016. Data was collected by consecutive sampling. Knee OA was diagnosed from clinical and radiologic evaluation based on American College of Rheumatology 1986 criteria. Body fat distribution was measured by bioelectrical impedance analysis (BIA). Conventional radiography of the knee was used to evaluate joint
space narrowing (JSN). The correlation between body fat distribution and joint space width was analyzed by bivariate analysis

Result: A total of 56 subjects were recruited, majority were women (73.2%). Median visceral fat was 12% (7.5-16.5), median subcutaneous fat was 30.2% (16.5-37.9), and median visceral to subcutaneous fat ratio was 0,40 (0,26-0,80). The mean medial tibiofemoral joint space width was 2.34 mm (SD 0.78). Bivariate analysis revealed a correlation between visceral fat and medial tibiofemoral joint space width (r: -0,474 p: < 0,001). There is no correlation between subcutaneous fat and medial tibiofemoral joint space width (r: -0,187 p:0,169); and visceral to subcutaneous fat ratio and medial
tibiofemoral joint space width (r: -0,225 p: 0,09).

Conclusion: Visceral fat is correlated with medial tibiofemoral joint space width (r: -0.474 p: < 0.001). There is no correlation between subcutaneous fat, and visceral to subcutaneous fat ratio, with medial tibiofemoral joint space width.

Keywords: Osteoarthritis, obesity, visceral fat, subcutaneous fat, visceral to subcutaneous fat ratio, medial tibiofemoral joint space width

Article Details

How to Cite
Herikurniawan, H., Isbagio, H., Soewondo, P., Diana, N., & Setiati, S. (2018). The Correlation between Body Fat Distribution and Medial Tibiofemoral Joint Space Width in Obese Knee Osteoarthritis Patients. Indonesian Journal of Rheumatology, 9(1). https://doi.org/10.37275/ijr.v9i1.63

References

  1. Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013;105:185-99.
  2. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas). Jakarta; 2013
  3. Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med. 2011 Spring; 2(2): 205–12.
  4. King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013; 138(2): 185-93.
  5. Teichtahl AJ, Wang Y, Wluka AE, Cicuttini FM. Obesity and knee osteoarthritis: new insights provided by body composition studies. Obesity. 2008;16(2):232-40.
  6. Conde J, Scotece M, Gomez R, Lopez V, Gomez-Reino JJ, Gualillo O. Adipokines and osteoarthritis: novel molecules involved in the pathogenesis and progression of disease. Arthritis. 2011
  7. Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010;11(1):11-8.
  8. Kaess BM, Pedley A, Massaro JM, Murabito J, Hoffmann U, Fox CS. The ratio of visceral to subcutaneous fat, a metric of body fat distribution, is a unique correlate of cardiometabolic risk. Diabetologia. 2012;55(10):2622- 30
  9. Wang Y, Wluka AE, English DR, Teichtahl AJ, Giles GG, O’Sullivan R, et al. Body composition and knee cartilage properties in healthy, community based adults. Ann Rheum Dis. 2007;66(9):1244-8.
  10. Berry PA, Wluka AE, Davies-Tuck ML, Wang Y, Strauss BJ, Dixon JB, et al. The relationship between body composition and structural changes at the knee. Rheumatology. 2010.
  11. Langow SS. Hubungan Leptin dengan Cartilage Oligometric Matrix Protein dan Lebar Celah Sendi Tibiofemoral Medial pada Pasien Osteoartritis Lutut dengan Obesitas. Jakarta: Universitas Indonesia; 2014
  12. Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001;25(5):622-7
  13. Wang Y, Wluka AE, English DR, Teichtahl AJ, Giles GG, O’Sullivan R, et al. Body composition and knee cartilage properties in healthy, communitybased adults. Ann Rheum Dis. 2007;66(9):1244-8.
  14. Berry PA, Wluka AE, Davies-Tuck ML, Wang Y, Strauss BJ, Dixon JB, et al. The relationship between body composition and structural changes at the knee. Rheumatology. 2010.
  15. Sanghi D, Srivastava RN, Singh A, Kumari R, Mishra R, Mishra A. The association of anthropometric measures and osteoarthritis knee in non-obese subjects: a cross sectional study. Clinics (Sao Paulo). 2011;66(2):275-9
  16. Mahajan A, Tandon V, Verma S, Sharma S. Osteoarthritis and Menopause. Indian Rheumatol Assoc 2005;13:21-5
  17. Spector TD, Hart DJ, Byrne J, Harris PA, Dacre JE, Doyle DV. Definition of osteoarthritis of the knee for epidemiological studies. Ann Rheum Dis 1993;52(11):790-4
  18. Sowers MF, Yosef M, Jamadar D, Jacobson J, Karvonen-Gutierrez C, Jaffe M. BMI vs. body composition and radiographically defined osteoarthritis of the knee in women: a 4-year follow-up study. Osteoarthritis Cartilage. 2008;16(3):367-72
  19. Wajchenberg BL. Subcutaneous and Visceral Adipose Tissue: Their Relation to the Metabolic Syndrome. Endocrine Reviews 2000;21:697–738
  20. Conde J, Scotece M, Gomez R, Lopez V, Gomez-Reino JJ, Gualillo O. Adipokines and osteoarthritis: novel molecules involved in the pathogenesis and progression of disease. Arthritis. 2011
  21. Kaess BM, Pedley A, Massaro JM, Murabito J, Hoffmann U, Fox CS. The ratio of visceral to subcutaneous fat, a metric of body fat distribution, is a unique correlate of cardiometabolic risk. Diabetologia. 2012;55(10):2622- 30
  22. Karrameita N. Korelasi antara rasio lemak visceral abdomen: lemak subkutan abdomen dengan tekanan darah. Jakarta: Universitas Indonesia; 2015