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Master thesis

DXA body composition, sarcopenia and knee and hip osteoarthritis : results from the KHOALA cohort

Abstract : Objective: To analyse the associations between anthropometric measures, sarcopeniaand osteoarthritis (OA) location and severity (clinical and structural) in patients withsymptomatic hip and/or knee OA.Methods: Skeletal muscle and fat mass were measured by dual X-ray absorptiometry(DXA) in a subset of patients of the Knee and Hip OsteoArthritis Long-term assessment(KHOALA) cohort. Fat mass index (FMI) and fat-free mass index (FFMI) were defined astotal fat mass/height 2 and total lean and bone mass/height 2, respectively. We used 2definitions of sarcopenia by weight and height. Pain and function were measured by theWestern Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and qualityof life (QoL) by the Medical Outcomes Study Short Form 36 (SF-36). Structural severitywas graded by the Kellgren & Lawrence (KL) classification. Multivariate logistic ormultiple regression models were computed.Results: 358 patients underwent DXA (67% women, mean [SD] age 63.4 [8.4] years,mean BMI 29.5 [5.6] kg/m2); 25.4% had hip and 74.6% knee OA. FMI and FFMI werehigher in patients with knee than hip OA, but only FMI was independently associatedmore with knee than hip OA (OR=1.2, 95% CI [1.1-1.3], p<0.0001). KL grade 3 and 4were associated with FFMI > 66th than < 33th percentile (OR=2.4, 95% CI [1.3-4.3],p=0.003). Sarcopenia and fat mass distribution were not associated with joint locationor KL grade. Increased FMI but not FFMI was associated with increased pain on a visualanalog scale and impaired QoL. WOMAC scores were higher (greater impairment) forsarcopenic patients than those with body composition in the normal range. Prevalenceof sarcopenia was greater with knee than hip OA (31.1% vs 20.2%). Pain, function orQoL did not differ between patients with sarcopenia and obesity and did not differbetween obese patients with or without sarcopenia.Conclusion: In patients with symptomatic knee or hip OA and normal BMI, pain isgreater and functional ability more impaired for those with than without sarcopenia.This impairment did not differ from that for obese patients. Only FMI was independentlyassociated with OA location and only FFMI was independently associated with KL grade
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Clémence Jeanmaire. DXA body composition, sarcopenia and knee and hip osteoarthritis : results from the KHOALA cohort. Sciences du Vivant [q-bio]. 2015. ⟨hal-01732534⟩

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