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Type: Journal article
Title: Obesity defined by body mass index and waist circumference and risk of total knee arthroplasty for osteoarthritis: a prospective cohort study
Author: Lim, Y.Z.
Wang, Y.
Cicuttini, F.M.
Giles, G.G.
Graves, S.
Wluka, A.E.
Hussain, S.M.
Citation: PLoS ONE, 2021; 16(1 January):1-9
Publisher: Public Library Science
Issue Date: 2021
ISSN: 1932-6203
Statement of
Yuan Z. Lim, Yuanyuan Wang, Flavia M. Cicuttini, Graham G. Giles, Stephen Graves, Anita E. Wluka, Sultana Monira Hussain
Abstract: Objective: To examine the risk of total knee arthroplasty (TKA) due to osteoarthritis associated with obesity defined by body mass index (BMI) or waist circumference (WC) and whether there is discordance between these measures in assessing this risk. Methods: 36,784 participants from the Melbourne Collaborative Cohort Study with BMI and WC measured at 1990–1994 were included. Obesity was defined by BMI (≥30 kg/m2) or WC (men ≥102cm, women ≥88cm). The incidence of TKA between January 2001 and December 2018 was determined by linking participant records to the National Joint Replacement Registry. Results: Over 15.4±4.8 years, 2,683 participants underwent TKA. There were 20.4% participants with BMI-defined obesity, 20.8% with WC-defined obesity, and 73.6% without obesity defined by either BMI or WC. Obesity was classified as non-obese (misclassified obesity) in 11.7% of participants if BMI or WC alone was used to define obesity. BMI-defined obesity (HR 2.69, 95%CI 2.48–2.92), WC-defined obesity (HR 2.28, 95%CI 2.10–2.48), and obesity defined by either BMI or WC (HR 2.53, 95%CI 2.33–2.74) were associated with an increased risk of TKA. Compared with those without obesity, participants with misclassified obesity had an increased risk of TKA (HR 2.06, 95%CI 1.85–2.30). 22.7% of TKA in the community can be attributable to BMI-defined obesity, and a further 3.3% of TKA can be identified if WC was also used to define obesity. Conclusions: Both BMI and WC should be used to identify obese individuals who are at risk of TKA for osteoarthritis and should be targeted for prevention and treatment.
Keywords: Humans; Osteoarthritis, Knee; Obesity; Body Mass Index; Arthroplasty, Replacement, Knee; Risk Factors; Prospective Studies; Aged; Middle Aged; Female; Male; Waist Circumference
Rights: © 2021 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
RMID: 1000041414
DOI: 10.1371/journal.pone.0245002
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