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• W2938974820 abstract "Purpose: While there is discordance between body mass index (BMI) and waist circumference (WC) in classifying individuals as having obesity in a number of populations, no previous study has examined the risk of osteoarthritis in relation to different combinations of BMI and WC, though obesity is a major contributing factor in the pathogenesis of osteoarthritis. The aim of this study was to examine whether different combinations of BMI- and WC-defined obesity were associated with the risk of knee and hip arthroplasty due to osteoarthritis in two large prospective cohort studies. Methods: This study examined 38,924 participants from the Melbourne Collaborative Cohort Study (MCCS) and 9,135 participants from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. Obesity status was classified into four categories based on the presence of BMI-defined obesity (BMI ≥30 kg/m2) and WC-defined obesity (WC ≥102cm for men and ≥88 cm for women): (i) no obesity according to BMI and WC (N/N); (ii) obesity according to WC, but not BMI (N/Ob); (iii) obesity according to BMI, but not WC (Ob/N); (iv) obesity according to BMI and WC (Ob/Ob), where N = no-obesity and Ob = obesity. Knee or hip osteoarthritis was defined as the first primary knee or hip arthroplasty with a contemporaneous diagnosis of osteoarthritis, by linking the cohort records to the Australian Orthopaedic Association of National Joint Replacement Registry. Hazard ratios and 95% confidence intervals (CI) for the relationship between obesity categories and knee or hip OA was explored using Cox proportional hazards regression model. Results: Over 9.1±2.3 years, 311 knee arthroplasty and 199 hip arthroplasty were identified in the AusDiab study. Over 11.5±3.1 years, 1,875 knee arthroplasty and 1,505 hip arthroplasty were identified in the MCCS. After adjustment for age, sex, smoking status, physical activity and ethnicity, in both the cohorts, the risk of knee arthroplasty for osteoarthritis was increased in those with obesity defined by WC (N/Ob) [AusDiab: HR 1.25 (95% CI 0.89, 1.74); MCCS: 1.79 (1.51, 2.53)] and obesity defined by BMI (Ob/N) [AusDiab: 2.19 (0.96, 4.99); MCCS: 2.39 (2.02, 2.84)] compared to those without obesity (N/N). In both the cohorts those with obesity defined by both BMI and WC (Ob/Ob) had the highest risk of knee arthroplasty for osteoarthritis compared to those without obesity [AusDiab: 3.00 (2.33, 3.86); MCCS: 3.14 (2.82, 3.49)]. The results were similar for men and women when stratified analyses were performed. There was an increased risk of hip arthroplasty for osteoarthritis only in those who had obesity defined both BMI and WC (Ob/Ob) compared with those having no obesity [AusDiab: 1.67 (1.19, 2.34); MCCS 1.32 (1.14, 1.52)]. Conclusions: The risk of knee arthroplasty for osteoarthritis associated with obesity was higher when obesity was defined by a combination of BMI and WC compared with the risk when obesity was defined by WC alone or BMI alone. The risk of hip arthroplasty for osteoarthritis associated with obesity was only significant when obesity was defined using a combination of BMI and WC. Furthermore, a stronger association between obesity and osteoarthritis was observed for the knee than the hip. These findings suggest that those who have obesity defined by either BMI or WC should be targeted to reduce the burden of knee osteoarthritis. In contrast, targeting those who have obesity defined by combination of both BMI and WC is beneficial to reduce the burden of hip osteoarthritis." @default.
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• W2938974820 date "2019-04-01" @default.
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• W2938974820 title "Association between body mass index-and waist circumference-defined obesity with the risk of knee and hip arthroplasty for osteoarthritis" @default.
• W2938974820 doi "https://doi.org/10.1016/j.joca.2019.02.647" @default.
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