Does obesity predict knee pain over fourteen years in women, independently of radiographic changes?

Goulston, Lyndsey M., Kiran, A., Javaid, M. Kassim, Soni, A., White, K .M., Hart, D. J., Spector, T. D. and Arden, N. K. (2011) Does obesity predict knee pain over fourteen years in women, independently of radiographic changes? Arthritis & Rheumatism, 63 (10), 1398-1406. (doi:10.1002/acr.20546). (PMID:21739621)

Abstract

Objective. To examine longitudinal patterns in body mass index (BMI) over 14 years and its association with knee pain
in the Chingford Study.
Methods. We studied a total of 594 women with BMI data from clinic visits at years (Y) 1, 5, 10, and 15. Knee pain at Y15
was assessed by questionnaire. Associations between BMI over 14 years and knee pain at Y15 were examined using
logistic regression.
Results. BMI significantly increased from Y1 to Y15 (P < 0.0005) with medians (interquartile ranges) of 24.5 kg/m2
(22.5–27.2 kg/m2) and 26.5 kg/m2 (23.9–30.1 kg/m2), respectively. At Y15, 45.1% of subjects had knee pain. A greater BMI
at Y1 (odds ratio [OR] 1.34, 95% confidence interval [95% CI] 1.05–1.69), at Y15 (OR 1.34, 95% CI 1.10–1.61), and change
in BMI over 15 years (OR 1.40, 95% CI 1.00–1.93) were significant predictors of knee pain at Y15 (P < 0.05). BMI change
was associated with bilateral (OR 1.61, 95% CI 1.05–1.76, P ? 0.024) but not unilateral knee pain (OR 1.22, 95% CI
0.73–1.76, P ? 0.298). The association between BMI change and knee pain was independent of radiographic knee
osteoarthritis (OA). The strength of association between BMI and knee pain at Y15 was similar during followup
measurements.
Conclusion. Over 14 years, a higher BMI predicts knee pain at Y15 in women, independently of radiographic knee OA.
When adjusted, the association was significant in bilateral, not unilateral, knee pain, suggesting alternative pathologic
mechanisms may exist. The longitudinal effect of BMI on knee pain at Y15 is equally important at any time point, which
may assist reducing the population burden of knee pain.

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