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Obesity Contributes to Rapid Cartilage Loss OAK BROOK, Ill -- July 14, 2009 -- Obesity, among other factors, is strongly associated with an increased risk of rapid cartilage loss, according to a study published in the August issue of Radiology. “We have isolated demographic and MRI (magnetic resonance imaging)-based risk factors for progressive cartilage loss,” said lead author, Frank W. Roemer, MD, Boston University, and the Quantitative Imaging Center, Boston University School of Medicine, Boston, Massachusetts. “Increased baseline body mass index was the only non-MRI-based predictor identified.” “Osteoarthritis is a slowly progressive disorder, but a minority of patients with hardly any osteoarthritis at first diagnosis exhibit fast disease progression,” said Dr. Roemer. “So we set out to identify baseline risk factors that might predict rapid cartilage loss in patients with early knee osteoarthritis or at high risk for the disease.” The researchers recruited patients from the Multicenter Osteoarthritis (MOST) Study, a prospective study of 3,026 people, aged 50 to 79 years, at risk for osteoarthritis or with early x-ray evidence of the disease. Dr. Roemer’s study consisted of 347 knees in 336 patients (65.2% female; mean age, 61.2 years; mean body mass index [BMI], 29.5). Only knees with minimal or no baseline cartilage damage were included. Of 347 knees selected for the study, 20.2% exhibited slow cartilage loss over the 30-month follow-up period and 5.8% showed rapid cartilage loss. Rapid cartilage loss was defined by a whole organ MRI of at least 5, indicating a large full thickness loss of 75% in any subregion of the knee during the follow-up period. The results showed that the top risk factors contributing to rapid cartilage loss were baseline cartilage damage, high BMI, tears or other injury to the meniscus and severe lesions seen on MRI at the initial exam. Other predictors were synovitis and effusion. Excess weight was significantly associated with an increased risk of rapid cartilage loss. For a 1-unit increase in BMI, the odds of rapid cartilage loss increased by 11%. No other demographic factors, including age, sex and ethnicity, were associated with rapid cartilage loss. “As obesity is one of the few established risk factors for osteoarthritis, it is not surprising that obesity may also precede and predict rapid cartilage loss,” Dr. Roemer said. “Weight loss is probably the most important factor to slow disease progression.” SOURCE: Radiological Society of North America E-mail this page to a friend or colleague! To print, use this version