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. 2023 Oct 5;15(19):4263.
doi: 10.3390/nu15194263.

A Higher Skeletal Muscle Mass and Lower Adiposity Phenotype Is Associated with Better Cardiometabolic Control in Adults with Hip and Knee Osteoarthritis: Results from the Chilean National Health Survey 2016-2017

Francisco Guede-Rojas  1 , Paulina Ibacache-Saavedra  1 , María Inés Leal  1 , Marcelo Tuesta  1 , Cristóbal Durán-Marín  2 , Fernanda Carrasco-Marín  3 , Igor Cigarroa  4 , Cristian Alvarez  1 , Mikel Izquierdo  5   6 , Pedro Delgado-Floody  7   8
Affiliations

A Higher Skeletal Muscle Mass and Lower Adiposity Phenotype Is Associated with Better Cardiometabolic Control in Adults with Hip and Knee Osteoarthritis: Results from the Chilean National Health Survey 2016-2017

Francisco Guede-Rojas et al. Nutrients. .

Abstract

Objective: This study aimed to (1) characterize cardiometabolic factors in self-reported hip and knee osteoarthritis (OAD) across four body composition phenotypes defined by muscle mass and adiposity, and (2) associate risk factors with diabetes and hypertension (HTN).

Methods: A cross-sectional analysis of the Chilean National Health Survey 2016-17 (n = 4996) stratified participants into four groups: low skeletal muscle mass/high waist circumference (Low-SMM/High-WC), low SMM/low WC (Low-SMM/Low-WC), high SMM/high WC (High-SMM/High-WC), and high SMM/low WC (reference group). Each group was further divided into subgroups with or without diagnosed hip or knee OAD. The main outcomes were fasting plasma glucose, systolic (SBP)/diastolic (DBP) blood pressure (continuous outcomes), and other secondary factors such as cardiovascular risk (CVR).

Results: In the hip OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (145 vs. 127 mmHg, p < 0.0001, diff +18 mmHg). In the knee OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (141 vs. 134 mmHg, p < 0.0001, diff +7 mmHg). The SBP showed a significant interaction between the group and OAD diagnosis (p = 0.007 hip OAD; p < 0.0001 knee OAD).

Conclusions: Hip and knee OAD associates with elevated SBP/DBP in older adults. OAD groups showed an OR above 2 for diabetes, 2.7 for HTN, 4.5 for metabolic syndrome, and over 2 for moderate-to-high cardiovascular risk. OAD interacts substantially with cardiometabolic factors, especially in low muscle mass/high adiposity phenotypes. Lifestyle optimization of physical activity and nutrition to preserve muscle mass and mitigate adiposity is essential for cardiometabolic health promotion in OAD patients.

Keywords: arterial hypertension; body fat; diabetes; older adults; osteoarthritis; skeletal muscle mass.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design. (OAD) Osteoarthritis diagnosed. Categories of osteoarthritis conditions are described as hip osteoarthritis diagnosed (Hip-OAD), no hip osteoarthritis diagnosed (No-Hip-OAD), knee osteoarthritis diagnosed (Knee-OAD), no knee osteoarthritis diagnosed (No-Knee-OAD).
Figure 2
Figure 2
Fasting plasma glucose, glycated haemoglobin, systolic and diastolic blood pressure through four different human adult phenotypes with hip and knee osteoarthritis diagnosed (OAD). Groups are described as follows: low skeletal muscle mass and high waist circumference phenotypical model (Low-SMM/High-WC), low skeletal muscle mass and low waist circumference phenotypical model (Low-SMM/Low-WC), high skeletal muscle mass and high waist circumference phenotypical model (High-SMM/High-WC), and high skeletal muscle mass and low waist circumference phenotypical model (High-SMM/Low-WC), reference group (Ref.). Categories are described as follows: Hip osteoarthritis diagnosed (Hip-OAD), no hip osteoarthritis diagnosed (No-Hip-OAD), knee osteoarthritis diagnosed (Knee-OAD), no knee osteoarthritis diagnosed (No-Knee-OAD), type 2 diabetes mellitus (T2DM), prediabetes (Pre-T2DM), elevated blood pressure (Ele-BP), hypertension stage 1 (HTN1), and hypertension stage 2 (HTN2). (HbA1c) Glycated hemoglobin. (ES) Denotes Cohen d effect size. (‡) Denotes significant differences vs. Ref. group at p < 0.0001. (A) Fasting glucose in Hip and No-Hip-OAD. (B) Fasting glucose in Knee and No-Knee-OAD. (C) Glycated hemoglobin in Hip and No-Hip-OAD. (D) Glycated hemoglobin in Knee and No-Knee-OAD. (E) Systolic blood pressure in Hip and No-Hip-OAD. (F) Systolic blood pressure in Knee and No-Knee-OAD. (G) Diastolic blood pressure in Hip and No-Hip-OAD. (H) Diastolic blood pressure in Knee and No-Knee-OAD.
Figure 3
Figure 3
Lipid profile markers (total cholesterol (A,B), low-density lipids (C,D), high-density lipids (E,F), and triglycerides (G,H) for four different human adult body composition phenotypes (based on skeletal muscle mass using calf circumference and waist circumference) in relationship with hip and knee osteoarthritis diagnosed (OAD) categories). Groups are described as follows: (Low-SMM/High-WC) Low-skeletal muscle mass and high waist circumference phenotypical model. (Low-SMM/Low-WC) Low skeletal muscle mass and low waist circumference phenotypical model. (High-SMM/High-WC) High skeletal muscle mass and high waist circumference phenotypical model. (High-SMM/Low-WC) High skeletal muscle mass and low waist circumference phenotypical model. (Ref.) Reference group. Categories are described as follows: (Hip-OAD) Hip osteoarthritis diagnosed. (No-Hip-OAD) No hip osteoarthritis diagnosed. (Knee-OAD) Knee osteoarthritis diagnosed. (No-Knee-OAD) No Knee osteoarthritis diagnosed. (Ref.) Reference group. (ES) Denotes Cohen d effect size. (HCh) Hypercholesterolemia. (HTg) Hypertriglyceridemia. (†) Denotes significant differences vs. Ref. group at p < 0.05.
Figure 4
Figure 4
Markers of mineral content (A,B), non-alcoholic fatty liver disease (C–F), and inflammation (G,H) in adults for four different human adult body composition phenotypes (based on skeletal muscle mass using calf circumference and waist circumference) in relation to hip and knee osteoarthritis diagnosed (OAD) categories. Groups are described as follows: (Low-SMM/High-WC) Low skeletal muscle mass and high waist circumference phenotypical model. (Low-SMM/Low-WC) Low skeletal muscle mass and low waist circumference phenotypical model. (High-SMM/High-WC) High skeletal muscle mass and high waist circumference phenotypical model. (High-SMM/Low-WC) High skeletal muscle mass and low waist circumference phenotypical model. (Ref.) Reference group. Categories are described as follows: (Hip-OAD) Hip osteoarthritis diagnosed. (No-Hip-OAD) No hip osteo-arthritis diagnosed. (Knee-OAD) Knee osteoarthritis diagnosed. (No-Knee-OAD) No knee osteoarthritis diagnosed. (ES) Denotes Cohen d effect size. (‡) Denotes significant differences vs. Ref. group at p < 0.0001. (†) Denotes significant differences vs. Ref. group at p < 0.05.
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