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Overweight and health problems of the lower extremities: osteoarthritis, pain and disability

  • A Tukker (a1) (a2), TLS Visscher (a1) (a2) and HSJ Picavet (a1)
Abstract
AbstractAim

To examine the association between overweight and health problems of the lower extremities, i.e. osteoarthritis (OA), pain and disability.

Methods

Cross-sectional data from the Dutch population-based Musculoskeletal Conditions & Consequences Cohort (DMC3), comprising a random sample from the Dutch population aged >25 years (n 3664), were analysed using multivariate logistic regression. Overweight was defined as BMI ≥ 25·0 kg/m2, moderate overweight as 25·0 kg/m2 ≤ BMI < 30·0 kg/m2 and obesity as BMI ≥ 30·0 kg/m2. Health problems of the lower extremities were: (i) self-reported OA of the hip or knee as told by a doctor; (ii) presence of self-reported chronic pain (>3 months) of the lower extremities; and (iii) disabilities in mobility as measured by the Euroqol questionnaire (EQ-5D).

Results

Moderate overweight was associated with self-reported OA of the hip or knee (OR = 1·7; 95 % CI 1·4, 2·1), chronic pain of the lower extremities at one or more location(s) (OR = 1·6; 95 % CI 1·3, 1·9) and disability in mobility (OR = 1.7; 95 % CI 1·4, 2·0). For obesity these odds were higher: 2·8 (95 % CI 2·1, 3·7), 2·5 (95 % CI 1·9, 3·2) and 3·0 (95 % CI 2·3, 3·9), respectively. Also, among those with OA, moderate overweight and obesity were associated with disability in mobility.

Conclusion

There is a strong association between overweight/obesity and health problems of the lower extremities, i.e. OA, pain and disability. The increasing prevalence of overweight and obesity worldwide urges for public health action not only for diabetes and heart disease, but also OA.

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Corresponding author
*Corresponding author: Email susan.picavet@rivm.nl
References
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1. Han TS, Tijhuis MA, Lean ME & Seidell JC (1998) Quality of life in relation to overweight and body fat distribution. Am J Public Health 88, 18141820.
2. Rissanen AM (2006) The economic and psychosocial consequences of obesity. Ciba Found Symp 201, 194201.
3. Lievense AM, Bierma-Zeinstra SMA, Verhagen AP, van Baar ME, Verhaar JAN & Koes BW (2002) Influence of obesity on the development of osteoarthritis of the hip: a systematic review. Rheumatology 41, 11551162.
4. Peat G, McCarney R & Croft P (2002) Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis 60, 9197.
5. Coggon D, Reading I, Croft P, McLaren M, Barrett D & Cooper C (2001) Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord 25, 622627.
6. Oliveria SA, Felson DT, Cirillo PA, Reed JI & Walker AM (1999) Body weight, body mass index, and incident symptomatic osteoarthritis of the hand, hip, and knee. Epidemiology 10, 161166.
7. Hochberg MC, Lethbridge-Cejku M, Scott WW Jr, Reichle R, Plato CC & Tobin JD (1995) The association of body weight, body fatness and body fat distribution with osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging. J Rheumatol 22, 488493.
8. Gast G-MC, Frenken FJ, Van Leest LA, Wendel-Vos GC & Bemelmans WJ (2006) Intra-national variation in trends in overweight and leisure time physical activities in The Netherlands since 1980: stratification according to sex, age and urbanisation degree. Int J Obes (Lond) 31, 515520.
9. Schokker DF, Visscher TLS, Van Baak MA & Seidell JC (2007) Prevalence of overweight and obesity in The Netherlands. Obes Rev 8, 101108.
10. Visscher TLS & Seidell JC (2001) The public health impact of obesity. Annu Rev Public Health 22, 355375.
11. Picavet HSJ & Hoeymans N (2002) Physical disability in The Netherlands: prevalence, risk groups and time trends. Public Health 116, 231237.
12. Picavet HSJ & Schouten JSAG (2003) Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)study. Pain 102, 167178.
13. Picavet HSJ (2001) National Health Survey by mail or home interview: effects on response. J Epidemiol Community Health 55, 408413.
14. Euroqol Group (1990) Euroqol – a new facility for the measurement of health related quality of life. Health Policy 16, 199208.
15. Picavet HS & Hoeymans N (2004) Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study. Ann Rheum Dis 63, 723729.
16. Anderson JJ & Felson DT (1988) Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol 128, 179189.
17. Sowers MF, Hochberg M, Crabbe JP, Muhich A, Crutchfield M & Updike S (1996) Association of bone mineral density and sex hormone levels with osteoarthritis of the hand and knee in premenopausal women. Am J Epidemiol 143, 3847.
18. Sowers MF, Lachance L, Hochberg M & Jamadar D (2000) Radiographically defined osteoarthritis of the hand and knee in young and middle-aged African American and Caucasian women. Osteoarthritis Cartilage 8, 6977.
19. Cimmino MA, Sarzi-Puttini P, Scarpa R, Caporali R, Parazzini F, Zaninelli A & Marcolongo R (2005) Clinical presentation of osteoarthritis in general practice: determinants of pain in Italian patients in the AMICA study. Semin Arthritis Rheum 35, Suppl. 1, 1723.
20. Felson DT, Anderson JJ, Naimark A, Walker AM & Meenan RF (1988) Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med 109, 1824.
21. Manninen P, Riihimaki H, Heliovaara M & Makela P (1996) Overweight, gender and knee osteoarthritis. Int J Obes Relat Metab Disord 20, 595597.
22. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P & Levy D (1997) Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum 40, 728733.
23. Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM & Klag MJ (1999) Body mass index in young men and the risk of subsequent knee and hip osteoarthritis. Am J Med 107, 542548.
24. Miranda H, Viikari-Juntura E, Martikainen R & Riihimaki H (2002) A prospective study on knee pain and its risk factors. Osteoarthritis Cartilage 10, 623630.
25. Felson DT, Zhang Y, Anthony JM, Naimark A & Anderson JJ (1992) Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med 116, 535539.
26. Jinks C, Jordan K & Croft P (2006) Disabling knee pain – another consequence of obesity: results from a prospective cohort study. BMC Public Health 6, 258.
27. Holmberg S, Thelin A & Thelin N (2005) Knee osteoarthritis and body mass index: a population-based case–control study. Scand J Rheumatol 34, 5964.
28. Flugsrud GB, Nordsletten L, Espehaug B, Havelin LI & Meyer HE (2002) Risk factors for total hip replacement due to primary osteoarthritis: a cohort study in 50,034 persons. Arthritis Rheum 46, 675682.
29. Flugsrud GB, Nordsletten L, Espehaug B, Havelin LI, Engeland A & Meyer HE (2006) The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons. Arthritis Rheum 54, 802807.
30. Karlson EW, Mandl LA, Aweh GN, Sangha O, Liang MH & Grodstein F (2003) Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors. Am J Med 114, 9398.
31. Felson DT & Zhang Y (1998) An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 41, 13431355.
32. Tugwell P, Chambers L, Torrance G, Reynolds D, Wolfson M, Bennett K, Badley E, Jamieson E & Stock S (1993) The population health impact of arthritis. J Rheumatol 20, 10481051.
33. O’Reilly SC, Muir KR & Doherty M (1996) Screening for pain in knee osteoarthritis: which question? Ann Rheum Dis 55, 931933.
34. Quintana JM, Arostegui I, Escobar A, Lafuente I, Arenaza JC, Garcia I & Aguirre U (2007) Validation of a screening questionnaire for hip and knee osteoarthritis in old people. BMC Musculoskeletal Dis 8, 84.
35. Okoro CA, Hootman JM, Strine TW, Balluz LS & Mokdad AH (2004) Disability, arthritis, and body weight among adults 45 years and older. Obes Res 12, 854861.
36. Schouten JSAG, van den Ouweland FA & Valkenburg HA (1992) A 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee. Ann Rheum Dis 51, 932937.
37. Peltonen M, Lindroos AK & Torgerson JS (2003) Musculoskeletal pain in the obese: a comparison with a general population and long-term changes after conventional and surgical obesity treatment. Pain 104, 549557.
38. Zamboni M, Mazzali G, Zoico E, Harris TB, Meigs JB, Di Francesco V, Fantin F, Bissoli L & Bosello O (2005) Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond) 29, 10111029.
39. Messier SP, Gutekunst DJ, Davis C & DeVita P (2005) Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum 52, 20262032.
40. Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, Ettinger WH Jr, Pahor M & Williamson JD (2004) Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum 50, 15011510.
41. Focht BC, Rejeski WJ, Ambrosius WT, Katula JA & Messier SP (2005) Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum 53, 659665.
42. Rothman KJ & Greenland S (editors) (1998) Applications of stratified analysis methods. In Modern Epidemiology, 2nd ed., pp. 281301. Philadelphia, PA: Lippincott-Raven.
43. Leveille SG, Wee CC & Iezzoni LI (2005) Trends in obesity and arthritis among baby boomers and their predecessors, 1971–2002. Am J Public Health 95, 16071613.
44. Hupkens CL, van den Berg J & van der Zee J (1999) National health interview surveys in Europe: an overview. Health Policy 47, 145168.
45. Rosenbloom AL, Joe JR, Young RS & Winter WE (1999) Emerging epidemic of type 2 diabetes in youth. Diabetes Care 22, 345354.
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Public Health Nutrition
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