Prevalence of sarcopenic obesity in adults with end-stage knee osteoarthritis

Osteoarthritis Cartilage. 2019 Dec;27(12):1735-1745. doi: 10.1016/j.joca.2019.05.026. Epub 2019 Jul 2.


Objective: To identify the prevalence of sarcopenic obesity, a phenotype of low muscle mass and high adiposity, in adults with end-stage knee osteoarthritis (OA). Various diagnostic criteria, including assessment of muscle/fat mass, muscle strength and physical function, were used to identify patients with and without sarcopenic obesity, and to compare outcomes of pain, function and quality of life.

Design: Cross-sectional clinical study including adults with a body mass index (BMI) ≥30 kg/m2 and knee OA. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Assessments included gait speed, handgrip strength, six minute walk test, and self-reported pain, physical function, and health-related quality of life using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQol Foundation (EQ-5D).

Results: 151 adults (59% female) aged 65.1 ± 7.9 years, mean BMI 37.1 ± 5.5 kg/m2, were included. Prevalence of sarcopenic obesity using diagnostic cut-offs of appendicular skeletal muscle mass (ASM) relevant to height2, weight and BMI varied from 1.3% (95% confidence interval (CI): 0.2-4.7%) to 14.6% (9.4-21.2%) and 27.2% (20.2-35%), respectively. A combined diagnostic approach including low ASM with either low strength or low function yielded a prevalence of 8.6% (4.7-14.3%). Sarcopenic obesity influenced walking speed, endurance, strength, and patient-reported difficulty with self-care activities, regardless of diagnostic approach.

Conclusion: Prevalence of sarcopenic obesity varied depending on diagnostic criteria. Given the impact of this condition and OA on physical function, we suggest a combined diagnostic approach be used to clarify expected prevalence and enable early clinical identification and management of sarcopenic obesity in patients with knee OA.

Keywords: Osteoarthritis; Sarcopenic obesity; Total knee arthroplasty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Alberta / epidemiology
  • Arthralgia
  • Body Composition
  • Cross-Sectional Studies
  • Female
  • Hand Strength
  • Humans
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Osteoarthritis, Knee / epidemiology*
  • Osteoarthritis, Knee / physiopathology
  • Prevalence
  • Quality of Life*
  • Sarcopenia / epidemiology*
  • Walk Test
  • Walking Speed

Grant support