Adam G Culvenor1, David T Felson2, Jingbo Niu3, Wolfgang Wirth4, Martina Sattler4, Torben Dannhauer4, Felix Eckstein4. 1. Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria, and La Trobe University, Bundoora, Victoria, Australia. 2. Boston University School of Medicine, Boston, Massachusetts, and University of Manchester and Central Manchester NHS Foundation Trust, Manchester, UK. 3. Boston University School of Medicine, Boston, Massachusetts. 4. Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.
Abstract
OBJECTIVE: To determine whether lower thigh muscle specific-strength increases the risk of incident radiographic knee osteoarthritis (RKOA), and whether there exists a sex-specific relationship between thigh muscle specific-strength and body mass index (BMI). METHODS: A total of 161 Osteoarthritis Initiative participants (62% female) with incident RKOA (Kellgren/Lawrence grade 0/1 at baseline, developing an osteophyte and joint space narrowing grade ≥1 by year 4) were matched to 186 controls (58% female) without incident RKOA. Thigh muscle anatomical cross-sectional areas (ACSAs) were determined at baseline using axial magnetic resonance imaging scans. Isometric extensor and flexor muscle strength was measured at baseline, and specific strength (strength ÷ ACSA) was calculated. Logistic regression assessed the risk of incident RKOA associated with muscle specific-strength (with and without adjustment for BMI). RESULTS: Lower knee extensor- and flexor-specific strength significantly increased the risk of incident RKOA in women but not in men (odds ratio 1.47 [95% confidence interval (95% CI) 1.10-1.96] and 1.41 [95% CI 1.06-1.89], respectively). The significant relationship in women was lost after adjustment for BMI. Lower specific strength was associated with higher BMI in women (r = -0.29, P < 0.001), but not in men, whereas absolute strength was associated with BMI in men (r = 0.28, P = 0.001), but not in women. CONCLUSION: Lower thigh muscle specific-strength predicts incident RKOA in women, with this relationship being confounded by BMI. The sex-specific relationship between muscle specific-strength and BMI provides a possible explanation why women with muscle-strength deficits typically have a poorer prognosis than men with similar strength deficits.
OBJECTIVE: To determine whether lower thigh muscle specific-strength increases the risk of incident radiographic knee osteoarthritis (RKOA), and whether there exists a sex-specific relationship between thigh muscle specific-strength and body mass index (BMI). METHODS: A total of 161 Osteoarthritis Initiative participants (62% female) with incident RKOA (Kellgren/Lawrence grade 0/1 at baseline, developing an osteophyte and joint space narrowing grade ≥1 by year 4) were matched to 186 controls (58% female) without incident RKOA. Thigh muscle anatomical cross-sectional areas (ACSAs) were determined at baseline using axial magnetic resonance imaging scans. Isometric extensor and flexor muscle strength was measured at baseline, and specific strength (strength ÷ ACSA) was calculated. Logistic regression assessed the risk of incident RKOA associated with muscle specific-strength (with and without adjustment for BMI). RESULTS: Lower knee extensor- and flexor-specific strength significantly increased the risk of incident RKOA in women but not in men (odds ratio 1.47 [95% confidence interval (95% CI) 1.10-1.96] and 1.41 [95% CI 1.06-1.89], respectively). The significant relationship in women was lost after adjustment for BMI. Lower specific strength was associated with higher BMI in women (r = -0.29, P < 0.001), but not in men, whereas absolute strength was associated with BMI in men (r = 0.28, P = 0.001), but not in women. CONCLUSION: Lower thigh muscle specific-strength predicts incident RKOA in women, with this relationship being confounded by BMI. The sex-specific relationship between muscle specific-strength and BMI provides a possible explanation why women with muscle-strength deficits typically have a poorer prognosis than men with similar strength deficits.
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