Weight cycling related to cartilage degeneration in OA knees

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Repetitive overweight or weight loss or obesity patients with knee osteoarthritis it is associated with cartilage and significantly greater bone marrow edema degeneration than stable weight or constant weight loss, the research suggests.

A presentation at the OARSI 2021 World Congress outlined the results of a to study using data from the Osteoarthritis Initiative of 2,271 individuals with knee osteoarthritis and a body mass index (BMI) of 25 kg / m2 or above, which examined the effects of “bicycle weight” on OA outcomes.

Gabby Joseph, doctor, from the University of California, San Francisco, told the conference, which was sponsored by the Osteoarthritis Research Society International, that previous studies had shown that weight loss improves symptoms of AO and slow progression, and weight gain increases the risk of AO. However, there are still no studies that have examined the effects of weight cycling.

The study compared four-year MRI data for those who showed less than 3% weight loss or gain during this time, the control group, compared to those who lost more than 5 % during this time and those who earned more than 5%. Among these, there were 249 individuals 10% of the annual weight change during this period, who were designated as weight cyclists. They tended to be younger, women and with a slightly higher average BMI than non-cyclists.

Weight cyclists had a significantly greater progression of cartilage degeneration and bone marrow edema degeneration (measured by whole organ magnetic resonance scoring) than those who did not, regardless of their weight gain or loss at the end of the study period.

However, the study did not see significant differences in meniscus progression between cyclists and non-cyclists, and cartilage thickness decreased in all groups over the 4 years with no significant effects associated with weight gain, the loss or bicycle. Joseph commented that future studies could use voxel-based relaxometry to more closely study localized cartilage abnormalities.

The researchers also examined the effect of weight cycling on changes in walking speed and found that weight cyclists had significantly lower walking speeds at the end of the four years, regardless of overall weight change.

“What we’ve seen is that fluctuations are not beneficial to your joints,” Joseph told the conference. “When we advise patients who want to lose weight, we want to do it in a very consistent way; we don’t want to diet yo-yo.” He gave the example of a patient who started the study with a BMI of 36, went up to 40, and then went down to 32.

Commenting on the study, Lisa Carlesso, doctor, from McMaster University, Hamilton, Ont., said it addresses a major problem because weight cycling is common as people struggle to maintain weight loss.

While it is difficult to speculate on the physiological mechanisms that could explain the effect, Carlesso noted that there were significantly more women than men among weight cyclists.

“We know, for example, that obese women with knee OA have significantly higher levels of adipokine leptin, compared to men, and leptin is involved in cartilage degeneration,” Carlesso said. “Similarly, we have no information on joint alignment or joint load measurements, two things that could influence the structural changes found.”

He suggested that these two possibilities could be explored in future studies on weight cycling and its effects.

“New lines of research have opened up that need to be examined to mechanically explain the relationship between cycling and worse cartilage and bone marrow degeneration,” Carlesso said.

The study was supported by the National Institutes of Health. No conflicts of interest were declared.

This article originally appeared on MDedge.com, which is part of the Medscape professional network.





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