Original article
Sex and Body Mass Index Correlate With Western Ontario and McMaster Universities Osteoarthritis Index and Quality of Life Scores in Knee Osteoarthritis

Presented to the World Congress on Osteoarthritis, September 23–26, 2010, Brussels, Belgium.
https://doi.org/10.1016/j.apmr.2011.05.009Get rights and content

Abstract

Elbaz A, Debbi EM, Segal G, Haim A, Halperin N, Agar G, Mor A, Debi R. Sex and body mass index correlate with Western Ontario and McMaster Universities Osteoarthritis Index and quality of life scores in knee osteoarthritis.

Objective

To examine the associations of sex, body mass index (BMI), and age with knee osteoarthritis (OA) symptomatic severity.

Design

A cross-sectional retrospective analysis.

Setting

Patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Data were acquired from a stored database of a private therapy center.

Participants

Patients (N=1487) with symptomatic knee OA were evaluated.

Interventions

Not applicable.

Main Outcome Measures

WOMAC questionnaire and SF-36.

Results

BMI correlated significantly with worse knee OA symptoms for all WOMAC and SF-36 subcategories (all P≤.001). Age correlated significantly with worse symptoms only for WOMAC function and SF-36 physical functioning (P=.001 and P=.009, respectively). A significant difference across BMI quintiles was found for all WOMAC and SF-36 subcategories (all P≤.01). Women showed worse knee OA symptoms in all WOMAC and SF-36 subcategories (all P≤.001). There was a significant interaction of sex by BMI in WOMAC pain and WOMAC function (P=.01 and P=.02, respectively).

Conclusions

Based on the results of this analysis, it can be concluded that women and patients with a higher BMI with knee OA are at a greater risk for worse symptoms.

Section snippets

Design

This was a retrospective cross-sectional survey of OA symptoms reported by patients with knee OA, who were evaluated for treatment at the All Phases of Step Cycle Therapy Center, Israel. Data were collected retrospectively from a secure database system.

Recruitment of Participants

The clinic treats patients throughout Israel using a customized biomechanical gait therapy for patients with musculoskeletal disorders. The majority of patients arrive from Tel Aviv and Haifa. The database was reviewed for all knee OA patients

Participant Characteristics

This was a cross-sectional analysis of 1487 patients (950 women and 537 men) who came to 1 therapy clinic with symptomatic knee OA. The mean age was 61.9±10.6 years, and the mean BMI was 30.9±6.2kg/m2.

Sex

A significant difference was found between sexes for all WOMAC and SF-36 subcategories. Women patients with knee OA reported significantly worse symptoms than men in all knee OA questionnaire subcategories. Results are presented in table 1.

BMI and Age

An increase in BMI correlated significantly with worse

Discussion

This was a cross-sectional survey of 1487 knee OA patients. Results showed that men and women differed in all questionnaire subcategories of symptomatic knee OA, with women reporting worse symptoms. The correlation and Kruskal-Wallis calculations complemented each other and demonstrated that BMI, rather than age, was correlated with all measures of knee OA symptomatic severity. An examination of the interaction effect of sex on the association between BMI and knee OA symptomatic severity showed

Conclusions

Being a woman and increased BMI correlated with worse symptoms of knee OA as evaluated by the WOMAC questionnaire and SF-36. The relationship between BMI and knee OA symptomatic severity was stronger in women than in men. Increased age only weakly correlated with an increase in knee OA functional severity. These findings are important in caring for and advising patients with knee OA, especially women and overweight patients. Current and future interventions for knee OA should be designed or

Acknowledgements

We thank Nira Koren-Morag, PhD, for statistical analysis assistance.

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    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

    Clinical trial registration number: NCT00767780.

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