Objective
In elders, decreased muscle mass (sarcopenia) and increased fat mass (obesity) may contribute to difficulties with physical function. This study was undertaken to investigate the prevalence of sarcopenic-obesity and its impact on physical function, quality of life and pain in patients with end-stage knee osteoarthritis over 65 years old.
Methods
In this cross-sectional study, we assessed a total of 562 patients (77 males and 485 females; average age 72.67±4.44 years) who were diagnosed with end-stage knee osteoarthritis (OA). We divided patient into three groups according to the presence sarcopenia and obesity (defined as a loss of skeletal muscle mass by Bioelectrical Impedance Analysis). The concept of sarcopenic-obesity is defined as patients with sarcopenia and obesity. All patients completed performance-based physical function tests including stair climbing test (SCT), 6-minute walk test (6MWT), timed up and go test (TUG), instrumental gait analysis for spatio-temporal parameters. Self-reported physical function and pain were measured using the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS), and self-reported quality of life was measured using the EuroQOL five dimensions (EQ-5D) questionnaire.
Results
Pure obesity was diagnosed in 363 subjects (64.6%), pure sarcopenia in 25 (4.4%) and sarcopenic-obesity in 15 (2.7%). Among 15 patients with sarcopenic-obesity, 9 (60%) were males and 6 (40%) were females. In the analysis of variance (ANOVA) and Duncan multiple range tests, sarcopenic-obesity group exhibited significantly higher scores in SCT-ascent, SCT-descent, and lower scores in 6MWT, WOMAC-stiffness in other groups (P<0.05). In male, sarcopenic-obesity group exhibited significantly higher scores in SCT-ascent, SCT-descent, TUG in other groups (P<0.05). In female, sarcopenic-obesity group exhibited significantly higher scores in SCT-ascent, SCT-descent in other groups (P<0.05).
Conclusions
This study confirmed that sarcopenic-obesity was present in patients with end-stage knee OA and has a negative impact on physical function. Given the impact of sarcopenic-obesity on outcomes for patients with end-stage knee OA, we suggest clarification of the expected prevalence and management of this condition in patients with knee OA.
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Table 1. Demographic and Disease-Related Characteristics of the Subjects (N=562)
Table 2. Demographic data and performance-based physical function, self-reported physical function, quality of life and pain in patients with end-stage knee osteoarthritis according to groups (N=562)
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