Sarcopenic obesity prevalence and clinical implications in patients with advanced knee osteoarthritis and class II-III obesity.

Sarcopenic obesity (SO) was present in 28% of adults with advanced knee osteoarthritis and BMI ≥35 kg/m2.

• Prevalence was 28% (95%CI 15.5-40.4) out of 50 adults
• Sample was 74% female, mean age 63.7 ± 6.9 years, mean BMI 42.1 ± 4.6 kg/m2
• Diagnosis was based on published criteria identifying co-presence of low muscle function, low muscle mass, and high fat mass
• This was a cross-sectional analysis of baseline data from the POMELO pilot randomized clinical trial

Individuals with SO had significantly shorter 6-minute walk test (6MWT) distances compared to those without SO.

• Those with SO walked -78.6 m less than those without SO (p = 0.012)
• 6MWT was used as an objective measure of physical function
• This difference was statistically significant

Individuals with SO had worse self-reported physical function as measured by the WOMAC function score.

• WOMAC function score was 7.2 points worse in those with SO compared to those without SO (p = 0.046)
• The Western Ontario and McMaster Osteoarthritis Index (WOMAC) was used to assess self-reported physical function
• This difference reached statistical significance

Individuals with SO had lower health-related quality of life as measured by the EQ-5D visual analog scale.

• EQ-5D visual analog score was -14.7 points lower in those with SO compared to those without SO (p = 0.016)
• Health-related quality of life was assessed using the Euroqol EQ-5D
• This difference was statistically significant

The study assessed multiple measures of muscle mass and function using standardized tools including DXA, handgrip strength, and chair sit-to-stands.

• Muscle mass was measured as appendicular lean soft tissue by DXA
• Muscle function assessments included maximal handgrip strength (both absolute and relative to body size) and chair sit-to-stands
• Fat mass was also measured by DXA
• Multiple established diagnostic criteria for SO were compared

The authors concluded that identification of SO may better stratify patients and enable personalized support to preserve muscle mass and function prior to weight loss or arthroplasty considerations.

• Individuals with advanced knee OA and larger body size are described as being at risk for SO
• SO is characterized as 'an unfavourable condition of high fat and low muscle mass and function that markedly impacts mobility and morbidity'
• The authors suggest personalized support to preserve muscle mass and function should be considered
• This recommendation applies prior to weight loss or arthroplasty considerations