Benefits of Massive Weight Loss on Symptoms, Systemic Inflammation and Cartilage Turnover in Obese Patients with Knee Osteoarthritis

Université Paris 7, UFR médicale, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, Paris Cedex, France.
Annals of the rheumatic diseases (Impact Factor: 10.38). 10/2010; 70(1):139-44. DOI: 10.1136/ard.2010.134015
Source: PubMed


To investigate the effect of massive weight loss on (1) knee pain and disability, (2) low-grade inflammation and metabolic status and (3) joint biomarkers in obese patients with knee osteoarthritis (OA).
140 patients involved in a gastric surgery programme were screened for painful knee OA, and 44 were included (age 44 ± 10.3 years, body mass index (BMI) 50.7 ± 7.2 kg/m(2)). Clinical data and biological samples were collected before and 6 months after surgery.
Before surgery, interleukin 6 (IL-6) levels were correlated with levels of high-sensitivity C reactive protein (hsCRP) (p=0.006) and Helix-II (p=0.01), a biomarker of cartilage turnover, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score (p=0.03). Surgery resulted in substantial decrease in BMI (-20%). Levels of insulin and insulin resistance were decreased at 6 months. Knee pain decreased after surgery (24.5 ± 21 mm vs 50 ± 26.6 mm; p<0.001), and scores on all WOMAC subscales were improved. Levels of IL-6 (p<0.0001), hsCRP (p<0.0001), orosomucoid (p<0.0001) and fibrinogen (p=0.04) were decreased after surgery. Weight loss resulted in a significant increase in N-terminal propeptide of type IIA collagen levels (+32%; p=0.002), a biomarker of cartilage synthesis, and a significant decrease in cartilage oligomeric matrix protein (COMP) (-36%; p<0.001), a biomarker of cartilage degradation. Changes in COMP concentration were correlated with changes in insulin levels (p=0.02) and insulin resistance (p=0.05).
Massive weight loss improves pain and function and decreases low-grade inflammation. Change in levels of joint biomarkers with weight loss suggests a structural effect on cartilage.

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Available from: Pascal Richette, Feb 03, 2014
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    • "The morbid obesity has been proposed to accelerate the damage to joints through with increased systemic inflammation [4]. Peltonen et al was also observed in a study showing the prevalence of hip and knee pain leading to work restriction in obese individuals than normal population [5]. "
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    • "These predictions regarding the effects of interventions seem to be supported by the literature. Studies in patients with knee OA and overweight or obesity have shown that weight reduction interventions lead to small to large effect sizes with greater improvements in activity limitations than in pain [33-35]. Little is known about the effect of depression interventions in patients with knee OA. "
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