CHANGE IN BODY-FAT, BUT NOT BODY-WEIGHT OR METABOLIC CORRELATES OF OBESITY, IS RELATED TO SYMPTOMATIC RELIEF OF OBESE PATIENTS WITH KNEE OSTEOARTHRITIS AFTER A WEIGHT CONTROL PROGRAM

Objective, To determine the variable most closely related to symptomat ic relief of osteoarthritis (OA) of the knee in response to a weight c ontrol program. Methods, Twenty-two patients diagnosed with knee OA wh ose body mass index (BMI) was more than 26.4 were treated with a low c alorie diet, an appetite suppressant, and nonsteroidal antiinflammator y drugs for 6 weeks. The patients were instructed to follow a walking program. We analyzed BMI, percent body fat, the average number of step s per day by pedometer, and the metabolic correlates of obesity (blood pressure, fasting blood serum glucose, total cholesterol, triglycerid es, and serum insulin) at the beginning and end of therapy. The correl ation between the change in each variable and the remission score (Del ta score) using the Severity Index of Lequesne, et al was evaluated. R esults. Delta score of knee OA was more strongly associated with reduc tion in percent body fat (p = 0.0013, r = 0.62) than other variables. Significant correlation was also observed between the number of steps per day and Delta score (p = 0.0031, r = -0.58). No other variable, in cluding weight loss, was significantly correlated with Delta score. Th ere was a significant correlation between Delta percent body fat and t he number of steps per day (p = 0.012, r = -0.62). Conclusion, In a we ight control program, decreasing body fat and increasing physical acti vity are more important than body weight loss or decreasing other indi ces of obesity in producing symptomatic relief of knee OA, although th ere is not necessarily a cause and effect relationship between body fa t and OA score.