Skeletal Radiology

, Volume 41, Issue 6, pp 633–641 | Cite as

Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects—data from the Osteoarthritis Initiative

  • Marc A. LabergeEmail author
  • Thomas Baum
  • Warapat Virayavanich
  • Lorenzo Nardo
  • M. C. Nevitt
  • J. Lynch
  • C. E. McCulloch
  • Thomas M Link
Scientific Article



To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA).

Materials and methods

We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI < 25 kg/m2, n = 38), overweight (BMI 25–29.9 kg/m2, n = 37), and obese (BMI ≥ 30 kg/m2, n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI.


The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression.


Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months.


Osteoarthritis Knee BMI Obesity Meniscus Cartilage 



Body mass index


Kellgren Lawrence


Magnetic resonance imaging




Osteoarthritis Initiative


Western Ontario and McMaster University


Whole-organ MR Imaging Score



The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. The analyses were funded through the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases, grant U01-AR-059507). The study sponsors had no involvement in the study design, collection, analysis or interpretation of data, or manuscript editing.

Conflict of interest

There is no conflict of interest for any author.


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Copyright information

© ISS 2011

Authors and Affiliations

  • Marc A. Laberge
    • 1
    Email author
  • Thomas Baum
    • 1
  • Warapat Virayavanich
    • 1
  • Lorenzo Nardo
    • 1
  • M. C. Nevitt
    • 2
  • J. Lynch
    • 2
  • C. E. McCulloch
    • 2
  • Thomas M Link
    • 1
  1. 1.Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical ImagingUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoUSA

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