Although several studies have shown that low skeletal muscle mass is correlated with knee osteoarthritis, no studies have investigated the correlation between skeletal muscle mass and hip and lumbar spine osteoarthritis (OA).
This study aimed to delineate the relationship between low skeletal muscle mass and radiographic OA (ROA) of the knee, hip, and lumbar spine.
This is a cross-sectional study using the public data obtained from the Fifth Korean National Health and Nutrition Examination Survey (2010–2011). We included subjects aged ≥ 50 years who completed the surveys (3813 subjects). ROA was assessed by knee, hip, and lumbar spine radiographs and defined as Kellgren/Lawrence (KL) grade of at least 2 in the knee and lumbar spine, whereas KL grade ≥ 1 in the hip. Multivariate logistic regression analyses were performed to evaluate the effects of low skeletal muscle mass on radiographic joint degeneration.
Appendicular skeletal muscle mass (ASM) was higher in subjects with healthy joints than in subjects with knee and lumbar spine ROA (18.9 ± 0.1 kg vs. 17.1 ± 0.2 kg, P < 0.0001 and 18.6 ± 0.1 kg vs. 17.4 ± 0.2 kg, P < 0.0001, respectively), whereas it was higher in those with ROA than in those with healthy hip (17.9 ± 0.1 kg vs. 19.1 ± 0.2 kg P < 0.0001). On multivariate logistic regression analysis, lower skeletal muscle mass independently associated with knee ROA [odds ratio (OR) 1.348; 95% confidence interval (CI) 1.037–1.752]. However, it was inversely associated with lumbar spine ROA (OR 0.786; 95% CI 0.623–0.991).
Low skeletal muscle mass was independently associated with knee ROA alone, whereas it was inversely associated with lumbar spine ROA. These opposite results might originate from measuring the area of ASM.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Felson DT, Zhang Y (1998) An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 41:1343–1355
Park JH, Hong JY, Han K et al (2017) Prevalence of symptomatic hip, knee, and spine osteoarthritis nationwide health survey analysis of an elderly Korean population. Medicine (Baltimore) 96:e6372
Felson DT, Lawrence RC, Dieppe PA et al (2000) Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 133:635–646
Glass NA, Torner JC, Frey Law LA et al (2013) The relationship between quadriceps muscle weakness and worsening of knee pain in the MOST cohort: a 5-year longitudinal study. Osteoarthr Cartil 21:1154–1159
Wang Y, Wluka AE, Berry PA et al (2012) Increase in vastus medialis cross-sectional area is associated with reduced pain, cartilage loss, and joint replacement risk in knee osteoarthritis. Arthritis Rheum 64:3917–3925
Lee SY, Ro HJ, Chung SG et al (2016) Low skeletal muscle mass in the lower limbs is independently associated to knee osteoarthritis. PLoS One 11:e0166385
Karlsson MK, Magnusson H, Coster MC et al (2014) Patients with hip osteoarthritis have a phenotype with high bone mass and low lean body mass. Clin Orthop Relat Res 472:1224–1229
De Lorenzo A, Soldati L, Sarlo F et al (2016) New obesity classification criteria as a tool for bariatric surgery indication. World J Gastroenterol 22:681–703
Janssen I, Heymsfield SB, Ross R (2002) Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 50:889–896
Hwang B, Lim JY, Lee J et al (2012) Prevalence rate and associated factors of sarcopenic obesity in korean elderly population. J Korean Med Sci 27:748–755
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
Lee S, Kim TN, Kim SH (2012) Sarcopenic obesity is more closely associated with knee osteoarthritis than is nonsarcopenic obesity: a cross-sectional study. Arthritis Rheum 64:3947–3954
Lee S, Nardo L, Kumar D et al (2015) Scoring hip osteoarthritis with MRI (SHOMRI): a whole joint osteoarthritis evaluation system. J Magn Reson Imaging 41:1549–1557
Baumgartner RN, Koehler KM, Gallagher D et al (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147:755–763
Karlsson MK, Magnusson H, Coster M et al (2015) Patients with knee osteoarthritis have a phenotype with higher bone mass, higher fat mass, and lower lean body mass. Clin Orthop Relat Res 473:258–264
Dannhauer T, Sattler M, Wirth W et al (2014) Longitudinal sensitivity to change of MRI-based muscle cross-sectional area versus isometric strength analysis in osteoarthritic knees with and without structural progression: pilot data from the Osteoarthritis. Initiat MAGMA 27:339–347
Cruz-Jentoft AJ, Landi F, Schneider SM et al (2014) Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 43:748–759
Ogon I, Takebayashi T, Takashima H et al (2017) Magnetic resonance spectroscopic analysis of multifidus muscles lipid content and association with spinopelvic malalignment in chronic low back pain. Br J Radiol 90:20160753
Zhang Y, Jordan JM (2010) Epidemiology of osteoarthritis. Clin Geriatr Med 26:355–369
Kim C, Linsenmeyer KD, Vlad SC et al (2014) Prevalence of radiographic and symptomatic hip osteoarthritis in an urban United States community: the Framingham osteoarthritis study. Arthritis Rheumatol 66:3013–3017
Kinds MB, Welsing PM, Vignon EP et al (2011) A systematic review of the association between radiographic and clinical osteoarthritis of hip and knee. Osteoarthr Cartil 19:768–778
Meakin JR, Fulford J, Seymour R et al (2013) The relationship between sagittal curvature and extensor muscle volume in the lumbar spine. J Anat 222:608–614
Masaki M, Ikezoe T, Fukumoto Y et al (2015) Association of sagittal spinal alignment with thickness and echo intensity of lumbar back muscles in middle-aged and elderly women. Arch Gerontol Geriatr 61:197–201
Jun HS, Kim JH, Ahn JH et al (2016) The effect of lumbar spinal muscle on spinal sagittal alignment. Eval Muscle Quant Qual Neurosurg 79:847–855
Sahin MS, Ergun A, Aslan A (2015) The relationship between osteoarthritis of the lumbar facet joints and lumbosacropelvic morphology. Spine (Phila Pa 1976) 40:E1058-1062
Tian W, Lv Y, Liu Y et al (2014) The high prevalence of symptomatic degenerative lumbar osteoarthritis in Chinese adults: a population-based study. Spine (Phila Pa 1976) 39:1301–1310
Dillon CF, Rasch EK, Gu Q et al (2006) Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991–94. J Rheumatol 33:2271–2279
Lacey RJ, Thomas E, Duncan RC et al (2008) Gender difference in symptomatic radiographic knee osteoarthritis in the Knee Clinical Assessment–CAS(K): a prospective study in the general population. BMC Musculoskelet Disord 9:82
O’Connor MI (2007) Sex differences in osteoarthritis of the hip and knee. J Am Acad Orthop Surg 15:S22–S25
Hitt K, Shurman JR 2nd, Greene K et al (2003) Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am 85-A Suppl 4:115–122
Traina F, De Clerico M, Biondi F et al (2009) Sex differences in hip morphology: is stem modularity effective for total hip replacement? J Bone Joint Surg Am 91 Suppl 6:121–128
Bouyer B, Mazieres B, Guillemin F et al (2016) Association between hip morphology and prevalence, clinical severity and progression of hip osteoarthritis over 3 years: The knee and hip osteoarthritis long-term assessment cohort results. Joint Bone Spine 83:432–438
Ahn T, Kim CH, Kim TH et al (2016) What is the prevalence of radiographic hip findings associated with femoroacetabular impingement in asymptomatic Asian volunteers? Clin Orthop Relat Res 474:2655–2661
Chen LK, Liu LK, Woo J et al (2014) Sarcopenia in Asia: consensus report of the asian working group for sarcopenia. J Am Med Dir Assoc 15:95–101
Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423
This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (NRF-2017M3A9D8048711). This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
This study was approved by the Korea Centers for Disease Control and Prevention Institutional Review Board and was conducted in compliance with Declaration of Helsinki.
For this type of study, formal consent is not required.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Jeon, H., Lee, S., Lim, J. et al. Low skeletal muscle mass and radiographic osteoarthritis in knee, hip, and lumbar spine: a cross-sectional study. Aging Clin Exp Res 31, 1557–1562 (2019). https://doi.org/10.1007/s40520-018-1108-5
- Knee joint
- Hip joint
- Lumbar vertebrae
- Cross-sectional studies