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- Mediating effect of lower extremity muscle on the relationship between obesity and osteoarthritis in middle-aged and elderly women in Korea: based on the 2009-2011 Korea National Health and Nutrition Examination Survey
- Minjun Kim, Joonwoong Kim, Inhwan Lee
- Epidemiol Health. 2024;46:e2024027. Published online February 2, 2024
- DOI: https://doi.org/10.4178/epih.e2024027
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AbstractOBJECTIVES
This study investigated whether the lower extremity muscle mass index (LMI) mediates the relationship between general obesity, central obesity, and knee osteoarthritis in middle-aged and elderly women in Korea.METHODSData of 2,843 women aged ≥50 years were collected from the Korean National Health and Nutrition Examination Survey conducted between 2009 and 2011. General obesity and central obesity were evaluated based on body mass index (BMI) and waist circumference (WC), calculated through anthropometric measurements and body composition assessments. LMI was calculated by dividing the muscle mass in both legs—measured using the dual-energy X-ray absorptiometry—by body weight. Knee osteoarthritis was defined as a Kellgren-Lawrence scale (KL) grade of ≥2 as assessed through radiographic images.RESULTSKnee osteoarthritis prevalence, indicated by KL grades, was significantly higher in the general obesity and central obesity groups compared to the normal group, and conversely, lower with varying LMI levels. Using mediation analysis with bootstrapping and adjusting for covariates, we found that LMI mediated the relationship between BMI and KL (β, 0.005; 95% confidence interval [CI], 0.000 to 0.010) and WC and KL grade (β, 0.002; 95% CI, 0.001 to 0.003), explaining 4.8% and 6.7% of the total effects of BMI and WC on KL grade, respectively.CONCLUSIONSThe study suggested that LMI partially mediates the link between general obesity and/or central obesity and knee osteoarthritis, proposing that a higher proportion of lower limb muscle mass relative to body weight can alleviate the increased risk of knee osteoarthritis caused by obesity. -
SummaryKorean summary
본 연구는 한국의 50세 이상 여성들을 대상으로 비만 및 복부비만과 무릎골관절염의 관계에 대한 다리근육비율의 매개 효과를 분석한 결과, 다리근육비율은 비만의 진단하는 사용되는 체질량지수, 복부비만의 진단에 사용되는 허리둘레와 무릎 골관절염의 진단에 사용되는 KL등급의 관계를 부분적으로 매개하는 것으로 나타났다. 이러한 결과는 다리근육의 강화가 비만 및 복부비만으로 인한 무릎골관절염의 위험을 완화할 수 있음을 시사하며, 건강한 생활습관과 규칙적인 근력운동의 병행을 통해 다리 근육을 강화하는 것이 무릎 골관절염의 예방을 위한 전략으로 권장되어야 함을 시사한다.Key Message
Research examining the mediating effect of lower extremity muscle mass on the relationships of knee osteoarthritis to general and central obesity is scarce. Herein, we demonstrate the mediating effect of lean mass index on the relationships of knee osteoarthritis with body mass index and waist circumference in Korean women aged 50 years or older. We propose that strengthening leg muscles may mitigate, to some extent, the risk of knee osteoarthritis associated with general and central obesity. We recommend a regimen for strengthening leg muscles through healthy lifestyle habits and regular strength training, in conjunction with weight and abdominal fat management.
- Associations of depressive symptoms with lower extremity function and balance in Korean older adults
- Bong Jo Kim, Kyupin Ha, Hyun Soo Kim, Hye Ran Bae, Minkook Son
- Epidemiol Health. 2024;46:e2024021. Published online January 15, 2024
- DOI: https://doi.org/10.4178/epih.e2024021
- 1,731 View
- 55 Download
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AbstractOBJECTIVES
The relationship of depressive symptoms to lower extremity function and balance, especially in older adults without a depression diagnosis, remains unclear. Therefore, our study analyzed this relationship using a large sample of Korean older adults.METHODSWe used data from the Korean National Health Insurance Service’s Health Screening Program database. Individuals aged 66 years who had undergone the National Screening Program for Transitional Ages in Korea and were without a diagnosis of depressive disorder were included. The lower extremity function and balance were evaluated using 2 physical tests, while depressive symptoms were assessed using a 3-question survey. Multivariable-adjusted logistic regression analysis was used to examine the association between depressive symptoms and lower extremity function and balance.RESULTSAmong 66,041 individuals, those with depressive symptoms showed significantly higher rates of abnormal lower extremity function and abnormal balance. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association of depressive symptoms to abnormal lower extremity function and abnormal balance were (aOR, 1.34; 95% CI, 1.25 to 1.44) and (aOR, 1.38; 95% CI, 1.29 to 1.48), respectively. Assessment of the relationship based on depressive symptom scores revealed that higher scores were associated with higher aORs (p for trend <0.001). Subgroup analyses further confirmed this relationship, especially among patients with cerebrovascular disease or dementia.CONCLUSIONSThis study revealed an association between depressive symptoms and the abnormal lower extremity function and balance of 66-year-old individuals without a diagnosis of depressive disorder. -
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