Osteoarthritis

Does fat mass contribute to knee osteoarthritis risk beyond weight itself? Data from the Multicenter Osteoarthritis Study

Osteoarthritis CartilagePublished Prospective cohort study

Main finding · Incident radiographic knee OA, females (highest vs lowest % fat mass in weight category)Result — go to the resultRelative risk 1.29 95% CI 1.02–1.64

Authors' conclusion

A higher relative fat mass did not influence increased risk of incident ROA in males, but there was a potential threshold effect in females.

Study context

Population
Multicenter Osteoarthritis (MOST) Study participants with DXA body composition and no radiographic knee OA in ≥1 knee at baseline (60% female, mean age 61.7 years, BMI 29.6 kg/m²)2,646 knees
Participants
1,611 participants
Exposure
Highest vs lowest % fat mass quartile within sex-specific weight categories
Outcome
Incident radiographic knee OA (KL grade ≥2 or knee replacement)
Follow-up
7 years
Methodological detailssex-specific weight categories, % fat mass quartiles (lowest as referent), spline analyses
  • Sex-specific weight categories
  • % fat mass quartiles (lowest as referent)
  • Spline analyses

Main finding

As reported in the abstract

Incident radiographic knee OA, females (highest vs lowest % fat mass in weight category)

Relative risk

1.29

95% CI 1.02–1.64

Q4vs Q1
RR 1.29 (95% CI 1.02–1.64)
Incident ROA developed in knees after 7 years (overall)
27.6%

Observational data: associations, not effects.

Original publication

Does fat mass contribute to knee osteoarthritis risk beyond weight itself? Data from the Multicenter Osteoarthritis Study. Osteoarthritis Cartilage. Published 23 July 2026. doi:10.1016/j.joca.2026.07.007

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