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Diabetes, Cardiovascular Risks, and Lipoproteins · Journal article
Journal of Clinical Medicine · September 7, 2026
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This cross-sectional study of 108 KOA patients and 33 controls found that over 85% were overweight or obese and 63.9% had metabolic syndrome, with visceral fat distribution and glucose levels correlating with OARSI severity scores. However, multivariate regression identified age as the only independent predictor of KOA severity, suggesting metabolic associations may be confounded or secondary. The findings raise a hypothesis about metabolic contributions to KOA but do not establish causality or independent metabolic determinants.
Cross-sectional, single-center observational study. Patients aged 45–80 years; 108 with radiologically confirmed knee osteoarthritis and 33 control subjects; single center.. Compared with: Control subjects without KOA. n = 141. Single center (location not specified in text).
Over 85% of KOA patients were overweight or obese; 63.9% met metabolic syndrome criteria WHtR, BRI, and serum glucose levels positively correlated with OARSI scores Age remained the only independent predictor of higher OARSI scores in multivariate linear regression analysis
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The finding that age alone independently predicts KOA severity suggests that metabolic interventions, while potentially beneficial for cardiometabolic health in KOA patients, may not directly modify structural disease progression. Clinicians should not expect metabolic syndrome management alone to slow KOA severity; age-related mechanisms appear primary.
Cross-sectional single-center study without intervention showing associations between metabolic markers and KOA severity; age alone predicts severity independently, limiting the metabolic findings' causal interpretation.
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The finding that age alone independently predicts KOA severity suggests that metabolic interventions, while potentially beneficial for cardiometabolic health in KOA patients, may not directly modify structural disease progression. Clinicians should not expect metabolic syndrome management alone to slow KOA severity; age-related mechanisms appear primary.
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Background/Objectives: Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders worldwide, causing pain and disability. In addition to mechanical overload, increasing evidence suggests that metabolic disorders and abdominal obesity may contribute to the pathogenesis and progression of OA through mild inflammation and metabolic dysregulation. Methods: This cross-sectional, single-center study included 108 patients with radiologically confirmed KOA and 33 control subjects aged 45–80 years. KOA severity was assessed using the Kellgren–Lawrence scale and the Osteoarthritis Research Society International (OARSI) scale. Anthropometric and metabolic measurements, namely body mass index (BMI), waist-to-height ratio (WHtR), body shape index (ABSI), body roundness index (BRI), lipid accumulation product (LAP), visceral adiposity index (VAI), and dysfunctional obesity index (DAI), were analyzed. Correlation and multivariate regression analyses were performed to identify factors associated with KOA severity. Results: Over 85% of KOA patients were overweight or obese, and 63.9% met the criteria for metabolic syndrome. KOA patients had a significantly higher BMI, WHtR, waist circumference, BRI, LAP, and a higher prevalence of obesity than the control group. WHtR, BRI, and serum glucose levels positively correlated with OARSI scores. In multivariate linear regression analysis, age remained the only independent predictor of higher OARSI scores. Saturated fat intake exceeded recommended levels in both groups, but macronutrient intake was not associated with KOA severity. Conclusions: Age is the strongest independent predictor of structural KOA severity; however, visceral fat distribution and serum glucose levels correlate with the OARSI score, and modifying them may help improve cardiometabolic health in patients with KOA.
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