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Open Access Highly Accessed Research article

The association of body-mass index and depressed mood with knee pain and activity limitations in knee osteoarthritis: results from the Amsterdam osteoarthritis cohort

Jasmijn FM Holla1*, Marike van der Leeden123, Dirk L Knol4, Leo D Roorda1, Martin van der Esch1, Ramon E Voorneman5, Willem F Lems56 and Joost Dekker1237

Author Affiliations

1 Amsterdam Rehabilitation Research Centre | Reade, PO Box 58271, 1040 HG Amsterdam, The Netherlands

2 Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, The Netherlands

3 EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands

4 Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands

5 Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands

6 Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands

7 Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands

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BMC Musculoskeletal Disorders 2013, 14:296  doi:10.1186/1471-2474-14-296

Published: 17 October 2013

Abstract

Background

Body-mass index (BMI) and depressed mood are both positively associated with pain and activity limitations in knee osteoarthritis (OA), and are interrelated. The aims of the present study were: 1) to assess whether BMI and depressed mood are independently associated with knee pain and activity limitations; and 2) to compare the relative contributions of BMI and depressed mood to knee pain and activity limitations.

Methods

A cross-sectional study in 294 patients with clinical knee OA. Regression analyses were performed with knee pain or activity limitations (self-reported and performance-based) as dependent variables, and BMI and depressed mood as independent variables. All analyses were adjusted for age, gender, marital status, education level, radiographic OA and comorbidity. Dominance analyses were performed to examine the relative contributions of BMI and depressed mood to knee pain and activity limitations.

Results

BMI and depressed mood were positively and independently associated with knee pain and activity limitations. BMI and depressed mood explained small parts (3.0% and 2.3%, respectively) of variance in knee pain. BMI explained a substantial part of variance in both self-reported (9.8%) and performance-based (20.4%) activity limitations, while depressed mood explained a small part of variance (3.1% in self-reported and 2.6% in performance-based activity limitations).

Conclusions

In patients with knee OA both BMI and depressed mood seem to be independently associated with knee pain and activity limitations. The contribution of BMI to activity limitations is most substantial, thereby offering a relevant target for interventions.

Keywords:
Activity limitations; Body-mass index; Depressed mood; Knee; Osteoarthritis; Pain