Investigation of the association of weight loss with radiographic hip osteoarthritis in older community-dwelling female adults

Objective: Most guidelines recommending weight loss for hip osteoarthritis are based on research on knee osteoarthritis. Prior studies found no association between weight loss and hip osteoarthritis, but no previous studies have targeted older adults. Therefore, we aimed to determine whether there is any clear benefit of weight loss for radiographic hip osteoarthritis in older adults because weight loss is associated with health risks in older adults. Methods: We used data from white female participants aged ≥65 years from the Study of Osteoporotic Fractures. Our exposure of interest was weight change from baseline to follow-up at 8 years. Our outcomes were the development of radiographic hip osteoarthritis (RHOA) and the progression of RHOA over 8 years. Generalized estimating equations (clustering of 2 hips per participant) were used to investigate the association between exposure and outcomes adjusted for major covariates. Results: There was a total of 11,018 hips from 5509 participants. There was no associated benefit of weight loss for either of our outcomes. The odds ratios (95% confidence intervals) for the development and progression of RHOA were 0.99 (0.92–1.07) and 0.97 (0.86–1.09) for each 5% weight loss, respectively. The results were consistent in sensitivity analyses where participants were limited to those who reported trying to lose weight and who also had a body mass index in the overweight or obese range. Conclusion: Our findings suggest no associated benefit of weight loss in older female adults in the structure of the hip joint as assessed by radiography.

Table S1.Characteristics of the RHOA development cohort and the RHOA progression cohort during follow up , stratified by weight loss (5% or more from baseline), stable weight (less than 5% weight change from baseline) and weight gain (5% or more from baseline).

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Participants 13* (a) Report numbers of individuals at each stage of study-eg numbers potentially eligible, examined for eligibility, confirmed eligible, included in the study, completing follow-up, and analysed  1 and 2 END OF DOCUMENT

Figure C .
Figure C. Outcomes of degeneration of individual structural features of the hip in univariate and multivariable analyses Figure 1 and Results (Characteristics of the RHOA development cohort and the RHOA progression cohort).(b) Give reasons for non-participation at each stage N/A (c) Consider use of a flow diagram Figure 1 Descriptive data 14* (a) Give characteristics of study participants (eg demographic, clinical, social) and information on exposures and potential confounders Tables1 and 2, Figures A and B. Results (Characteristics of the RHOA development cohort and the RHOA progression cohort) (b) Indicate number of participants with missing data for each variable of interest

Table S2 .
Sensitivity Analyses.Association of weight loss with the odds of development and progression of RHOA by the 8-year follow up visit in people who had the intention to lose weight and overweight or obesity, as shown in univariate and multivariable analyses.The estimates are reported as point estimates of 5% weight loss from baseline to the 8-year follow up visit, either 1 in the RHOA development cohort, or 2 in the RHOA progression cohort.*Multivariable analyses were adjusted for the baseline values of age, weight, calcaneus bone mineral density, use of nonsteroidal anti- inflammatory drugs (NSAIDs), smoking status, physical activity status, and severity of hip osteoarthritis as assessed by radiography (sum of the score from radiography of individual structural features of the hip).CI: Confidence Interval; RHOA: Radiographic Hip Osteoarthritis.
Funding 22 Give the source of funding and the role of the funders for the present study and, if applicable, for the original study on which the present article is based Funding sources *Give information separately for cases and controls in case-control studies and, if applicable, for exposed and unexposed groups in cohort and cross-sectional studies.An Explanation and Elaboration article discusses each checklist item and gives methodological background and published examples of transparent reporting.The STROBE checklist is best used in conjunction with this article (freely available on the Web sites of PLoS Medicine at http://www.plosmedicine.org/,Annals of Internal Medicine at http://www.annals.org/,and Epidemiology at http://www.epidem.com/).Information on the STROBE Initiative is available at www.strobe-statement.org. Note: