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<p>To investigate the associations of waist circumference (WC) and calf circumference (CC) with functional performance in women with symptomatic radiographic knee osteoarthritis (OA), and to explore whether lower-leg muscle quality influences the relationship between CC and functional outcomes. This exploratory cross-sectional study included 28 women with symptomatic radiographic knee OA (Kellgren–Lawrence grades II–IV). WC and CC were measured using standardized anthropometric procedures andCC was analyzed as both raw and after correction for subcutaneous fat-thickness. Functional performance was evaluated using the 6-minute walk test (6MWT) and the 30-second chair stand test (30sCST). Lower-leg muscle quality was estimated using ultrasound echo intensity. Associations between anthropometric measures and functional outcomes were examined using Spearman correlation coefficients. Associations identified in correlation analyses were further explored using regression models to examine the potential influence of lower-leg muscle quality on the associations involving CC and to examine influence of pain intensity and radiographic severity on the associations of WC with functional performance. Greater WC was associated with poorer performance in both the 6MWT (ρ = −0.706, p = 0.001) and the 30sCST (ρ = −0.648, p = 0.001). Associations between CC and functional performance were weaker and less consistent. In the most affected limb, CC was not associated with 6MWT distance and showed a borderline association with 30sCST performance (ρ = −0.360, p = 0.060). In the contralateral limb, greater CC was inversely associated with 30sCST performance before (ρ = −0.482, p = 0.009) and after correction for subcutaneous fat thickness (ρ = −0.452, p = 0.016). These associations were no longer statistically significant after adjustment for lower-leg muscle quality. In the primary regression models, WC remained as the only significant predictor and explained 53% of the variance in 6MWT distance and 37% of the variance in 30sCST performance. Forced adjustment for pain intensity and radiographic severity produced only minimal changes in the WC coefficients. In women with symptomatic radiographic knee OA, greater WC was consistently associated with poorer functional performance, supporting its potential value as a simple anthropometric marker of functional vulnerability. CC did not behave as an indicator of better functional capacity; when associations were observed, they were inverse and appeared to be influenced by muscle quality, suggesting that CC alone may not adequately reflect functional muscle mass in this population. Larger longitudinal studies are needed to confirm these findings and clarify their clinical utility.</p>

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Central adiposity is associated with poorer functional capacity in women with knee osteoarthritis: a cross-sectional study with exploratory adjustment for pain intensity and radiographic severity

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  • 发表日期：

    2026年7月14日

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  • Josiel Gomes Ribeiro,
  • Gabriela Martins Alvarez,
  • Giorgio Silvano Ferreira Poletto,
  • Marcelo Peduzzi de Castro,
  • Walter Herzog,
  • Heiliane de Brito Fontana

摘要

To investigate the associations of waist circumference (WC) and calf circumference (CC) with functional performance in women with symptomatic radiographic knee osteoarthritis (OA), and to explore whether lower-leg muscle quality influences the relationship between CC and functional outcomes. This exploratory cross-sectional study included 28 women with symptomatic radiographic knee OA (Kellgren–Lawrence grades II–IV). WC and CC were measured using standardized anthropometric procedures andCC was analyzed as both raw and after correction for subcutaneous fat-thickness. Functional performance was evaluated using the 6-minute walk test (6MWT) and the 30-second chair stand test (30sCST). Lower-leg muscle quality was estimated using ultrasound echo intensity. Associations between anthropometric measures and functional outcomes were examined using Spearman correlation coefficients. Associations identified in correlation analyses were further explored using regression models to examine the potential influence of lower-leg muscle quality on the associations involving CC and to examine influence of pain intensity and radiographic severity on the associations of WC with functional performance. Greater WC was associated with poorer performance in both the 6MWT (ρ = −0.706, p = 0.001) and the 30sCST (ρ = −0.648, p = 0.001). Associations between CC and functional performance were weaker and less consistent. In the most affected limb, CC was not associated with 6MWT distance and showed a borderline association with 30sCST performance (ρ = −0.360, p = 0.060). In the contralateral limb, greater CC was inversely associated with 30sCST performance before (ρ = −0.482, p = 0.009) and after correction for subcutaneous fat thickness (ρ = −0.452, p = 0.016). These associations were no longer statistically significant after adjustment for lower-leg muscle quality. In the primary regression models, WC remained as the only significant predictor and explained 53% of the variance in 6MWT distance and 37% of the variance in 30sCST performance. Forced adjustment for pain intensity and radiographic severity produced only minimal changes in the WC coefficients. In women with symptomatic radiographic knee OA, greater WC was consistently associated with poorer functional performance, supporting its potential value as a simple anthropometric marker of functional vulnerability. CC did not behave as an indicator of better functional capacity; when associations were observed, they were inverse and appeared to be influenced by muscle quality, suggesting that CC alone may not adequately reflect functional muscle mass in this population. Larger longitudinal studies are needed to confirm these findings and clarify their clinical utility.