Rheumatology Advance Access originally published online on February 4, 2007
Rheumatology 2007 46(5):861-867; doi:10.1093/rheumatology/kel434
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Relationship of height, weight and body mass index to the risk of hip and knee replacements in middle-aged women
Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK, 1National Centre for Epidemiology and Public Health, Australian National University, Canberra, Australia and 2MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK.
Correspondence to: Dr Bette Liu, Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive Oxford, OX3 7LF, UK. E-mail: Bette.Liu{at}ceu.ox.ac.uk
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Abstract |
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Objectives. To examine the effect of height, weight and body mass index (BMI) on the risk of hip and knee replacement in middle-aged women.
Methods. In a prospective cohort study 490 532 women aged 50–69 yrs who were recruited in the UK in 1996–2001 were followed over 2.9 yrs for incident primary hip and knee replacements.
Results. Height, weight and BMI were all associated with the risk of hip and knee replacement. Comparing the tallest group (
170 cm) with the shortest (<155 cm) the relative risks were 1.90 (95%CI 1.55–2.32) for hip replacement and 1.55 (95%CI 1.19–2.00) for knee replacement. Comparing the heaviest group (75 kg) with the lightest (<60 kg) the relative risks of hip and knee replacement were 2.37 (95%CI 2.04–2.75) and 9.71 (95%CI 7.39–12.77), respectively. Comparing obese women (BMI 30 kg/m2) to women with a BMI < 22.5 kg/m2, the relative risks for hip and knee replacement were 2.47 (95%CI 2.11–2.89) and 10.51 (95%CI 7.85–14.08), respectively. These effects did not vary according to age, education, alcohol and tobacco consumption, or with use of hormonal therapies. Currently, an estimated 27% of hip replacements and 69% of knee replacements in middle-aged women in the UK are attributable to obesity.
Conclusion. In middle-aged women, the risk of having a hip or knee replacement increases with both increasing height and increasing BMI. From a clinical perspective, relatively small increases in average BMI among middle-aged women are likely to have a substantial impact on the already increasing rates of joint replacement in the UK.
KEY WORDS: Joint replacement, Obesity, Anthropometry, Prospective study, Million Women Study
Submitted 25 September 2006;
revised version accepted 5 December 2006.
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