Work intensity and fat mass percentage are associated with asymptomatic morphometric vertebral fractures in knee osteoarthritis patients: A cross-sectional study

Knee osteoarthritis (OA) is a common condition with a prevalence of 365 million individuals globally, and it is an independent risk factor for falls and fractures, notably asymptomatic morphometric vertebral fractures (AMVF). The high prevalence of knee OA, the severity of AMVF, and their combined impacts on quality of life underscore the need for early detection, appropriate treatment and management. To address this, our cross-sectional study aims to identify potential predictive factors associated with AMVF in knee OA patients. Our cohort consisted of 76 patients diagnosed with knee OA, predominantly female (84.2%), of Malay ethnicity (84.2%), and obese (55.3%). In univariable analysis, significant association was found between occupation (moderate or heavy work) and AMVF (p<0.001). Diabetes mellitus comorbidity (p = 0.016) and fat mass percentage (p = 0.027) also demonstrated a significant association with AMVF in knee OA patients. Multivariable logistic regression analysis revealed that an increase in fat mass percentage resulted in decreased AMVF incidence (HR: 0.83, 95% CI: 0.70-0.97; p = 0.018), while occupation (moderate or heavy work) remained a highly significant predictor (HR: 57.76, 95% CI: 4.23-788.57; p = 0.002). These findings support the potential importance of considering occupational activities and body fat composition in managing AMVF among knee OA patients, but further research is required to establish causal relationships.