MRI-based analysis of thigh intramuscular fat and its associations with age, sex, and BMI using data from the osteoarthritis initiative data

The degree of thigh intramuscular fat in individuals without OA is fundamental for distinguishing natural variations in intramuscular fat from pathological changes. The goals of this study were to estimate the degree of thigh intramuscular fat in individuals without radiographic OA or frequent pain and assess the associations of age, sex, and BMI with the degree of intramuscular fat. Individuals without knee or hip radiographic OA, without total knee/hip arthroplasty, and without frequent knee/hip pain were selected from the OAI database (n = 710). Goutallier Grades (GGs) of the quadriceps and hamstring muscles were assessed based on 3 T MR images on a scale from 0 (normal muscle) to 4 (more fat than muscle). The associations between demographic variables and GG outcomes were evaluated using mixed effects models. The most prevalent GGs among the muscles were Grades 1 and 2; Grade 4 was infrequent (< 1%). Greater BMI (p < 0.001) and age (p < 0.001) were each associated with greater GG. Women had greater GG than men (greatest difference in the vastus medialis: coeff. = 0.214, p < 0.001). At lower BMI, women had greater intramuscular fat than men; at higher BMI, men had greater intramuscular fat than women (p = 0.029 for BMI-sex interaction). While individuals without radiographic OA or frequent pain generally had low thigh intramuscular fat, higher BMI and age were associated with greater intramuscular fat, and GGs were greater in women than men. The relationship between BMI and intramuscular fat was sex-dependent. Thus, demographic variables must be considered when evaluating intramuscular fat.