Sex of patients with knee osteoarthritis (KOA) may impact changes in thigh muscle composition during weight loss, the most well-known disease-modifying intervention. We investigated longitudinal sex-based changes in thigh muscle quality during weight loss in participants with KOA. Using Osteoarthritis Initiative (OAI) cohort data, we included females and males with baseline radiographic KOA who experienced > 5 % reduction in Body Mass Index (BMI) over four years. Using a previously validated deep-learning algorithm, we measured Magnetic Resonance Imaging (MRI)-derived biomarkers of thigh muscles at baseline and year-4. Outcomes were the intra- and inter-muscular adipose tissue (Intra-MAT and Inter-MAT) and contractile percentage of thigh muscles between females and males. The analysis adjusted for potential confounders, such as demographics, risk factors, BMI change, physical activity, diet, and KOA status. A retrospective selection of available thigh MRIs from KOA participants who also had a 4-year weight loss (>5 % of BMI) yielded a sample comprising 313 thighs (192 females and 121 males). Female and male participants exhibited a comparable degree of weight loss (females: −9.72 ± 4.38, males: −8.83 ± 3.64, P-value=0.060). However, the changes in thigh muscle quality were less beneficial for females compared to males, as shown by a less degree of longitudinal decrease in Intra-MAT (change difference,95 %CI: 783.44 mm/4-year, 505.70 to 1061.19, P-value<0.001) and longitudinal increase in contractile percentage (change difference,95 %CI: −3.9 %/4-year, −6.5 to −1.4, P-value=0.019). In participants with KOA and 4-year weight loss, the longitudinal changes in thigh muscle quality were overall beneficial but to a less degree in females compared to males. Further research is warranted to investigate the underlying mechanisms and develop sex-specific interventions to optimize muscle quality during weight loss.

中文翻译：

---

膝骨关节炎患者减肥期间大腿肌肉成分的变化：使用骨关节炎倡议的数据进行性别特异性分析


膝骨关节炎（KOA）患者的性别可能会影响减肥期间大腿肌肉成分的变化，减肥是最著名的疾病缓解干预措施。我们调查了 KOA 参与者减肥期间大腿肌肉质量的纵向性别变化。使用骨关节炎倡议 (OAI) 队列数据，我们纳入了患有基线 X 线 KOA 的女性和男性，他们的体重指数 (BMI) 在四年内下降了 > 5%。使用先前经过验证的深度学习算法，我们测量了基线和第 4 年大腿肌肉的磁共振成像 (MRI) 衍生生物标志物。结果是女性和男性的肌内和肌间脂肪组织（Intra-MAT 和 Inter-MAT）以及大腿肌肉的收缩百分比。该分析针对潜在的混杂因素进行了调整，例如人口统计数据、风险因素、BMI 变化、体力活动、饮食和 KOA 状态。对同样经历了 4 年体重减轻（> BMI 5%）的 KOA 参与者的可用大腿 MRI 进行回顾性选择，产生了包含 313 条大腿（192 名女性和 121 名男性）的样本。女性和男性参与者的体重减轻程度相当（女性：-9.72 ± 4.38，男性：-8.83 ± 3.64，P 值=0.060）。然而，与男性相比，大腿肌肉质量的变化对女性的益处较小，Intra-MAT 的纵向下降程度较小（变化差异，95%CI：783.44 mm/4 年，505.70 至 1061.19，P -值<0.001）和收缩百分比的纵向增加（变化差异，95％CI：-3.9％/4年，-6.5至-1.4，P值=0.019）。在患有 KOA 且体重减轻 4 年的参与者中，大腿肌肉质量的纵向变化总体上是有益的，但与男性相比，女性的程度较小。 需要进一步的研究来调查潜在的机制并开发针对性别的干预措施，以优化减肥过程中的肌肉质量。