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Obesity was defined as a body mass index \u226530 kg\/m<jats:sup>2<\/jats:sup>. Cardiometabolic clustering classification was based on having \u22652 of the following factors: low levels of high\u2010density lipoprotein cholesterol; elevated levels of low\u2010density lipoprotein cholesterol, triglycerides, blood pressure, C\u2010reactive protein, waist:hip ratio, or glucose; or diabetes mellitus. The difference between lateral and medial knee JSW was used to determine joint space asymmetry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a sample of women (n = 482, mean age 47 years), prevalences of knee OA and persistent knee pain were 11% and 30%, respectively. The knee OA prevalence in nonobese women without cardiometabolic clustering was 4.7%, compared with 12.8% in obese women without cardiometabolic clustering and 23.2% in obese women with cardiometabolic clustering. Nonobese women without cardiometabolic clustering were less likely to perceive themselves as limited compared with women in all other obesity\/cardiometabolic groups (<jats:italic>P<\/jats:italic> &lt; 0.05). Similar associations were seen with knee pain and physical functioning measures. The inclusion of a joint space asymmetry measure was associated with knee OA but not with knee pain or physical functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Knee OA was twice as frequent in obese women with cardiometabolic clustering compared with those without, even when considering age and joint asymmetry. Obesity\/cardiometabolic clustering was also associated with persistent knee pain and impaired physical functioning.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.24739","type":"journal-article","created":{"date-parts":[[2009,9,29]],"date-time":"2009-09-29T10:28:11Z","timestamp":1254220091000},"page":"1328-1336","source":"Crossref","is-referenced-by-count":139,"title":["Knee osteoarthritis in obese women with cardiometabolic clustering"],"prefix":"10.1002","volume":"61","author":[{"given":"Maryfran","family":"Sowers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie A.","family":"Karvonen\u2010Gutierrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riann","family":"Palmieri\u2010Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon 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