{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:10:12Z","timestamp":1788786612901,"version":"build-2803163510"},"reference-count":66,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders worldwide, causing pain and disability. In addition to mechanical overload, increasing evidence suggests that metabolic disorders and abdominal obesity may contribute to the pathogenesis and progression of OA through mild inflammation and metabolic dysregulation. Methods: This cross-sectional, single-center study included 108 patients with radiologically confirmed KOA and 33 control subjects aged 45\u201380 years. KOA severity was assessed using the Kellgren\u2013Lawrence scale and the Osteoarthritis Research Society International (OARSI) scale. Anthropometric and metabolic measurements, namely body mass index (BMI), waist-to-height ratio (WHtR), body shape index (ABSI), body roundness index (BRI), lipid accumulation product (LAP), visceral adiposity index (VAI), and dysfunctional obesity index (DAI), were analyzed. Correlation and multivariate regression analyses were performed to identify factors associated with KOA severity. Results: Over 85% of KOA patients were overweight or obese, and 63.9% met the criteria for metabolic syndrome. KOA patients had a significantly higher BMI, WHtR, waist circumference, BRI, LAP, and a higher prevalence of obesity than the control group. WHtR, BRI, and serum glucose levels positively correlated with OARSI scores. In multivariate linear regression analysis, age remained the only independent predictor of higher OARSI scores. Saturated fat intake exceeded recommended levels in both groups, but macronutrient intake was not associated with KOA severity. Conclusions: Age is the strongest independent predictor of structural KOA severity; however, visceral fat distribution and serum glucose levels correlate with the OARSI score, and modifying them may help improve cardiometabolic health in patients with KOA.<\/jats:p>","DOI":"10.3390\/jcm15176906","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:12:25Z","timestamp":1788783145000},"page":"6906","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Knee Osteoarthritis and Metabolic Disorders: Practical Aspects from Primary Healthcare"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1090-3321","authenticated-orcid":false,"given":"Natalia","family":"Kasprzyk","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 60-545 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7583-8965","authenticated-orcid":false,"given":"Pawe\u0142","family":"Jagielski","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-1642","authenticated-orcid":false,"given":"Marta","family":"Stelmach-Mardas","sequence":"additional","affiliation":[{"name":"Department of Medical Education and Communication, Poznan University of Medical Sciences, 60-806 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8248-2247","authenticated-orcid":false,"given":"Ewa","family":"Lucka","sequence":"additional","affiliation":[{"name":"Clinical Rehabilitation Laboratory, Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, 60-545 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Ewelina","family":"Kowynia","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 60-545 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3438-0764","authenticated-orcid":false,"given":"Bogna","family":"Grygiel-G\u00f3rniak","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 60-545 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100587","DOI":"10.1016\/j.eclinm.2020.100587","article-title":"Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies","volume":"29\u201330","author":"Cui","year":"2020","journal-title":"EClinicalMedicine"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Giorgino, R., Albano, D., Fusco, S., Peretti, G.M., Mangiavini, L., and Messina, C. (2023). Knee Osteoarthritis: Epidemiology, Pathogenesis, and Mesenchymal Stem Cells: What Else Is New? An Update. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24076405"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1186\/s13018-025-06140-0","article-title":"Global, regional, and national burden of knee osteoarthritis: Findings from the Global Burden of Disease study 2021 and projections to 2045","volume":"20","author":"Ouyang","year":"2025","journal-title":"J. Orthop. Surg."},{"key":"ref_4","first-page":"66","article-title":"Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading","volume":"24","author":"Chen","year":"2020","journal-title":"J. Orthop. Transl."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1186\/s13075-018-1727-4","article-title":"Obesity alters the in vivo mechanical response and biochemical properties of cartilage as measured by MRI","volume":"20","author":"Collins","year":"2018","journal-title":"Arthritis Res. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"921","DOI":"10.3899\/jrheum.100569","article-title":"Association of knee osteoarthritis with the accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance in Japanese men and women: The ROAD study","volume":"38","author":"Yoshimura","year":"2011","journal-title":"J. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.joca.2012.06.006","article-title":"Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidaemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: A 3-year follow-up of the ROAD study","volume":"20","author":"Yoshimura","year":"2012","journal-title":"Osteoarthr. Cartil."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Xie, D.-X., Wei, J., Zeng, C., Yang, T., Li, H., Wang, Y.-L., Long, H.-Z., Wu, Z.-Y., Qian, Y.-X., and Li, K.-H. (2017). Association between metabolic syndrome and knee osteoarthritis: A cross-sectional study. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1890-9"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ferreira, J.R.S., Libardi, M.C., do Prado, C.B., Zandonade, E., Bezerra, O.M.d.P.A., and Salaroli, L.B. (2025). Predicting metabolic syndrome by lipid accumulation product, visceral adiposity index and body roundness index in Brazilian rural workers. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-21624-8"},{"key":"ref_10","first-page":"17300","article-title":"Predicted value of indices describing adipose distribution and function in women with metabolic syndrome","volume":"136","author":"Mardas","year":"2026","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_11","first-page":"794","article-title":"Predicting metabolic syndrome by visceral adiposity index, body roundness index, dysfunctional adiposity index, lipid accumulation product index, and body shape index in adults","volume":"39","author":"Hajhamidiasl","year":"2022","journal-title":"Nutr. Hosp."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.jbspin.2018.12.005","article-title":"The Phenotypic Approach to Osteoarthritis: A Look at Metabolic Syndrome-Associated Osteoarthritis","volume":"86","author":"Courties","year":"2019","journal-title":"Jt. Bone Spine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s13679-023-00520-5","article-title":"Obesity, Metabolic Syndrome, and Osteoarthritis\u2014An Updated Review","volume":"12","author":"Sampath","year":"2023","journal-title":"Curr. Obes. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1007\/s11999-016-4732-4","article-title":"Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis","volume":"474","author":"Kohn","year":"2016","journal-title":"Clin. Orthop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.1016\/j.joca.2006.11.009","article-title":"Atlas of individual radiographic features in osteoarthritis, revised","volume":"15","author":"Altman","year":"2007","journal-title":"Osteoarthr. Cartil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1093\/aje\/kwu111","article-title":"Body mass index categories in observational studies of weight and risk of death","volume":"180","author":"Flegal","year":"2014","journal-title":"Am. J. Epidemiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1093\/eurheartj\/eht151","article-title":"2013 ESH\/ESC guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)","volume":"34","author":"Mancia","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and management of the metabolic syndrome: An American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement","volume":"112","author":"Grundy","year":"2005","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Sto\u015b, K., Rychlik, E., Wo\u017aniak, A., O\u0142tarzewski, M., Jankowski, M., Gujski, M., and Juszczyk, G. (2022). Prevalence and Sociodemographic Factors Associated with Overweight and Obesity among Adults in Poland: A 2019\/2020 Nationwide Cross-Sectional Survey. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031502"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Traczyk, I., Kucharska, A., Si\u0144ska, B.I., Panczyk, M., Samel-Kowalik, P., K\u0142ak, A., Raciborski, F., Wyle\u017co\u0142, M., Samoli\u0144ski, B., and Szostak-W\u0119gierek, D. (2024). Prevalence of Overweight, Obesity, and Abdominal Obesity in Polish Adults: Sociodemographic Analysis from the 2016\u20132020 National Health Program. Nutrients, 16.","DOI":"10.3390\/nu16234248"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"105207","DOI":"10.1016\/j.jbspin.2021.105207","article-title":"Physical activity for osteoarthritis: Efficiency and review of recommandations","volume":"88","author":"Daste","year":"2021","journal-title":"Jt. Bone Spine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1016\/S0140-6736(19)30417-9","article-title":"Osteoarthritis","volume":"393","author":"Hunter","year":"2019","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3796","DOI":"10.1038\/s41598-023-30727-4","article-title":"Association of general and central obesity, and their changes with risk of knee osteoarthritis: A nationwide population-based cohort study","volume":"13","author":"Park","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e007568","DOI":"10.1136\/bmjopen-2014-007568","article-title":"Body mass index and risk of knee osteoarthritis: Systematic review and meta-analysis of prospective studies","volume":"5","author":"Zheng","year":"2015","journal-title":"BMJ Open"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Cheng, X., Wang, J., Wang, J., Yin, J., Xing, X., and Cai, G. (2026). Does metabolically healthy obesity increase the risk of knee and hand osteoarthritis? A population-based cohort study. BMC Musculoskelet. Disord., 27.","DOI":"10.1186\/s12891-026-09495-5"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100228","DOI":"10.1016\/j.mcpsp.2021.100228","article-title":"Correlation between Body Mass Index (BMI), Visual Analogue Scale (VAS) score and knee osteoarthritis grading","volume":"4","author":"Samma","year":"2021","journal-title":"Med. Cl\u00ednica Pr\u00e1ctica"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1038\/nrrheum.2012.135","article-title":"Metabolic syndrome meets osteoarthritis","volume":"8","author":"Zhuo","year":"2012","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s00296-025-05891-7","article-title":"Central obesity and radiographic severity are associated with symptomatic hand osteoarthritis: A population-based cross-sectional study","volume":"45","author":"Pimenta","year":"2025","journal-title":"Rheumatol. Int."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lim, Y.Z., Wang, Y., Cicuttini, F.M., Giles, G.G., Graves, S., Wluka, A.E., and Hussain, S.M. (2021). Obesity defined by body mass index and waist circumference and risk of total knee arthroplasty for osteoarthritis: A prospective cohort study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0245002"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"100181","DOI":"10.1016\/j.endmts.2024.100181","article-title":"The predictive value of body mass index, waist circumference, and triglycerides\/ high-density lipoprotein cholesterol ratio in assessing severity in patients with knee osteoarthritis and metabolic syndrome","volume":"16","author":"Phan","year":"2024","journal-title":"Endocr. Metab. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Tamini, S., Bondesan, A., Caroli, D., and Sartorio, A. (2024). The Lipid Accumulation Product Index (LAP) and the Cardiometabolic Index (CMI) Are Useful for Predicting the Presence and Severity of Metabolic Syndrome in Adult Patients with Obesity. J. Clin. Med., 13.","DOI":"10.3390\/jcm13102843"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Papathanasiou, K.A., Roussos, C.E., Armylagos, S., Rallidis, S.L., and Rallidis, L.S. (2024). Lipid Accumulation Product Is Predictive of Cardiovascular Hospitalizations among Patients with Stable Ischemic Heart Disease: Long-Term Follow-Up of the LAERTES Study. J. Cardiovasc. Dev. Dis., 11.","DOI":"10.3390\/jcdd11100316"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"9682","DOI":"10.1038\/s41598-025-94606-w","article-title":"Association between body roundness index and osteoarthritis\/rheumatoid arthritis: A cross-sectional study","volume":"15","author":"Gao","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"107861","DOI":"10.1016\/j.ypmed.2024.107861","article-title":"Association between lipid accumulation products and osteoarthritis among adults in the United States: A cross-sectional study, NHANES 2017\u20132020","volume":"180","author":"Huang","year":"2024","journal-title":"Prev. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1590\/1516-3180.2018.0293240119","article-title":"Cardiovascular risk assessment using the lipid accumulation product index among primary healthcare users: A cross-sectional study","volume":"137","author":"Vieira","year":"2019","journal-title":"Sao Paulo Med. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1080\/13697137.2016.1202229","article-title":"Body roundness index and body adiposity index: Two new anthropometric indices to identify metabolic syndrome among Chinese postmenopausal women","volume":"19","author":"Liu","year":"2016","journal-title":"Climacteric"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Ye, W., Wei, L., Wang, Z., Deng, Y., Ma, Z., Ling, W., Mei, J., Dong, Y., Zhang, X., and Miao, C. (2025). Associations of METS-VF and BRI with risk of osteoarthritis in patients with diabetes or prediabetes: Evidence from the NHANES 1999\u20132020. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1690153"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e2415051","DOI":"10.1001\/jamanetworkopen.2024.15051","article-title":"Body Roundness Index and All-Cause Mortality Among US Adults","volume":"7","author":"Zhang","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e000442","DOI":"10.1136\/rmdopen-2017-000442","article-title":"Association between osteoarthritis and dyslipidaemia: A systematic literature review and meta-analysis","volume":"3","author":"Baudart","year":"2017","journal-title":"RMD Open"},{"key":"ref_40","first-page":"S383","article-title":"Prevalence of cardiovascular disease risk factors among US adults with self-reported osteoarthritis: Data from the Third National Health and Nutrition Examination Survey","volume":"8","author":"Singh","year":"2002","journal-title":"Am. J. Manag Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3810\/pgm.2009.11.2073","article-title":"Increased prevalence of metabolic syndrome in individuals with osteoarthritis: An analysis of NHANES III data","volume":"121","author":"Puenpatom","year":"2009","journal-title":"Postgrad. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1001\/archinte.168.14.1568","article-title":"Menopause and the Metabolic Syndrome","volume":"168","author":"Janssen","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1097\/GME.0000000000001575","article-title":"The effect of menopause on metabolic syndrome: Cross-sectional results from the Canadian Longitudinal Study on Aging","volume":"27","author":"Christakis","year":"2020","journal-title":"Menopause"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2251-6581-12-1","article-title":"Metabolic syndrome and menopause","volume":"12","author":"Jouyandeh","year":"2013","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_45","first-page":"e506","article-title":"Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association","volume":"142","author":"Aggarwal","year":"2020","journal-title":"Circulation"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/ar2791","article-title":"Osteoarthritis associated with estrogen deficiency","volume":"11","author":"Largo","year":"2009","journal-title":"Arthritis Res. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1136\/annrheumdis-2013-204494","article-title":"Circulating C reactive protein in osteoarthritis: A systematic review and meta-analysis","volume":"74","author":"Jin","year":"2015","journal-title":"Ann. Rheum. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1111\/1756-185X.14948","article-title":"Impact of obesity and overweight on C-reactive protein concentrations and disease activity in rheumatoid arthritis: A systematic review and meta-analysis","volume":"26","year":"2023","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Wen, L., Kang, J.-H., Yim, Y.-R., Kim, J.-E., Lee, J.-W., Lee, K.-E., Park, D.-J., Kim, T.-J., Park, Y.-W., and Kweon, S.-S. (2016). Associations between body composition measurements of obesity and radiographic osteoarthritis in older adults: Data from the Dong-gu Study. BMC Musculoskelet. Disord., 17.","DOI":"10.1186\/s12891-016-1040-9"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Gallelli, L., Rania, V., Macr\u00ec, R., Suljagic, M., Michniewicz, A., Ler, D., Marcian\u00f2, G., Vocca, C., Palleria, C., and Scumaci, D. (2026). Inflammatory Biomarkers Are Associated with Pain and Functional Impairment in Knee Osteoarthritis Patients: A Cross-Sectional Pilot Study. J. Clin. Med., 15.","DOI":"10.3390\/jcm15093466"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.joca.2023.02.003","article-title":"Metabolic syndrome and the progression of knee osteoarthritis on MRI","volume":"31","author":"Jansen","year":"2023","journal-title":"Osteoarthr. Cartil."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Christofides, I., Vavliakis, I., de Klerk, H.H., Broekman, M., Verheyen, C.C., and Doornberg, J.N. (2026). Prevalence of hip and knee osteoarthritis in Europe: A systematic review and meta-analysis. BMC Musculoskelet. Disord., 27.","DOI":"10.1186\/s12891-026-09493-7"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/rheumatology\/keu409","article-title":"Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care","volume":"54","author":"Turkiewicz","year":"2015","journal-title":"Rheumatology"},{"key":"ref_54","first-page":"355","article-title":"Epidemiology of knee osteoarthritis","volume":"26","author":"Muraki","year":"2013","journal-title":"Clin. Geriatr. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.berh.2014.01.004","article-title":"The epidemiology of osteoarthritis","volume":"28","author":"Johnson","year":"2014","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Lee, D.Y. (2024). Prevalence and Risk Factors of Osteoarthritis in Korea: A Cross-Sectional Study. Medicina, 60.","DOI":"10.3390\/medicina60040665"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/BOR.0000000000000161","article-title":"Epidemiology of osteoarthritis: State of the evidence","volume":"27","author":"Allen","year":"2015","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.berh.2009.08.006","article-title":"Why is Osteoarthritis an Age-Related Disease?","volume":"24","author":"Anderson","year":"2010","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"He, Y., Li, Z., Alexander, P.G., Ocasio-Nieves, B.D., Yocum, L., Lin, H., and Tuan, R.S. (2020). Pathogenesis of Osteoarthritis: Risk Factors, Regulatory Pathways in Chondrocytes, and Experimental Models. Biology, 9.","DOI":"10.3390\/biology9080194"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA J., 8, 1461.","DOI":"10.2903\/j.efsa.2010.1461"},{"key":"ref_61","unstructured":"World Health Organization (2023). Total Fat Intake for the Prevention of Unhealthy Weight Gain in Adults and Children: WHO Guideline, World Health Organization."},{"key":"ref_62","unstructured":"Rychlik, E., Sto\u015b, K., Wo\u017aniak, A., Mojska, H., Przygoda, B., Wierzejska, R., Wojtasik, A., Matczuk, A., K\u0142ys, W., and O\u0142tarzewski, M. (2024). Normy \u017bywienia Dla Populacji Polski, Narodowy Instytut Zdrowia Publicznego PZH\u2014Pa\u0144stwowy Instytut Badawczy."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3677","DOI":"10.1016\/j.clnu.2020.03.028","article-title":"Association of types of dietary fats and all-cause and cause-specific mortality: A prospective cohort study and meta-analysis of prospective studies with 1,164,029 participants","volume":"39","author":"Mazidi","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_64","first-page":"h3978","article-title":"Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: Systematic review and meta-analysis of observational studies","volume":"351","author":"Mente","year":"2015","journal-title":"BMJ"},{"key":"ref_65","first-page":"e1","article-title":"Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association","volume":"136","author":"SSacks","year":"2017","journal-title":"Circulation"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12944-019-1035-2","article-title":"Dietary total fat, fatty acids intake, and risk of cardiovascular disease: A dose-response meta-analysis of cohort studies","volume":"18","author":"Zhu","year":"2019","journal-title":"Lipids Health Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6906\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:40:31Z","timestamp":1788784831000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":66,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176906"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176906","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]}}}