The validity of self-reported body mass index in a population-based osteoarthritis study

Obesity is a well-known risk factor for osteoarthritis (OA). The majority of obesity research in OA is performed using self-reported BMI-data, however, its validity in persons with OA is unknown. The aim of this study was to compare the validity of self-reported body mass index (BMI) in persons with and without clinical osteoarthritis (OA) in a population-based survey.

Height and weight were self-reported, and thereafter measured in 600 persons with and without clinical OA according to the American College of Rheumatology-criteria (knees, hips and/or hands). We compared the differences between measured and self-reported heights, weights and BMIs (kg/m2) for the two groups and explored whether demographic/clinical factors were associated with inaccurate reporting in the OA patients using multivariate linear regression analyses.

Mean (SD) age was 64 (8.7) years and 412 (69%) were women. Participants with clinical OA (n = 449) underreported their BMI to a greater extent than participants without clinical OA (n = 151) [mean (SD) difference 1.34 (1.68) kg/m2 and 0.78 (1.40) kg/m2 (p = 0.000), respectively]. There was a strong dose-dependent association between higher measured BMI and greater underreporting of BMI in multivariate analyses (BMI 25-29.99 kg/m2: B = 0.40, 95% CI, 0.06, 0.77), BMI ≥ 30 kg/m2: B = 1.30, 95% CI, 0.86, 1.75) in the clinical OA patients. A higher age as well as the time interval from self-reported to measured BMI-data were associated with inaccurate reporting.

Researchers using self-reported height and weight data should be aware of limited agreement with actual height and weight in overweight and obese individuals with clinical OA.