Association of Hand or Knee Osteoarthritis With Diabetes Mellitus in a Population of Hispanics From Puerto Rico

Abstract

Background Although a higher prevalence of osteoarthritis (OA) has been reported among diabetes mellitus (DM) patients, inconsistencies and limitations of observational studies have precluded a conclusive association. Objective To evaluate the association of hand or knee OA with DM in a population of Hispanics from Puerto Rico. Methods A cross-sectional study was performed in 202 subjects (100 adult DM patients as per the National Diabetes Data Group Classification, and 102 non-diabetic subjects). OA of hand and knee was ascertained using the American College of Rheumatology classification criteria. Sociodemographic characteristics, health-related behaviors, comorbidities, pharmacotherapy and DM clinical manifestations were determined. Multivariable logistic regression was used to evaluate the association of DM with hand or knee OA, and to evaluate factors associated with hand or knee OA among DM patients. Results The mean (standard deviation, SD) age for DM patients was 51.6 (13.1) years; 64.0% were females. The mean (SD) DM duration was 11.0 (10.4) years. The prevalence of OA in patients with DM and non-diabetics subjects was 49.0% and 26.5%, respectively (p<0.01). In the multivariable analysis, patients with DM had 2.18 the odds of having OA when compared to non-diabetic subjects (95% CI: 1.12–4.24). In a sub-analysis among DM patients, female patients were more likely to have hand or knee OA (OR [95% CI]: 5.06 [1.66–15.66]), whereas patients who did not use insulin alone for DM therapy were more likely to have OA (OR [95% CI]: 4.44 [1.22–16.12]). Conclusion In this population of Hispanics from Puerto Rico, DM patients were more likely to have OA of hands or knees than non-diabetic subjects. This association was retained in multivariable models accounting for established risk factors for OA. Among DM patients, females were at greater risk for OA, whereas the use of insulin was negatively associated.

Links Between Osteoarthritis and Diabetes

“…5,52 Results of a 20-year longitudinal cohort study of 927 individuals suggest that T2DM predicts both joint failure and hip and knee arthroplasty surgery, independently of age, sex, and BMI. 5 This study used both clinical measures (Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index) and advanced imaging techniques (ultrasound) to assess severity of OA.…”

Prevalence and risk factors for hand osteoarthritis

“…6,12 We excluded uncontrolled diabetes from our study but patients with controlled glycemic status without insulin for at least one year were evaluated for hand OA and significant association were found between DM and Hand OA. The effect of obesity is apparent in both sexes and is mainly associated with an excess of OA in the weight-bearing joints suggesting a mechanical effect, but in males obesity is also associated with an excess of OA of the DIP joints and the general pattern of OA in obese males approximates to that seen in the total females.…”

“…5 Diabetes Mellitus seems to be a risk factor for both hand and knee OA. 6 Familial aggregation of Heberden's nodes was described as early as the 1940s and has since been confirmed for hand osteoarthritis by several studies. 7 Plain radiographs are the method of choice to diagnose hand OA.…”

Diabetes Mellitus Related to Clinical Outcomes and Postoperative Bleeding of Total Knee Arthroplasty

“…And DM, as one important part of metabolic syndromes, is attracting the attention of the function in OA development [5]. In 2003, Mariely and the colleagues compared the data of 100 DM and 102 non-DM patients from Puerto Rico, via the analysis of multivariate regression curve, they showed that 49% of DM patients accompanied with DM, and only 26.5% of non-DM patients showed no OA, suggesting that DM patients had high risk of OA [6]. Then, Georg and the colleagues, by the nearly 20 years' follow-up of 927 participator, showed for the first time that DM was an independent risk factor of OA, with the exclusion of sex, age, BMI and other risk factors [7].…”