Metabolic osteoarthritis – relation of diabetes and cardiovascular disease with knee osteoarthritis

Abstract

Objective: There is an interest in identifying a metabolic OA phenotype. We therefore assessed the relation of diabetes and cardiovascular disease to prevalent and incident radiographic (ROA) and symptomatic knee osteoarthritis (SxOA). Design: In two large cohort studies of individuals with or at risk for knee OA, the Multicenter Osteoarthritis Study (MOST) and Osteoarthritis Initiative (OAI), participants self-reported diabetes and cardiovascular disease (CVD) at baseline. We assessed the relation of baseline diabetes and CVD (exposures) to ROA and SxOA cross-sectionally and after 60 (MOST) or 48 (OAI) months of follow-up using logistic regression with GEE to account for 2 knees within an individual, adjusting for potential confounders. Results: In MOST, 6,020 knees of 3,021 participants (60.1% female, mean ± SD age 62.5 ± 8.1, mean BMI 30.7 ± 6.0, 83.3% Caucasian) were included in the analyses. In OAI, 8,645 knees of 4,339 participants (58.2% female, mean ± SD age 61.1 ± 9.2, mean BMI 28.6 ± 4.8, 80.3% Caucasian) were included. We found no significant associations between prevalent diabetes or CVD and prevalent or incident ROA or SxOA. Effect estimates for prevalent ROA and SxOA ranged from 0.80 (95% CI 0.63e1.03) to 1.17 (0.91e1.51). Effect estimates for incident ROA ranged from 0.80 (0.58e1.11) to 0.88 (0.60e1.29) in MOST and from 0.75 (0.50e1.14) to 1.19 (0.81e1.74) in OAI, and for incident SxOA from 0.93 (0.65e1.31) to 1.22 (0.89 e1.67) in MOST and from 0.82 (0.59e1.16) to 1.19 (0.85e1.66) in OAI). Conclusions: Diabetes and CVD were not associated with prevalent or incident knee OA.

Synovial inflammation in osteoarthritis progression

“…Epidemiological studies show a higher prevalence of OA (radiographic and symptomatic) in patients with type 2 diabetes mellitus (T2DM) and a higher rate of arthroplasty 142,143 , with a meta-analysis reporting a higher risk of OA development in patients with T2DM than in those without T2DM (OR 1.46; 95% CI 1.08-1.96; P = 0.01) 144 . Although some studies neither confirmed these findings after adjustment for BMI 145,146 nor detected an association between T2DM and prevalence or incidence of OA 147,148 , some of the studies included in the meta-analysis reported the same increased risk after BMI adjustment, suggesting that T2DM is an independent risk factor for OA development 143 . For example, ultrasonography-detected synovitis and effusion were higher in patients with T2DM and end-stage knee OA who underwent arthroplasty than in those without T2DM, independent of patient BMI 143 .…”

Mesenchymal Stromal Cells in Osteoarthritis: Evidence for Structural Benefit and Cartilage Repair

“…It is expected that by 2030, 20% of adults will have developed OA in Western Europe and North America [ 3 ], which imposes the morbidity and economic burdens on patients, their families and the society [ 4 ]. Notably, recent studies have also showed robust evidence that OA is a significant risk factor for cardiovascular diseases (CVD) and suggested that patients with OA are twice as likely to develop ischemic heart disease and heart failure which increase mortality [ 5 , 6 ].…”

Comparison of Warming Needle Moxibustion and Drug Therapy for Treating Knee Osteoarthritis: A Systematic Review and Meta-analysis

“…KOA is the primary type of meniscus, with high risk of disability, and the incidence in female is higher than that in male [7]. In traditional Chinese medicine, it seems almost inevitable that the morbidity will further increase, with the aging of population and the increasing numbers of obesity [8][9][10]. Conventional treatment for KOA is based on medications such as glucocorticoids and nonsteroidal anti-inflammatory drugs (NSAIDs), and surgery would be considered for severe cases, with a cost unaffordable for many patients [11].…”