Skip to main content

Advertisement

Log in

Distribution of osteoarthritis in a Norwegian population-based cohort: associations to risk factor profiles and health-related quality of life

  • Epidemiology of RMD
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The objective of the study was to examine the hand-, knee- and hip osteoarthritis (OA) distribution, risk factor profiles and health-related quality of life (HRQoL) in a population-based OA cohort. Persons with self-reported OA responded to questionnaires and attended a clinical examination (N = 606). We analyzed cross-sectional associations to risk factor profiles and HRQoL dimensions (Short Form 36) in four mutually exclusive groups based on fulfillment of The American College of Rheumatology criteria: no OA (NOA), monoarticular upper extremity (hand) OA (MOAupper-ex.), monoarticular lower extremity (hip or knee) OA (MOAlower-ex.) and polyarticular OA (POA). Multivariate regression analyses and correspondence analysis were performed. The distribution of NOA, MOAupper-ex. MOAlower-ex. and POA was 21.1, 25.4, 22.4 and 31.0%, respectively. Compared to NOA, minor differences were found in risk factor profile in MOAupper-ex., whereas POA was significantly associated with sociodemographic, metabolic and mechanical features. The correspondence analysis identified different risk factor profiles between the four OA phenotypes, but the differences were not statistically significant (p = 0.13). Regarding HRQoL, neither OA groups were associated with poorer mental functioning. MOAlower-ex. and POA were associated with, among other things, poorer physical functioning (β = −6.2, 95% CI −11.2 to −1.2 and β = −12.5, 95% CI −17.4 to −7.9, respectively) and more pain (β = −5.4, 95% CI −10.4 to −0.3 and β = −10.5, 95% CI −15.3 to −5.8, respectively). In this cohort of persons with self-reported OA, POA was the most prevalent phenotype and was associated with an unfortunate risk factor profile and several diminished HRQoL dimensions. POA needs further attention in research and clinical care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Arden N, Nevitt MC (2006) Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol 20:3–25

    Article  PubMed  Google Scholar 

  2. Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81:646–656

    PubMed  PubMed Central  Google Scholar 

  3. Castell MV, van der Pas S, Otero A, Siviero P, Dennison E, Denkinger M et al (2015) Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskelet Disord 16:359

    Article  PubMed  PubMed Central  Google Scholar 

  4. Turkiewicz A, Petersson IF, Bjork J, Hawker G, Dahlberg LE, Lohmander LS et al (2014) Current and future impact of osteoarthritis on health care: a population-based study with projections to year 2032. Osteoarthritis Cartilage 22:1826–1832

    Article  CAS  PubMed  Google Scholar 

  5. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M et al (2014) The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73:1323–1330

    Article  PubMed  Google Scholar 

  6. Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK et al (2011) Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Ann Rheum Dis 70:1581–1586

    Article  PubMed  Google Scholar 

  7. Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–1537

    Article  CAS  Google Scholar 

  8. Ihlebaek C, Brage S, Natvig B, Bruusgaard D (2010) Occurrence of musculoskeletal disorders in Norway (Article in Norwegian). Tidsskr Nor Laegeforen 130:2365–2368

    Article  PubMed  Google Scholar 

  9. Shane Anderson A, Loeser RF (2010) Why is osteoarthritis an age-related disease? Best Pract Res Clin Rheumatol 24:15–26

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Reijman M, Pols HA, Bergink AP, Hazes JM, Belo JN, Lievense AM et al (2007) Body mass index associated with onset and progression of osteoarthritis of the knee but not of the hip: the Rotterdam Study. Ann Rheum Dis 66:158–162

    Article  CAS  PubMed  Google Scholar 

  11. Grotle M, Hagen KB, Natvig B, Dahl FA, Kvien TK (2008) Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord 9:132

    Article  PubMed  PubMed Central  Google Scholar 

  12. Felson DT (2010) Identifying different osteoarthritis phenotypes through epidemiology. Osteoarthr Cartil 18:601–604

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Nelson AE, Smith MW, Golightly YM, Jordan JM (2014) “Generalized osteoarthritis”: a systematic review. Semin Arthritis Rheum 43:713–720

    Article  PubMed  Google Scholar 

  14. Slatkowsky-Christensen B, Mowinckel P, Loge JH, Kvien TK (2007) Health-related quality of life in women with symptomatic hand osteoarthritis: a comparison with rheumatoid arthritis patients, healthy controls, and normative data. Arthritis Rheum 57:1404–1409

    Article  PubMed  Google Scholar 

  15. Pereira D, Severo M, Santos RA, Barros H, Branco J, Lucas R et al (2016) Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life. Clin Rheumatol 35:1555–1564

    Article  PubMed  Google Scholar 

  16. Michon M, Maheu E, Berenbaum F (2011) Assessing health-related quality of life in hand osteoarthritis: a literature review. Ann Rheum Dis 70:921–928

    Article  CAS  PubMed  Google Scholar 

  17. Geryk LL, Carpenter DM, Blalock SJ, DeVellis RF, Jordan JM (2015) The impact of co-morbidity on health-related quality of life in rheumatoid arthritis and osteoarthritis patients. Clin Exp Rheumatol 33:366–374

    PubMed  Google Scholar 

  18. Cuperus N, Vliet Vlieland TP, Mahler EA, Kersten CC, Hoogeboom TJ, van den Ende CH (2015) The clinical burden of generalized osteoarthritis represented by self-reported health-related quality of life and activity limitations: a cross-sectional study. Rheumatol Int 35:871–877

    Article  CAS  PubMed  Google Scholar 

  19. Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K et al (1990) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 33:1601–1610

    Article  CAS  PubMed  Google Scholar 

  20. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049

    Article  CAS  PubMed  Google Scholar 

  21. Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K et al (1991) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 34:505–514

    Article  CAS  PubMed  Google Scholar 

  22. Osteras N, Risberg MA, Kvien TK, Engebretsen L, Nordsletten L, Bruusgaard D, et al (2013) Hand, hip and knee osteoarthritis in a Norwegian population-based study–the MUST protocol. BMC Musculoskelet Disord 14:201

    Article  PubMed  PubMed Central  Google Scholar 

  23. World Health Organization (2011) Waist circumference and waist-hip ratio: report of a WHO Expert Consultation, Geneva, 8–11 Dec 2008. World Health Organization, 9789241501491

  24. Beighton P, Solomon L, Soskolne CL (1973) Articular mobility in an African population. Ann Rheum Dis 32:413–418

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Remvig L, Jensen DV, Ward RC (2007) Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature. J Rheumatol 34:804–809

    PubMed  Google Scholar 

  26. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  27. Pollard B, Johnston M, Dixon D (2013) Exploring differential item functioning in the SF-36 by demographic, clinical, psychological and social factors in an osteoarthritis population. BMC Musculoskelet Disord 14:346

    Article  PubMed  PubMed Central  Google Scholar 

  28. Loge JH, Kaasa S, Hjermstad MJ, Kvien TK (1998) Translation and performance of the Norwegian SF-36 Health Survey in patients with rheumatoid arthritis. I. Data quality, scaling assumptions, reliability, and construct validity. J Clin Epidemiol 51:1069–1076

    Article  CAS  PubMed  Google Scholar 

  29. Kothari M, Guermazi A, von Ingersleben G, Miaux Y, Sieffert M, Block JE et al (2004) Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis. Eur Radiol 14:1568–1573

    Article  PubMed  Google Scholar 

  30. Danielsson L, Lindberg H (1997) Prevalence of coxarthrosis in an urban population during four decades. Clin Orthop Relat Res 342:106–110

    Article  Google Scholar 

  31. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Magnusson K (2015) Hand osteoarthritis, pain and body weight. Associations and potential mechanisms [Dissertation]. Oslo, University of Oslo, p 79

  33. Pereira D, Peleteiro B, Araujo J, Branco J, Santos RA, Ramos E (2011) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage 19:1270–1285

    Article  CAS  PubMed  Google Scholar 

  34. Maillefert JF, Gueguen A, Monreal M, Nguyen M, Berdah L, Lequesne M et al (2003) Sex differences in hip osteoarthritis: results of a longitudinal study in 508 patients. Ann Rheum Dis 62:931–934

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Ranawat CS, Park CN, White PB, Meftah M, Bogner EA, Ranawat AS (2016) Severe hand osteoarthritis strongly correlates with major joint involvement and surgical intervention. J Arthroplasty 31:1693–1697

    Article  PubMed  Google Scholar 

  36. Dagenais S, Garbedian S, Wai EK (2009) Systematic review of the prevalence of radiographic primary hip osteoarthritis. Clin Orthop Relat Res 467:623–637

    Article  PubMed  Google Scholar 

  37. Chu Miow Lin D, Reichmann WM, Gossec L, Losina E, Conaghan PG, Maillefert JF (2011) Validity and responsiveness of radiographic joint space width metric measurement in hip osteoarthritis: a systematic review. Osteoarthr Cartil 19:543–549

    Article  CAS  PubMed  Google Scholar 

  38. Bijlsma JW, Berenbaum F, Lafeber FP (2011) Osteoarthritis: an update with relevance for clinical practice. Lancet 377:2115–2126

    Article  PubMed  Google Scholar 

  39. Nevitt MC (1996) Definition of hip osteoarthritis for epidemiological studies. Ann Rheum Dis 55:652–655

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Croft P, Cooper C, Wickham C, Coggon D (1990) Defining osteoarthritis of the hip for epidemiologic studies. Am J Epidemiol 132:514–522

    Article  CAS  PubMed  Google Scholar 

  41. Franklin J, Ingvarsson T, Englund M, Ingimarsson O, Robertsson O, Lohmander LS (2011) Natural history of radiographic hip osteoarthritis: a retrospective cohort study with 11–28 years of followup. Arthritis Care Res (Hoboken) 63:689–695

    Article  Google Scholar 

  42. Tukker A, Visscher TL, Picavet HS (2009) Overweight and health problems of the lower extremities: osteoarthritis, pain and disability. Public Health Nutr 12:359–368

    CAS  PubMed  Google Scholar 

  43. Hawker GA, Croxford R, Bierman AS, Harvey PJ, Ravi B, Stanaitis I et al (2014) All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis: a population based cohort study. PLoS One 9:e91286

    Article  PubMed  PubMed Central  Google Scholar 

  44. Prior JA, Jordan KP, Kadam UT (2014) Associations between cardiovascular disease severity, osteoarthritis co-morbidity and physical health: a population-based study. Rheumatology (Oxford) 53:1794–1802

    Article  Google Scholar 

  45. Moe RH, Grotle M, Kjeken I, Hagen KB, Kvien TK, Uhlig T (2013) Disease impact of hand OA compared with hip, knee and generalized disease in specialist rheumatology health care. Rheumatology (Oxford) 52:189–196

    Article  Google Scholar 

  46. Salaffi F, Carotti M, Stancati A, Grassi W (2005) Health-related quality of life in older adults with symptomatic hip and knee osteoarthritis: a comparison with matched healthy controls. Aging Clin Exp Res 17:255–263

    Article  PubMed  Google Scholar 

  47. Loge JH, Kaasa S (1998) Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scand J Soc Med 26:250–258

    Article  CAS  PubMed  Google Scholar 

  48. Marshall M, Peat G, Nicholls E, van der Windt D, Myers H, Dziedzic K (2013) Subsets of symptomatic hand osteoarthritis in community-dwelling older adults in the United Kingdom: prevalence, inter-relationships, risk factor profiles and clinical characteristics at baseline and 3-years. Osteoarthr Cartil 21:1674–1684

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kåre Birger Hagen.

Ethics declarations

Conflict of interest

Authors GØL, KM, NØ, MAR, LN and KBH declare that they have no conflict of interest.

Funding

No funding was received.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocols were approved by the Regional Committee for Medical and Health Research Ethics (2009/812a and 2009/1703a).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 22 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lombnæs, G.Ø., Magnusson, K., Østerås, N. et al. Distribution of osteoarthritis in a Norwegian population-based cohort: associations to risk factor profiles and health-related quality of life. Rheumatol Int 37, 1541–1550 (2017). https://doi.org/10.1007/s00296-017-3721-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-017-3721-6

Keywords

Navigation