The relationship between osteoarthritis and osteoporosis
- 2k Downloads
The relationship between osteoarthritis (OA) and osteoporosis (OP), the two most common skeletal disorders related to aging, is controversial. Previous studies suggest that OA is inversely related to OP when studied cross-sectionally and systematically. However, there are differences in the results depending on the parameter used to define OA. The purpose of this review is to analyze and summarize the literature, and derive possible answers to three key questions along with a brief introduction on underlying mechanisms: (1) Is OA correlated to a high bone mineral density (BMD)? (2) Does OA influence the progression of OP or osteoporotic fractures? (3) Does high BMD affect the incidence and progression of OA? A review of the literature suggests that OA is inversely related to OP in general when studied cross-sectionally and systematically. However, when analyzed in individual bones, the BMD of the appendicular skeleton in OA-affected joints may decrease, particularly in the upper extremities. On whether OA influences bone loss or osteoporotic fractures, differences are observed according to the affected joints. The risk for osteoporotic fracture does not seem to decrease despite a high BMD in patients with OA, probably due to postural instability and muscle strength. Low BMD at the lumbar spine is associated with a lower incidence of knee OA although it does not arrest the progression of knee OA.
KeywordsOsteoarthritis Osteoporosis Relationship Incidence Progression
This study was supported by a grant from the National Research Foundation of Korea (2009-0092196).
Conflict of interest
No potential conflicts of interest were disclosed.
- 2.Burger H, van Daele PL, Odding E, Valkenburg HA, Hofman A, Grobbee DE, Schutte HE, Birkenhager JC, Pols HA (1996) Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam Study. Arthritis Rheum 39:81–86PubMedCrossRefGoogle Scholar
- 16.Ichchou L, Allali F, Rostom S, Bennani L, Hmamouchi I, Abourazzak FZ, Khazzani H, El Mansouri L, Abouqal R, Hajjaj-Hassouni N (2010) Relationship between spine osteoarthritis, bone mineral density and bone turn over markers in postmenopausal women. BMC Womens Health 10:25PubMedCentralPubMedCrossRefGoogle Scholar
- 24.Yoshimura N, Muraki S, Oka H, Mabuchi A, Kinoshita H, Yosihda M, Kawaguchi H, Nakamura K, Akune T (2009) Epidemiology of lumbar osteoporosis and osteoarthritis and their causal relationship—is osteoarthritis a predictor for osteoporosis or vice versa?: the Miyama study. Osteoporos Int 20:999–1008PubMedCrossRefGoogle Scholar
- 25.Nevitt MC, Zhang Y, Javaid MK, Neogi T, Curtis JR, Niu J, McCulloch CE, Segal NA, Felson DT (2010) High systemic bone mineral density increases the risk of incident knee OA and joint space narrowing, but not radiographic progression of existing knee OA: the MOST study. Ann Rheum Dis 69:163–168PubMedCentralPubMedCrossRefGoogle Scholar
- 27.Dequeker J, Mohan S, Finkelman RD, Aerssens J, Baylink DJ (1993) Generalized osteoarthritis associated with increased insulin-like growth factor types I and II and transforming growth factor beta in cortical bone from the iliac crest. Possible mechanism of increased bone density and protection against osteoporosis. Arthritis Rheum 36–12:1702–1708CrossRefGoogle Scholar
- 34.Jin WJ, Jiang SD, Jiang LS, Dai LY (2008) Differential bone metabolism between postmenopausal women with osteoarthritis and osteoporosis. J Bone Miner Res 23:2469–2478Google Scholar
- 38.Velasco J, Zarrabeitia MT, Prieto JR, Perez-Castrillon JL, Perez-Aguilar MD, Perez-Nuñez MI, Sañudo C, Hernandez-Elena J, Calvo I, Ortiz F et al (2010) Wnt pathway genes in osteoporosis and osteoarthritis: differential expression and genetic association study. Osteoporos Int 21:109–118PubMedCrossRefGoogle Scholar
- 55.Meacock SC, Bodmer JL, Billingham ME (1990) Experimental osteoarthritis in guinea-pigs. J Exp Pathol (Oxford) 71:279–293Google Scholar
- 64.Marinović M, Bazdulj E, Celić T, Cicvarić T, Bobinac D (2012) Histomorphometric analysis of subchondral bone of the femoral head in osteoarthritis and osteoporosis. Coll Antropol 35:19–23Google Scholar
- 67.Li ZC, Dai LY, Jiang LS, Qiu S (2012) Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: implication for fatigue microdamage, bone microarchitecture, and biomechanical properties. Arthritis Rheum 64:3955–3962PubMedCrossRefGoogle Scholar