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An in-depth study of the associations between osteoarthritis- and osteoporosis-related phenotypes at different skeletal locations

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Abstract

Summary

The relationship between OA and osteoporosis characteristics remains controversial. This study revealed that age-adjusted hand OA is associated with lower hand/arm BMD levels. Wrist fracture occurrence is associated with increased OA hand scores and low arm BMD. Conversely, age-adjusted knee and spine OA is associated with high spine, hip, and total BMDs.

Introduction

Osteoarthritis (OA) and osteoporosis are two common musculoskeletal diseases which contribute a high burden of disability, yet assessments of their relationship remains controversial. The aim of this study was to clarify the association between bone mineral densities (BMD) of the hand, arm, spine, hip, and total body, and OA of the hand and knee and lumbar disc degeneration in two different ethnic groups.

Methods

Radiographic assessments of the hand, knee, and spine were collected and coded for joint space narrowing, osteophytes, and the Kellgren-Lawrence score from Chuvashian (n = 1504) and British (n = 2280) individuals. BMD measurements of standard skeletal sites were estimated by dual X-ray absorptiometry. Age- and familial-adjusted regression analyses were conducted to determine associations.

Results

Knee OA affection was positively associated with elevated hip, spine, and total body BMD levels (p < 0.001). Additionally, disc degeneration phenotypes showed significant positive associations with the hip, spine, and total BMD (p < 0.001). However, increased hand OA scores was significantly negatively correlated with arm and hand BMD measurements in males and females in both samples (p < 0.001). Additionally, higher hand OA scores were significantly associated with wrist fracture.

Conclusions

We discovered a clear pattern of association between hand OA and low hand and arm BMD, with increased risk of wrist fracture, as well as reproducing previous associations between knee and spine OA and elevated spine, hip, and total body BMD. It appears that hand OA manifests differently in comparison to hip and knee OA.

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Abbreviations

BMD:

Bone mineral density

FMI:

Fat mass index

JSN:

Joint space narrowing

JSN_28:

Joint space narrowing 28 hand joint scores

KL:

Kellgren-Lawrence

KL_28:

Kellgren-Lawrence 28 hand joint scores

LDD:

Lower disc degeneration

LMI:

Lean mass index

MCI:

Metacarpal cortical indices

OA:

Osteoarthritis

OP:

Osteoporosis

OSP:

Osteophyte

OSP_28:

Osteophyte 28 hand joint scores

OTD radius-ulna BMD:

One-third distal averaged radius and ulna bone mineral densities

RHOA:

Radiographic hand osteoarthritis

RKOA:

Radiographic knee osteoarthritis

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Acknowledgments

The research is submitted in partial fulfillment of the requirements for the PhD degree in Medical Sciences from the Department of Anatomy and Anthropology, Human Population Research Unit, Sackler Faculty of Medicine, Tel Aviv University.

Funding

This work was supported by Israel Science Foundation (grant no. 2054/19) to GL and the Israeli Ministry of Aliyah and Integration – The Center for Absorption in Science to MK. TwinsUK is funded by the Wellcome Trust, Medical Research Council, European Union, the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust in partnership with King’s College London.

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Authors and Affiliations

  1. Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Tel Aviv, Israel

    M. Kasher, S. Cherny & G. Livshits

  2. Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK

    F.M.K. Williams, M.B. Freidin & G. Livshits

  3. Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    S. Cherny

  4. Adelson Medical School, Ariel University, Ariel, Israel

    G. Livshits

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  1. M. Kasher
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Correspondence to G. Livshits.

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Kasher, M., Williams, F., Freidin, M. et al. An in-depth study of the associations between osteoarthritis- and osteoporosis-related phenotypes at different skeletal locations. Osteoporos Int 31, 2197–2208 (2020). https://doi.org/10.1007/s00198-020-05504-y

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