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Associations between obesity, diabetes mellitus, and cardiovascular disease with progression states of knee osteoarthritis (KOA)

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Abstract

Background

Data on common comorbidities targeting at different progression states of knee osteoarthritis (KOA) in continuous time are limited.

Aims

To examine the associations between obesity, diabetes mellitus (DM), and cardiovascular disease (CVD) with the progression of KOA.

Methods

Data were obtained from the Osteoarthritis Initiative for up to 48 months. Progression states of KOA were defined as (1) normal; (2) asymptomatic radiographic KOA (RKOA, Kellgren–Lawrence grade ≥ 2 in at least one knee); (3) only knee symptoms; (4) symptomatic KOA (SxKOA, a combination of RKOA and knee symptoms in the same knee). A multi-state Markov model was used to investigate the associations while accounting for potential confounders.

Results

Participants with obesity had an increased risk of developing RKOA [normal to asymptomatic RKOA, adjusted hazard ratio (aHR) 1.55, 95% confidence interval (95% CI) (1.07, 2.24); only knee symptoms to SxKOA, aHR 2.25, 95% CI (1.60, 3.18)], and an increased risk of developing knee symptoms [normal to only knee symptoms, aHR 1.45, 95% CI (1.15, 1.83); asymptomatic RKOA to SxKOA, aHR 1.33, 95% CI (1.16, 1.52)]. DM was also significantly associated with development of RKOA or knee symptoms [normal to asymptomatic RKOA, aHR 1.92, 95% CI (1.12, 3.30); normal to only knee symptoms, aHR 1.78, 95% CI (1.12, 2.84)]. Knee symptoms were less likely to be relieved among participants with CVD, compared with those without [only knee symptoms to normal, aHR 0.60, 95% CI (0.38, 0.94)].

Conclusions

Obesity, DM and CVD are associated with an increased risk for SxKOA progression. Common comorbidities should be considered to prevent KOA development.

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Data availability

The datasets generated and/or analyzed during the current study are available in the OAI repository, https://nda.nih.gov/oai.

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Acknowledgements

We would like to thank the Osteoarthritis Initiative (OAI) participants, investigators, and Clinical Center’s staff for generating this publicly available dataset.

Funding

This work was supported by the Beijing Postdoctoral Research Foundation of China (Grant number: 2021-ZZ-010). The funders had no role in the study design, data collection and analysis, interpretation of data, manuscript writing, or decision to submit.

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Authors and Affiliations

  1. Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing, 100050, People’s Republic of China

    Huibin Long, Ruiqi Cao, Heyong Yin, Fei Yu & Ai Guo

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Contributions

All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. Study conception and design (HBL, HYY, RQC, FY, AG); acquisition of data (HBL); analysis and interpretation of data (HBL, HYY, RQC, FY, AG).

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Correspondence to Fei Yu or Ai Guo.

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Conflict of interest

The authors declare no conflicts of interest relevant to this work.

Ethics approval and informed consent

The OAI was approved and meets all criteria for ethical standards regarding human and animal studies defined in the Declaration of Helsinki. Institutional review boards at each OAI clinical site and the OAI coordinating center (University of California, San Francisco) approved the OAI study (approval number 10-00532). Informed consent was obtained from all participants. No further ethical approval was required for the analyses of these anonymized patient-level data in this study.

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Long, H., Cao, R., Yin, H. et al. Associations between obesity, diabetes mellitus, and cardiovascular disease with progression states of knee osteoarthritis (KOA). Aging Clin Exp Res 35, 333–340 (2023). https://doi.org/10.1007/s40520-022-02312-8

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