Is abnormal glucose tolerance or diabetes a risk factor for knee, hip, or hand osteoarthritis? A systematic review

Dawson, L.; Fairley, Jessica; Papandony, Michelle C; Hussain, Sultana Monira; Cicuttini, Flavia Maria; Wluka, Anita E.

doi:10.1016/j.semarthrit.2018.02.008

Cited by 30 publications

(30 citation statements)

References 55 publications

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“…Our findings corroborate with a recent systematic review,14 which reported little evidence to suggest that impaired glucose metabolism was a risk factor for OA. This is in contrary to two previous meta-analyses on the same topic 10 11.…”

Section: Discussionsupporting

confidence: 92%

“…Although the latter meta-analysis reported a positive association between OA and DM that was maintained after adjustment of BMI, this meta-analysis involved a much fewer number of studies and did not include several more recent large studies which showed negative results 9 12 13. More recently, Dawson et al reported that there was little evidence to suggest impaired glucose metabolism as a risk factor for OA 14. However, it was a qualitative analysis which did not include a meta-analysis.…”

Section: Introductionmentioning

confidence: 98%

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Diabetes mellitus is not a risk factor for osteoarthritis

Khor

Hong

et al. 2020

RMD Open

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BackgroundAssociation between diabetes mellitus (DM) and risk of osteoarthritis (OA) can be confounded by body mass index (BMI), a strong risk factor for both conditions. We evaluate the association between DM or hyperglycaemia with OA using systematic review and meta-analysis.MethodsWe searched PubMed and Web of Science databases in English for studies that gave information on the association between DM and OA. Two meta-analysis models were conducted to address: (1) risk of DM comparing subjects with and without OA and (2) risk of OA comparing subjects with and without DM. As far as available, risk estimates that adjusted for BMI were used.Results31 studies with a pooled population size of 295 100 subjects were reviewed. 16 and 15 studies reported positive associations and null/ negative associations between DM and OA. 68.8% of positive studies had adjusted for BMI, compared with 93.3% of null/negative studies. In meta-analysis model 1, there was an increase prevalence of DM in subjects with OA compared with those without (OR 1.56, 95% CI 1.28 to 1.89). In meta-analysis model 2, there was no increased risk of OA (OR 1.14, 95% CI 0.98 to 1.33) in subjects with DM compared with those without, regardless of gender and OA sites. Comparing subjects with DM to those without, an increased risk of OA was noted in cross-sectional studies, but not in case-control and prospective cohort studies.ConclusionsThis meta-analysis does not support DM as an independent risk factor for OA. BMI was probably the most important confounding factor.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 98%

Diabetes mellitus is not a risk factor for osteoarthritis

Khor

Hong

et al. 2020

RMD Open

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“…Despite previous findings that fasting serum glucose was not significantly associated with either prevalent or incident radiographic KOA, [26][27][28][29] we identified fasting serum glucose as a potentially statistically important variable for classifying people who will develop AKOA. While this finding is surprising, it may be explained by CART's ability to detect possible interactions with small sample sizes, whereas standard statistical analyses would not be powered to detect interactions.…”

Section: Discussioncontrasting

confidence: 92%

Role of Magnetic Resonance Imaging in Classifying Individuals Who Will Develop Accelerated Radiographic Knee Osteoarthritis

Price

Harkey

Ward

et al. 2019

Journal Orthopaedic Research

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We assessed whether adding magnetic resonance (MR)‐based features to a base model of clinically accessible participant characteristics (i.e., serological, radiographic, demographic, symptoms, and physical function) improved classification of adults who developed accelerated radiographic knee osteoarthritis (AKOA) or not over the subsequent 4 years. We conducted a case–control study using radiographs from baseline and the first four annual visits of the osteoarthritis initiative to define groups. Eligible individuals had no radiographic KOA in either knee at baseline (Kellgren–Lawrence [KL] grade <2). We classified two groups matched on sex (i) AKOA: at least one knee developed advanced‐stage KOA (KL = 3 or 4) within 48 months and (ii) did not develop AKOA within 48 months. The MR‐based features were assessments of bone, effusion/synovitis, tendons, ligaments, cartilage, and menisci. All characteristics and MR‐based features were from the baseline visit. Classification and regression tree analyses were performed to determine classification rules and identify statistically important variables. The CART models with and without MR features each explained approximately 40% of the variability. Adding MR‐based features to the model yielded modest improvements in specificity (0.90 vs. 0.82) but lower sensitivity (0.62 vs. 0.70) than the base model. There was consistent evidence that serum glucose, effusion‐synovitis volume, and cruciate ligament degeneration are statistically important variables in classifying individuals who will develop AKOA. We found common MR‐based measures failed to dramatically improve classification. These findings also show a complex interplay among participant characteristics and a need to identify novel characteristics to improve classification. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2420–2428, 2019

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“…The compound metabolic syndrome showed a none significant tendency to increase osteoarthritis of both hips. These results are partially in line with previous studies which show that most singular components of metabolic syndrome as well as the compound metabolic syndrome have no impact on osteoarthritis of the hip joints [10,27,28], whereas other studies have shown, that prevalence of metabolic syndrome is higher in patients with osteoarthritis [29]. It has to be acknowledged, that most studies showing a positive association between metabolic syndrome or its singular components (e.g.…”

Section: Discussionsupporting

confidence: 91%

“…Furthermore, a systemic analysis of 40 studies (21.299 participants) showed no evidence for diabetes as an independent risk factor for hip and hand osteoarthritis, but little evidence for knee osteoarthritis [27]. However, it should be stated that only about half of the evaluated studies used objective radiographic measurements [27]. Several studies in the literature proposed that osteoarthritis and hypertension share traditional risk factors (i.e.…”

Section: Plos Onementioning

confidence: 99%

Association between metabolic syndrome and hip osteoarthritis in middle-aged men and women from the general population

Walter

Wintermeyer²,

Klinger

et al. 2020

PLoS ONE

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Objective To investigate the impact of metabolic syndrome and its components on osteoarthritis of the hip joints compared to a healthy cohort in the KORA MRI-study. Methods Randomly selected men and women from the general population were classified as having metabolic syndrome, defined as presence of central obesity plus two of the following four components: elevated blood pressure (BP), elevated fasting glucose, elevated triglycerides (TG) and low HDL-cholesterol (HDL-c), or as controls without metabolic syndrome. Therefore, each subject underwent detailed assessment of waist circumference as well as fasting glucose, systolic and diastolic BP, TG, and HDL-c concentrations as well as a full-body MR scan. MR measurements were performed on a 3 Tesla scanner (Magnetom Skyra, Siemens) including a dual-echo Dixon and a T2 SS-FSE sequence for anatomical structures. In order to quantify osteoarthritis of the hip, assessment was performed by two independent, experienced radiologists for joint gap narrowing, osteophytic lipping and subchondral changes (e.g. sclerosis, pseudocysts). Associations between metabolic syndrome components and hip degeneration were estimated by logistic regression models providing odds ratios. Results Among 354 included participants (mean age: 56.1 ± 9.2 years; 55.4% male), 119 (34%) had metabolic syndrome, while 235 (66%) were part of the control group. Except for elevated

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Is abnormal glucose tolerance or diabetes a risk factor for knee, hip, or hand osteoarthritis? A systematic review

Cited by 30 publications

References 55 publications

Diabetes mellitus is not a risk factor for osteoarthritis

Diabetes mellitus is not a risk factor for osteoarthritis

Role of Magnetic Resonance Imaging in Classifying Individuals Who Will Develop Accelerated Radiographic Knee Osteoarthritis

Association between metabolic syndrome and hip osteoarthritis in middle-aged men and women from the general population

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