Is Osteoarthritis in Women Affected by Hormonal Changes or Smoking?

Abstract

The influence of sex hormone related events and smoking on the development of OA in women was investigated in a case-controlled postal survey. One hundred and twenty-nine patients with nodal generalized osteoarthritis (NGOA) and 145 with non-nodal pauciarticular large joint osteoarthritis (LJOA) were identified from the database of a Nottingham OA clinic. For each patient, three age-matched controls were randomly selected from the same general practice. Sixty-three per cent of questionnaires (690/1096) were returned: NGOA, 95; NGOA controls, 226; LJOA, 113; LJOA controls, 256. There were no differences in age at menarche or menopause, rates of hysterectomy, oral contraceptive use, or hormone replacement use between cases and controls. Fewer OA patients had ever smoked [(Odds Ratio (OR) 0.65, 95% Confidence Interval (CI) 0.45-0.95)] and subset analysis demonstrated that this negative association occurred only in the LJOA group (OR 0.43, CI 0.25-0.72), particularly in those with knee OA (OR 0.29, CI 0.14-0.62). A previous successful pregnancy was negatively associated with NGOA (OR 0.47, CI 0.24-0.95). This study demonstrates no association between oestrogen-related hormonal events and OA, but a negative association between smoking and LJOA. Such data supports the concept that OA is a heterogeneous disease and underlines the need to differentiate OA subsets.

Relationship between cigarette smoking and radiographic knee osteoarthritis in Chinese population: a cross-sectional study

“…This study suggested that the primary exposure of cigarette smoking was negatively associated with radiographic knee OA in the Chinese population, which was consistent with some previous researches [29,[40][41][42][43]. Two recent studies, including a large-sample prospective cohort study conducted by Mnatzaganian et al [40,41], considered total joint replacement (TJR) as a surrogate indicator of severe OA and demonstrated a strong inverse dose-response relationship between the duration of cigarette smoking and the risk of TJR.…”

“…A large-sample prospective cohort study conducted by Jarvholm [42] indicated that smoking might reduce the risk of hip OA in men, but the effect was weak when compared to the BMI and age. Samanta [43] suggested that there was a negative association between cigarette smoking and large joint OA, but on the contrary, Wilder [20] confirmed clinically that cigarette smoking was not a protective factor for radiographic OA in knee, hand, foot and cervical spine. The Chingford study also found no clear evidence on the protective effect of cigarette smoking for hand and knee OA in women [44].…”

Risk factors for incident radiographic knee osteoarthritis in the elderly. The framingham study

“…In cross-sectional studies, others (4,5,20,31) have also reported that subjects with OA are less likely to be smokers than are their matched controls. However, this finding is not universal (32).…”

The Association between a History of Parental Addictions and Arthritis in Adulthood: Findings from a Representative Community Survey

“…For example, parental addiction has been associated with adult children's alcohol abuse [17,18], smoking [17,19], and other substances abuse [7,17,18]. In turn, these health behaviors, particularly cigarette smoking [20,21] and alcohol consumption [22], are associated with an elevated risk of adult onset arthritis [8].…”