Osteoarthritis, mobility-related comorbidities and mortality: an overview of meta-analyses

Abstract

Aims: The objective of this review was to examine the relationship between osteoarthritis (OA) and mobility-related comorbidities, specifically diabetes mellitus (DM) and cardiovascular disease (CVD). It also investigated the relationship between OA and mortality. Methods: An overview of meta-analyses was conducted by performing two targeted searches from inception to June 2020. The association between OA and (i) DM or CVD ( via PubMed and Embase); and (ii) mortality ( via PubMed) was investigated. Meta-analyses were selected if they included studies that examined adults with OA at any site and reported associations between OA and DM, CVD, or mortality. Evidence was synthesized qualitatively. Results: Six meta-analyses met inclusion criteria. One meta-analysis of 20 studies demonstrated a statistically significant association between OA and DM, with pooled odds ratio of 1.41 (95% confidence interval: 1.21, 1.65; n = 1,040,175 patients). One meta-analysis of 15 studies demonstrated significantly increased risk of CVD among OA patients, with a pooled risk ratio of 1.24 (1.12, 1.37, n = 358,944 patients). Stratified by type of CVD, OA was shown to be associated with increased heart failure (HF) and ischemic heart disease (IHD) and reduced transient ischemic attack (TIA). There was no association reported for stroke or myocardial infarction (MI). Three meta-analyses did not find a significant association between OA (any site) and all-cause mortality. However, OA was found to be significantly associated with cardiovascular-related death across two meta-analyses. Conclusion: The identified meta-analyses reported significantly increased risk of both DM and CVD (particularly, HF and IHD) among OA patients. It was not possible to confirm consistent directional or causal relationships. OA was found to be associated with increased mortality, but mostly in relation to CVD-related mortality, suggesting that further study is warranted in this area.

Activity limitation and participation restriction in Osteoarthritis and Rheumatoid arthritis: findings based on the National Health and Nutritional Examination Survey

“…Second, as the NHANES is cross-sectional, the associations that we observed might not be causal and might have resulted from other potential confounders that we did not adjust for. In adult research, for example, arthritic conditions may co-occur with other cardiometabolic comorbidities, such as heart diseases and diabetes mellitus [ 40 ], which in turn also affects physical functioning. However, we accounted for adjusting measured comorbidities in attempt to establish the relationships stated.…”

Cardiovascular comorbidity of osteoarthritis: clinical significance and therapy strategies

“…В другом исследовании, сравнившем в период с 1998 по 2013 годы пациентов старше 45 лет с остеоартритом (n=123993) и без ОА (n=121318), установлено, что смертность от сердечно-сосудистых заболеваний в группе пациентов с ОА составила 60,1%, в группе сравнения -48,1% [3]. Обзор метаанализов последних лет установил, что риск смерти (HR) от сердечнососудистых заболеваний (ССЗ) у пациентов с ОА составляет 1,53 (95 ДИ 1,27-1,84) [4]. Кроме того, метаанализ 32 когортных исследований выявил увеличение риска инсульта у пациентов с ОА, причем вне зависимости от возраста пациентов (HR -1,40 (95 ДИ 1,28-1,54)) [5].…”

Association between hyperuricemia and the risk of mortality in patients with osteoarthritis: A study based on the National Health and Nutrition Examination Survey database

“…OA is a primary cause of chronic pain and long-term disability in adults [ 4 ]. Furthermore, patients with OA exhibit a significantly increased risk of all-cause mortality as well as heightened susceptibility to cardiovascular disease (CVD) mortality [ 5 , 6 ]. Therefore, identifying factors that influence the mortality risk in patients with OA is crucial for the prognostic management of these patients.…”