Prevalence and Risk Factors of Spine, Shoulder, Hand, Hip, and Knee Osteoarthritis in Community-dwelling Koreans Older Than Age 65 Years

Abstract

Background Osteoarthritis (OA) is common and disabling among older patients around the world. Data exploring the prevalence and risk factors of OA are of paramount importance in establishing healthcare policies. However, few studies have evaluated these topics among Asian populations. Questions/purposes This study was conducted to determine the prevalence and risk factors of radiographic OA in the spine, shoulder, hand, hip, and knee in Koreans older than age 65 years.Methods A simple random sample (N = 1118) was drawn from a roster of elderly individuals older than age 65 years in Seongnam. Of the 1118 invited subjects, 696 (males = 298, females = 398) participated in this study (a response rate of 62%). The mean age of respondents was 72 ± 5 years (range, 65-91 years). Radiographs of the lumbar spine, shoulder, hand, hip, and knee were taken and afterward evaluated for radiographic OA. The KellgrenLawrence grading system was used for all mentioned joints, and radiographic OA was defined as Grade 2 changes or higher. The association of sex, aging, and obesity with OA in each of the mentioned joints was determined with the help of multivariate logistic regression. Results The highest prevalence of radiographic OA was seen in the spine (number of subjects with OA/number of whole population = 462 of 696 [66%]) followed by the hand (415 of [CI], 3.9-8.4; p \ 0.001) and hand OA (OR, 2.3; 95% CI, 1.6-3.1; p \ 0.001), and male sex was associated with spine OA (OR, 0.7; 95% CI, 0.5-1.0; p = 0.025). Aging was associated with radiographic OA in the spine, knee, and hand (OR per 5-year increments, 1.3 [95% CI, 1.1-1.6; p = 0.001], 1.6 [95% CI, 1.4-1.9; p \ 0.001], and 1.4 [95% CI, 1.2-1.7; p \ 0.001]), respectively) but not associated with OA in the hip and shoulder. Obesity was associated with knee OA (OR, 3.4; 95% CI, 2.4-5.0; p \ 0.001) and spine OA (OR, 1.5; 95% CI, 1.1-2.2; p = 0.014) but not with OA in other joints. Conclusions OA of the spine, hand, and knee is likely to become a major public health problem rather than shoulder and hip OA in Korea. Associations of demographic factors

What is the Prevalence of Radiographic Hip Findings Associated With Femoroacetabular Impingement in Asymptomatic Asian Volunteers?

“…However, recent studies, including ours, show the opposite [25,30,31]. Our findings cannot explain the discordance between the high rate of FAI-related morphologic features and low rate of hip osteoarthritis in Asian populations [6]. Based on our results, there is not enough evidence to prove the conventional theory that FAI-related morphologic features are a strong predisposing factor for hip osteoarthritis.…”

Effects of dietary fatty acid content on humeral cartilage and bone structure in a mouse model of diet‐induced obesity

“…The influence of diet and obesity on joints that do not regularly bear body weight, such as the shoulder, remains unclear. While correlations have been observed between serum adipokine levels and shoulder OA, most clinical studies show mild or no association between obesity and OA in this joint . However, it is important to note that early changes in OA may be reflected in other joints or other tissues such as bone or synovium, depending on the type or cause of OA .…”

“…It is now hypothesized that the influence of obesity on OA may result primarily from metabolic changes that are reflected through chronic, low‐grade systemic inflammation that occurs secondary to increased adiposity and immune cell infiltration into visceral fat depots . However, since normal mechanical loading has been shown to be necessary to maintain cartilage homeostasis, the influence of obesity on other joints, such as the shoulder with its particularly complex loading environment, remains unclear, with some studies showing mild or no association between obesity and OA in this joint …”

“…3,[5][6][7] However, since normal mechanical loading has been shown to be necessary to maintain cartilage homeostasis, 8 the influence of obesity on other joints, such as the shoulder with its particularly complex loading environment, remains unclear, with some studies showing mild or no association between obesity and OA in this joint. 9 To study the mechanisms linking obesity and OA more directly, animal models of obesity have been developed using either a high-fat diet [10][11][12][13][14] or genetic ablation of leptin signaling (e.g., ob/ob or db/db mice). 15 Multiple studies have shown increased severity of spontaneous OA [15][16][17] or injury-induced OA 7,13,14 in animals fed a high-fat diet, but a lack of spontaneous OA in obese, leptin-deficient mice fed a standard chow diet.…”

“…While correlations have been observed between serum adipokine levels and shoulder OA, 21 most clinical studies show mild or no association between obesity and OA in this joint. 9 However, it is important to note that early changes in OA may be reflected in other joints 22 or other tissues such as bone or synovium, depending on the type or cause of OA. 23 For example, animal models of OA show an increase in subchondral trabecular separation, and decreases in both bone volume fraction (BV/TV) and mineral content (BMD) within the affected joint, 24 and previous studies have shown a decrease in overall bone quality with obesity.…”