Relationship of Bone Mineral Density and Knee Osteoarthritis (Kellgren-Lawrence Grade): Fifth Korea National Health and Nutrition Examination Survey

Abstract

Background Osteoarthritis (OA) and osteoporosis (OP) are the 2 most common bone disorders associated with aging. We can simply assume that older patients have a higher incidence of OA and OP with more severity. Although several papers have conducted studies on the relationship between OA and OP, none of them has demonstrated a conclusive link. In this study, we used radiological knee OA and bone mineral density (BMD; T-score of the total hip and lumbar spine) to analyze the incidence of OA and OP in a large population. We aimed to determine the relationship between OA and OP and investigate the associated risk factors Methods This cross-sectional study used data extracted from the 2010–2012 Korea National Health and Nutrition Examination Survey. We evaluated a total of 4,250 participants aged ≥ 50 years who underwent knee radiography and dual-energy X-ray absorptiometry and their laboratory results. The relationship between radiological knee OA and BMD was assessed. The generalized linear model was used to evaluate the relationship between BMD and Kellgren-Lawrence (KL) grade. Results The higher KL grade was associated with older age, higher body mass index (BMI), female sex, and lower hemoglobin level ( p < 0.001). No significant association was found between OA and the following variables: white blood cell, platelet, total cholesterol, vitamin D, alkaline phosphatase, parathyroid hormone, hypertension, diabetes, asthma, dyslipidemia, smoking status, alcohol consumption, and regular exercise ( p > 0.05). After adjusting for confounding factors (age, BMI, diabetes, hypertension, smoking, and alcohol consumption), the average T-scores of total hip and lumbar spine were the highest in the mild OA group with KL grade 2 (−0.22 ± 1.08 and −0.89 ± 1.46, respectively, p < 0.001). The average T-scores of the total hip and lumbar spine significantly decreased as OA progressed from moderate (KL grade 3; −0.49 ± 1.05 and −1.33 ± 1.38, respectively, p < 0.001) to severe (KL grade 4; −0.73 ± 1.13 and −1.74 ± 1.75, respectively, p < 0.001). T-scores of the moderate-to-severe OA group were significantly lower than those of the non-OA group (KL grades 0 and 1, p < 0.001). Conclusions Compared with the non-OA group, BMD (T-scores of the total hip and lumbar spine) was higher in the mild OA group and lower in the moderate-to-severe OA group.

The role of bone mineral density and cartilage volume to predict knee cartilage degeneration

“…Abdin-Mohamed M. et al,(2009) 21 proving that BMD of tibia do not increase in presence of knee OA; this result is in line with another recent study which illustrated that BMD was lower in moderate-to-severe OA states. 22 As already pointed out in a previous paper, it is possible to claim confidently the ensemble of purpose, experimental strategy (mainly, signal acquisition and processing workflows), and the promising findings obtained represent, to the best of the authors’ knowledge, a partially unexplored strategy in this field, which sets this study apart from others. Moreover, as already we claimed, 4 there were no studies which presented and evaluated the predictive power of similar 3D features extracted on MRI and CT data of the knee joint.…”

CT- and MRI-Based 3D Reconstruction of Knee Joint to Assess Cartilage and Bone

“…A recent study demonstrated that BMD was the highest when the knee OA was mild, and was significantly lower in moderate and severe OA. Generally, it is considered that the severity of OA increases and the level of BMD decreases with increasing age [ 51 ]. The different correlations between data could be due to the restricted number of participants, their characteristics, outcome measures or the status of the knee joint (as it is in the early stage).…”

Exercise-induced modulation of myokine irisin in bone and cartilage tissue—Positive effects on osteoarthritis: A narrative review

“…Other partial findings also support the reduction of bone density in osteoarthritis (Schreiber et al, 2018;Muhlenfeld et al, 2021;Zhu Z. et al, 2021). A review in regard to the relationship between BMD and osteoarthritis of the knee by Choi et al (2021) showed that patients with moderate and severe OA had significantly lower BMD than the normal ones. Patients with mild OA show an increase in BMD but this is most likely caused by a temporary increase in score due to high turnover of the osteoarthritic subchondral bone (Dequeker et al, 2003).…”