Background/Purpose:  Beyond obesity-related osteoarthritis (OA), association between metabolic syndrome and OA delineates the metabolic OA phenotype. Along this line, we aimed to investigate the prevalence of dyslipidemia in OA patients and whether OA and dyslipidemia are associated.

Methods:  We performed a systematic literature review from 3 electronic databases (PubMed, Embase and Cochrane) until January 2016, and abstracts of 2013-2015 meetings (ACR, EULAR, OARSI). We included cross-sectional, cohort and case control studies to assess the number of patients with OA and/or dyslipidemia. We calculated the mean (±SD) prevalence of dyslipidemia in patients with and without OA and the odds ratio (OR) (95% confidence interval (95%CI)) of having dyslipidemia among patients with OA. We used Revman V.5.3 to perform a meta-analysis. A random-effects model was used in case of high heterogeneity. Quality of the studies was assessed with STROBE score (%) and sensitivity analyses were performed.

Results:  From 605 published studies, 48 were included in the analysis (29 cross-sectional, 10 cohort and 9 case-control studies). The median of STROBE quality score was 69%. Twenty-one over 30 studies showed a positive association between OA and dyslipidemia. Twelve over 18 studies with a score STROBE > 60% found a positive association. Four over 7 studies that reported an OR adjusted on age and BMI were positive too. In 14,843 patients with OA, the mean prevalence of dyslipidemia was 30.2±0.6% (mean±SD), whereas in 196,168 patients without OA, the mean prevalence was 8%±0,1%. The risk of dyslipidemia was greater in OA than non-OA patients (OR=1.98 (1.43-2.75), p<0.0001) (Figure 1), especially for knee (OR=2.27 (1.33-3.89), p=0.003) and hand OA localizations (OR=2.12 (1.46-3.07), p<0.0001). Results were unchanged in sensitivity analyses (exclusion of studies with STROBE score <60% or including OA diagnosis not based on ACR criteria or Kellgren-Lawrence grading).

Figure 1: Forest Plot for dyslipidemia among patients with and without OA

Conclusion: OA Patients have a 2-fold increased risk for dyslipidemia, suggesting that this metabolic disturbance could be a risk factor of OA. Such a result supports the individualization of a metabolic OA phenotype.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-osteoarthritis-and-dyslipidemia-a-systematic-literature-review-and-meta-analysis/