ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 949

The Metabolic Syndrome, Its Elements and Knee Osteoarthritis: The Framingham Osteoarthritis (OA) Study

Jingbo Niu1, Mary Clancy2, Piran Aliabadi3 and David T. Felson1, 1Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, 2Clinical Epidemiology, BUSM, Boston, MA, 3Radiology, Brigham and Women's Hospital, Boston, MA

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Sunday, November 8, 2015

Title: Osteoarthritis - Clinical Aspects: Treatments and Epidemiology

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Recent studies have suggested an association between knee OA and the metabolic syndrome (MetS), but in these studies the relationship of this syndrome to OA has often vanished after adjustment for BMI. Since BMI adjusts for the effect of loading on the knee, adjustment for BMI is appropriate and any association of MetS elements with OA should be present after this adjustment. In defining the MetS, its elements are dichotomized and any association of these elements with OA is more likely to be detected if they are examined over their range and not just as dichotomous measures. We used data from the Framingham Osteoarthritis Study to assess the association between MetS and each of its elements to radiographic knee OA (ROA).

Methods: The Framingham Osteoarthritis Study recruited subjects from the Offspring Cohort. At exam 7 (2002-2005), we carried out a cross sectional evaluation of MetS and OA. MetS was defined by National Cholesterol Education Program criteria as having at least three out of the five elements: waist circumference >102 cm in men and >88 cm in women), hypertriglyceridemia (>150 mg/dL), low HDL (<40 mg/dL in men and <50 mg/dL in women), high blood pressure (systolic BP >130 mmHg, diastolic BP >85 mmHg or treatment), and hyperglycemia (fasting glucose >100mg/dL or diagnosis of diabetes). ROA was defined as having KL>2 in the tibiofemoral joint on PA view radiograph, patellofemoral OA on the lateral view radiograph, or knee replacement. Among subjects 50 years and older, we used binary regress to assess the relation of MetS and each of its elements to the prevalence of ROA in men and women separately. We tested each element of MetS as dichotomous measures, quartiles, and continuous measures. Age, history of knee injury and surgery were included as covariates. We tested models with and without controlling BMI to show how the effect of MetS was affected by excessive weight. Generalized estimating equations were used to control for the correlation between two knees of a subject.

Results: Among 1091 subjects (mean age: 62.0 years, BMI 28.1 kg/m2, 55.5% women), 41.4% of men and 28.6% of women had MetS. When adjusting for covariates other than BMI, large waist circumference, high tryglyceride and high systolic blood pressure were related to higher prevalence of ROA in both men; MetS, large waist circumference, high systolic blood pressure, and hyperglycemia were related to higher prevalence of ROA in women. After further adjusting for BMI, men with high waist circumference and tryglyceride tended to have a higher prevalence of ROA; while none of the above associations was observed in women (Table).

Conclusion: The association between MetS and radiographic knee OA observed in women can be explained by excessive weight. The relation of its elements, i.e., waist circumference, high blood pressure, and hyperglycemia, to radiographic knee OA was also due to excessive weight.

Table. Metabolic syndrome and prevalent knee OA

Women

Men

Adjusted RR

(95% CI)[1]

Adjusted RR

(95% CI)[2]

Adjusted RR

(95% CI)[1]

Adjusted RR

(95% CI)[2]

metabolic syndrome yes vs. no

1.5 (1.1, 1.9) **

0.9 (0.6, 1.1)

1.3 (0.9, 1.7)

1.0 (0.7, 1.4)

waist circumference

>102/88cm (m/w) yes vs. no

1.9 (1.3, 2.8) ***

1.0 (0.6, 1.5)

1.5 (1.1, 2.0) *

1.1 (0.7, 1.6)

2nd vs. lowest quartile

1.4 (0.8, 2.3)

1.1 (0.6, 1.8)

2.2 (1.3, 3.6) **

1.9 (1.2, 3.2) *

3rd vs. lowest quartile

1.5 (0.9, 2.5)

0.9 (0.6, 1.6)

2.0 (1.2, 3.3) **

1.6 (0.9, 2.8)

highest vs. lowest quartile

3.4 (2.1, 5.3) ***

1.3 (0.7, 2.4)

2.7 (1.7, 4.3) ***

1.8 (0.9, 3.6)

continuous, 10 units

1.35 (1.27, 1.44) ***

0.94 (0.76, 1.16)

1.26 (1.12, 1.41) ***

1.00 (0.77, 1.31)

triglyceride

>150 mg/dL yes vs. no

1.2 (0.9, 1.6)

0.9 (0.7, 1.2)

1.0 (0.8, 1.4)

1.0 (0.7, 1.4)

2nd vs. lowest quartile

1.2 (0.8, 1.8)

0.9 (0.6, 1.2)

1.7 (1.0, 2.6) *

1.5 (1.0, 2.4)

3rd vs. lowest quartile

1.0 (0.7, 1.5)

0.8 (0.5, 1.1)

1.9 (1.2, 2.9) **

1.6 (1.0, 2.6) *

highest vs. lowest quartile

0.8 (0.6, 1.3)

0.8 (0.5, 1.2)

1.5 (0.9, 2.4)

1.3 (0.8, 2.2)

continuous, 10 units

1.00 (0.98, 1.01)

0.98 (0.96, 1.00) *

1.01 (1.00, 1.03)

1.01 (0.99, 1.03)

HDL

<40/50 mg/dL (m/w) yes vs. no

1.2 (0.9, 1.6)

0.9 (0.7, 1.2)

0.9 (0.6, 1.2)

0.8 (0.6, 1.1)

lowest vs. highest quartile

1.2 (0.8, 1.8)

0.9 (0.6, 1.2)

0.9 (0.6, 1.4)

0.8 (0.5, 1.2)

2nd vs. highest quartile

1.0 (0.7, 1.5)

0.8 (0.5, 1.1)

1.0 (0.7, 1.5)

0.9 (0.6, 1.4)

3rd vs. highest quartile

0.8 (0.6, 1.3)

0.8 (0.5, 1.2)

0.8 (0.5, 1.2)

0.8 (0.5, 1.2)

continuous, 10 units

0.97 (0.89, 1.05)

1.05 (0.97, 1.14)

0.97 (0.86, 1.10)

1.01 (0.89, 1.14)

blood pressure

SBP >130 mmHg, DBP >85 mmHg yes vs. no

1.2 (0.9, 1.7)

0.9 (0.7, 1.2)

1.1 (0.8, 1.5)

0.9 (0.7, 1.3)

SBP, 2nd vs. lowest quartile

1.2 (0.8, 2.1)

1.0 (0.6, 1.6)

1.6 (0.9, 2.8)

1.4 (0.8, 2.5)

SBP, 3rd vs. lowest quartile

1.8 (1.2, 2.8) *

1.3 (0.9, 2.0)

1.8 (1.1, 3.0) *

1.5 (0.9, 2.6)

SBP, highest vs. lowest quartile

1.5 (0.9, 2.4)

1.1 (0.7, 1.7)

1.7 (1.0, 2.9) *

1.5 (0.9, 2.5)

SBP, continuous, 10 units

1.07 (1.01, 1.15) *

1.03 (0.96, 1.11)

1.08 (1.00, 1.16) *

1.07 (0.98, 1.15)

DBP, 2nd vs. lowest quartile

1.0 (0.7, 1.4)

0.9 (0.6, 1.2)

1.4 (0.9, 2.1)

1.3 (0.9, 2.0)

DBP, 3rd vs. lowest quartile

1.1 (0.7, 1.5)

0.9 (0.7, 1.3)

1.5 (1.0, 2.3)

1.4 (1.0, 2.2)

DBP, highest vs. lowest quartile

1.1 (0.7, 1.6)

0.9 (0.6, 1.3)

1.3 (0.8, 2.1)

1.3 (0.8, 2.0)

DBP, continuous, 10 units

1.06 (0.94, 1.21)

1.00 (0.89, 1.14)

1.14 (0.99, 1.32)

1.12 (0.97, 1.30)

Blood glucose

Fasting glucose >100mg/dL or diagnosis of diabetes, yes vs. no

1.5 (1.1, 1.9) **

0.9 (0.7, 1.2)

1.2 (0.9, 1.7)

1.1 (0.8, 1.5)

2nd vs. lowest quartile

1.4 (0.9, 2.3)

1.3 (0.8, 2.1)

1.2 (0.8, 1.8)

1.0 (0.7, 1.6)

3rd vs. lowest quartile

1.7 (1.1, 2.7) *

1.2 (0.8, 1.9)

1.3 (0.9, 2.0)

1.1 (0.7, 1.8)

highest vs. lowest quartile

2.0 (1.3, 3.2) **

1.2 (0.7, 1.8)

1.1 (0.7, 1.7)

0.9 (0.6, 1.4)

continuous, 10 units

1.07 (1.03, 1.12)**

1.00 (0.96, 1.05)

0.97 (0.91, 1.03)

0.94 (0.87, 1.01)

[1]adjusting for age, history of knee injury and surgery,

[2]adjusting for age, BMI, history of knee injury and surgery

*p-value <0.05, **p-value <0.01, ***p-value <0.001

Disclosure: J. Niu, None; M. Clancy, None; P. Aliabadi, None; D. T. Felson, None.

To cite this abstract in AMA style:

Niu J, Clancy M, Aliabadi P, Felson DT. The Metabolic Syndrome, Its Elements and Knee Osteoarthritis: The Framingham Osteoarthritis (OA) Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-metabolic-syndrome-its-elements-and-knee-osteoarthritis-the-framingham-osteoarthritis-oa-study/. Accessed .

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