Metabolic osteoarthritis - relation of diabetes and cardiovascular disease with knee osteoarthritis.

Objective: There is an interest in identifying a metabolic OA phenotype. We therefore assessed the relation of diabetes and cardiovascular disease to prevalent and incident radiographic (ROA) and symptomatic knee osteoarthritis (SxOA).

Design: In two large cohort studies of individuals with or at risk for knee OA, the Multicenter Osteoarthritis Study (MOST) and Osteoarthritis Initiative (OAI), participants self-reported diabetes and cardiovascular disease (CVD) at baseline. We assessed the relation of baseline diabetes and CVD (exposures) to ROA and SxOA cross-sectionally and after 60 (MOST) or 48 (OAI) months of follow-up using logistic regression with GEE to account for 2 knees within an individual, adjusting for potential confounders.

Results: In MOST, 6,020 knees of 3,021 participants (60.1% female, mean ± SD age 62.5 ± 8.1, mean BMI 30.7 ± 6.0, 83.3% Caucasian) were included in the analyses. In OAI, 8,645 knees of 4,339 participants (58.2% female, mean ± SD age 61.1 ± 9.2, mean BMI 28.6 ± 4.8, 80.3% Caucasian) were included. We found no significant associations between prevalent diabetes or CVD and prevalent or incident ROA or SxOA. Effect estimates for prevalent ROA and SxOA ranged from 0.80 (95% CI 0.63-1.03) to 1.17 (0.91-1.51). Effect estimates for incident ROA ranged from 0.80 (0.58-1.11) to 0.88 (0.60-1.29) in MOST and from 0.75 (0.50-1.14) to 1.19 (0.81-1.74) in OAI, and for incident SxOA from 0.93 (0.65-1.31) to 1.22 (0.89-1.67) in MOST and from 0.82 (0.59-1.16) to 1.19 (0.85-1.66) in OAI).

Conclusions: Diabetes and CVD were not associated with prevalent or incident knee OA.