Metabolic risk factors and the incidence and progression of radiographic hand osteoarthritis: a population-based cohort study

Marshall, Michelle; Peat, George; Nicholls, Elaine; Myers, Helen L.; Mamas, Mamas A.; Van Der Windt, Danielle A.

Abstract

OBJECTIVE: To determine whether selected metabolic factors are associated with greater amounts of radiographic hand osteoarthritis (OA) incidence and progression. METHODS: The study identified 706 adults, aged 50-69 years, with hand pain and hand radiographs at baseline, from two population-based cohorts. Metabolic factors (body mass index, hypertension, dyslipidaemia, and diabetes) were ascertained at baseline by direct measurement and medical records. Analyses were undertaken following multiple imputation of missing data, and in complete cases (sensitivity analyses). Multivariable regression models estimated associations between metabolic factors and two measures of radiographic change at 7 years for all participants, individuals free of baseline radiographic OA, and in baseline hand OA subsets. Estimates were adjusted for baseline values and other covariates. RESULTS: The most consistent and strong associations observed were between the presence of diabetes and the amount of radiographic progression in individuals with nodal OA [adjusted mean differences in Kellgren-Lawrence summed score of 4.50 (-0.26, 9.25)], generalized OA [3.27 (-2.89, 9.42)], and erosive OA [3.05 (-13.56, 19.67)]. The remaining associations were generally weak or inconsistent, although numbers were limited for analyses of incident radiographic OA and erosive OA in particular. CONCLUSION: Overall metabolic risk factors were not independently or collectively associated with greater amounts of radiographic hand OA incidence or progression over 7 years, but diabetes was associated with radiographic progression in nodal, and possibly generalized and erosive OA. Diabetes has previously been associated with prevalent but not incident hand OA. Further investigation in hand OA subsets using objective measures accounting for disease duration and control is warranted.

Citation

Marshall, M., Peat, G., Nicholls, E., Myers, H. L., Mamas, M. A., & Van Der Windt, D. A. (in press). Metabolic risk factors and the incidence and progression of radiographic hand osteoarthritis: a population-based cohort study. Scandinavian Journal of Rheumatology, 48(1), 52-63. https://doi.org/10.1080/03009742.2018.1459831

• Journal Article Type: Article
• Acceptance Date: Mar 27, 2018
• Online Publication Date: Jun 28, 2018
• Publicly Available Date: May 26, 2023
• Journal: Scandinavian Journal of Rheumatology
• Print ISSN: 0300-9742
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 48
• Issue: 1
• Pages: 52-63
• DOI: https://doi.org/10.1080/03009742.2018.1459831
• Keywords: Osteoarthritis, hand, incidence, progression, metabolic risk factors, subsets
• Public URL: https://keele-repository.worktribe.com/output/411731
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/03009742.2018.1459831