Abstract
BackgroundKnee osteoarthritis (KOA) is one form of degenerative arthritis that results from the breakdown of cartilage and underlying bone. The prevalence of KOA is considerably higher in women than in men; however, the reason for this difference has not been thoroughly elucidated to date. The aim of the present study was to estimate the effects of reproductive and hormone factors and obesity on KOA prevalence among Chinese women.MethodsThe cross-sectional study included 7510 women with a mean age of 62.6 ± 8.6 years. Knee pain was defined as pain or aching stiffness on most days for at least 1 month during the past 12 months or persistent pain or aching stiffness within the past week. Clinical KOA was diagnosed based on both pain complaints and a Kellgren-Lawrence grade ≥ 2 X-ray radiograph of at least one knee.ResultsOral contraceptives use (OR 1.18, 1.05–1.34), ≥3 pregnancies (1.38, 1.20–1.60), and postmenopausal hormone replacement therapy (HT) (1.59, 1.23–2.06) were positively associated with knee pain, while oral contraceptives use (1.28, 1.04–1.57), and HT (1.79, 1.21–2.65) were positively associated with clinical KOA. Obesity and oral contraceptives use showed additive and multiplicative effects on knee pain. The OR for knee pain among women with a BMI ≥24 kg/m2 and oral contraceptives use was 2.00 (1.68–2.38) compared with women with a BMI < 24 kg/m2 and no oral contraceptives use.ConclusionsA high number of pregnancies, oral contraceptives use, and HT are independent risk factors for KOA, and the effects of reproductive and hormone factors on KOA may be increased by obesity.
Highlights
Knee osteoarthritis (KOA) is one form of degenerative arthritis that results from the breakdown of cartilage and underlying bone
Participants with knee pain or clinical KOA were of older age, higher Body mass index (BMI), had more pregnancies, a longer post-menopause duration, and more use of hormone replacement therapy (HT) than their unaffected colleagues
No differences in alcohol drinking or workload were observed between participants with or without knee pain or clinical KOA
Summary
Knee osteoarthritis (KOA) is one form of degenerative arthritis that results from the breakdown of cartilage and underlying bone. The prevalence of KOA is considerably higher in women than in men; the reason for this difference has not been thoroughly elucidated to date. The aim of the present study was to estimate the effects of reproductive and hormone factors and obesity on KOA prevalence among Chinese women. A high prevalence of clinical KOA, ranging from 5.6 to 28.9%, has been reported across regions and countries [1,2,3]. Knee pain is the most common presenting feature of KOA. Lower limb disability following KOA is thought to be an important cause of poor quality of life and work limitations. KOA is reported to be one of the largest economic burdens worldwide [5, 6]
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