Comorbidities and health-related quality of life in Koreans with knee osteoarthritis: Data from the Korean National Health and Nutrition Examination Survey (KNHANES).

Hyemin Jeong,Jaejoon Lee,Sun Young Baek,Hoon-Suk Cha,Chan Hong Jeon,Yeong Hee Eun,Brecht Devleesschauwer,In Young Kim,Seon Woo Kim,Eun-Mi Koh

doi:10.1371/journal.pone.0186141

Abstract

ObjectivesThis study aimed to evaluate the association of knee osteoarthritis (OA) with comorbidities and health-related quality of life (HRQOL).MethodsA total of 8,907 (weighted n = 13,687,058) participants aged ≥50 years who had undergone knee radiography were selected from the 2010–2012 Korea National Health and Nutrition Examination Survey. OA was classified into four subgroups based on the presence or absence of pain and radiographic OA (ROA): non-OA (Pain-/ROA-), pain only (Pain+/ROA-), ROA only (Pain-/ROA+), and painful ROA (Pain+/ROA+). ROA was defined as Kellgren–Lawrence grade ≥ 2. HRQOL measurements including EuroQOL visual analogue scale (EQ-VAS) scores and the five dimensions and summary index of the EuroQOL-5 dimension (EQ-5D index) were also analyzed. Multivariable logistic regression and linear regression analyses were performed.ResultsAfter adjustment for socioeconomic and lifestyle characteristics, cardiovascular disease, malignancy, and other comorbidities were not significantly associated with OA. Pain only and painful ROA were each significantly associated with limitations in physical activity (odds ratio (OR) 2.66, 95% CI 2.07–3.44, p < 0.001 and OR 2.83, 95% CI 2.25–3.58, p < 0.001, respectively), lower EQ-VAS (β-coefficient = -10.95, p < 0.001 and β-coefficient = -9.75, p < 0.001, respectively), and EQ-5D index (β-coefficient = -0.10, p < 0.001 and β-coefficient = -0.13, p < 0.001) compared with the non-OA group, whereas ROA only was not associated with limitations in physical activity or lower HRQOL score.ConclusionsComorbidities were not significantly associated with knee OA after adjustment. Knee OA was associated with physical activity and HRQOL. Painful knee OA, with or without ROA, was more strongly associated with decreased physical activity and lower quality of life than ROA without pain.

Highlights

Osteoarthritis (OA) is the most common musculoskeletal disorder and causes disability in elderly populations [1]
Knee OA was associated with physical activity and health-related quality of life (HRQOL)
Recent studies reported that proinflammatory cytokines and systemic inflammation are associated with the pathogenesis of OA [3,4]

Summary

Introduction

Osteoarthritis (OA) is the most common musculoskeletal disorder and causes disability in elderly populations [1]. The prevalence of OA increases, and this can cause a considerable economic burden on society [2]. Recent studies reported that proinflammatory cytokines and systemic inflammation are associated with the pathogenesis of OA [3,4]. Rheumatoid arthritis (RA) is a chronic inflammatory disease that is associated with increased prevalence of several comorbidities including cardiovascular disease, infection, malignancy, lung disease, and neuropsychiatric disease [5,6,7,8]. The Rotterdam study concluded that OA was not associated with increased risk of cardiovascular disease [12]. Several studies on comorbidities other than cardiovascular disease in patients with OA have been published, one of which found that OA was associated with gastritis, obesity, and respiratory infections [13]

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