¿Do metabolic syndrome has a role in quality of life in patients with early knee osteoarthritis?

Abstract

Purpose: Introducción. Metabolic syndrome (MetS) has been described to be more prevalent in osteoarthritis (OA) patients (57%) compared to patients without OA (23%) in USA. MetS have been described as a factor for incident OA, increased inflammation and more severe pain in affected joint compared with OA patients without MetS. Some groups consider that metabolic OA is part of a systemic metabolic disorder. However, there is a little information about the impact of MetS in patients with early knee osteoarthritis (eKOA) in terms of pain, knee function and quality of life (QofL). Objective: To evaluate burden of MetS in patients with eKOA in terms of pain, knee function, and QofL. Methods: Patients and methods. We conducted a Cross-sectional study that included patients both gender with eKOA according to ACR criteria, patients must have Kellgren and Lawrence ≤ 2 in plain radiography of knee. Were excluded patients with systemic inflammatory diseases, secondary OA, and fibromyalgia. Patients with eKOA were divided in two groups: eKOA with and without MetS according to ATP-III criteria. With a structured clinical interview, we collected socio-demographic, joint function (WOMAC and Lequesne index), QofL (EuroQol and SF36) data. We used descriptive statistics and bivariate analysis using nonparametric statistical with program Stata 13®. Results: We studied 164 patients. Group 1 (eKOA without MetS) included 110 patients (67%), and group 2 (eKOA with MetS) 54 patients (33%). More than 80% were women in both groups. Body mass index was 28 in group 1 vs. 31.7 in group 2 (p = 0.001). The prevalence of co-morbidities was superior in group 2 51.8% vs. group 1 30.9% p = 0.009. WOMAC pain score was 6.89 in group 1 vs. 6.72 in group 2; physical function 22.1 vs. 24.1 and stiffness 2.78 vs. 3.2, respectively without statistic difference in these variables. Regarding to QofL evaluated by Euroqol, patients in group 1 had a score of 0.624 vs. 0.598 compare to group 2, p = 0.33. When we used SF36, no differences were found in QofL. Conclusions: eKOA with MetS have more co-morbidities, included higher body mass index. We did not find differences between patients with eKOA regardless if they had or not MetS, in terms of knee function, pain, stiffness and QofL This finding suggests that eKOA patients with MetS do not demand medical care on time, and probably it is the reason why patients in late stage of OA had more pain, less joint function, and worst QofL compared with eKOA without MetS. In future studies, we need to compare patients with early and late KOA with and without MetS, in order to find association in worst progression and symptoms in these patients.