Effect of insulin therapy on osteophyte formation and joint space stricture of knee osteoarthritis in type 2 diabetic mellitus

Abstract

Objective To investigate the insulin therapy on the osteophyte formation and joint space stricture in knee osteoarthritis (OA) with type 2 diabetes mellitus (T2DM)patients. Methods A retrospective study was performed on 311 cases (622 knees)of patients with OA who were admitted from July 2015 to August 2016.According to whether complicated with T2DM, patients were divided into 3 groups, 99 patients with T2DM without any treatment intervention or oral hypoglycemic drugs were in the non-insulin group, 112 patients with T2DM who were treated with insulin and hypoglycemic drugs combined with insulin were in the insulin group, and 100 patients without T2DM who were treated with knee joint pain and rehabilitation were in the control group.The knee joints of all patients were graded and graded using the Lequesne index and kellgren-lawrence (K-L)grades, and the correlation between insulin and osteoarthritis osteophyte formation and joint stenosis was analyzed. Results The gender of the non-insulin, insulin group and control group difference was statistically significant (P 0.05). The HbA1C% among the 3 groups had statistically significant difference (P 0.05). There was no statistically significant difference in K-L classification among the three groups (P>0.05). There was a statistically significant difference between the insulin group (89.7%)and the control group (86.0%)in joint space stenosis (P<0.05). Osteophyte formation in insulin group (19.7%)was significantly different from that in control group (11.6%, P<0.01). Osteophyte formation and joint space stenosis in the non-insulin group (36.0%, 99.5%)were significantly different from those in the insulin group (19.7%, 89.7%, P<0.05). Multivariate regression analysis showed that, after adjusting for age, gender, HbA1C%, and Lequesne index, insulin was an independent factor affecting osteophyte formation in osteoarthritis of the knee (OR=0.294, P<0.05)compared with non-insulin group and control group, respectively (OR=0.098, P<0.001). Conclusion Insulin treatment can effectively delay osteophyte formation and joint space narrowing in T2DM patients with knee osteoarthritis. Key words: Type 2 diabetes mellitus; Knee osteoarthritis; Insulin; Osteophyte