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.
Highlights
Symptomatic hand osteoarthritis (OA) is estimated to affect 8.2% of men and 15.9% of women in the general population [1]
One individual was excluded from the analyses examining the progression of the number of hand joints with Kellgren and Lawrence (KL)≥2 due to having the maximum number of 20 joints affected at baseline, where applicable this is indicated in the relevant results tables
Trends in the data indicated that the association between metabolic factors and progression might vary by hand OA subset
Summary
Symptomatic hand osteoarthritis (OA) is estimated to affect 8.2% of men and 15.9% of women in the general population [1]. Metabolic factors have been associated with hand OA but mainly in cross-sectional studies, systematic reviews have reported associations of obesity and type 2 diabetes with hand OA [5,6], and additional studies have reported associations between metabolic syndrome and hand OA [7,8,9]. These findings suggest systemic metabolic disturbances may play a role in the pathophysiology of hand OA. As the hands are not exposed to the joint loading effects of obesity, they are an ideal site to investigate associations between metabolic factors and OA
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