Metabolic syndrome and the incidence of knee osteoarthritis: A meta-analysis of prospective cohort studies.

Daqing Nie,Guixin Yan,Zhengyi Wang,Di Liu,Hongbo Li,Na Yuan,Wenyu Zhou,Guimei Yu,Yuanyuan Wang

doi:10.1371/journal.pone.0243576

Daqing Nie, Guixin Yan + Show 7 more

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https://doi.org/10.1371/journal.pone.0243576

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Abstract

BackgroundCross-sectional studies suggest an association between metabolic syndrome (MetS) and knee osteoarthritis (KOA). We performed a meta-analysis to evaluate whether MetS is an independent risk factor for KOA.MethodsProspective cohort studies evaluating the association between MetS and KOA in general population were retrieved from PubMed and Embase. Only studies with multivariate analyses were included. Data were pooled with a random-effect model, which is considered to incorporate heterogeneity among the included studies.ResultsFive studies including 94,965 participants were included, with 18,990 people with MetS (20.0%). With a mean follow-up duration of 14.5 years, 2,447 KOA cases occurred. Pooled results showed that MetS was not significant associated with an increased risk of KOA after controlling of factors including body mass index (adjusted risk ratio [RR]: 1.06, 95% CI: 0.92~1.23, p = 0.40; I2 = 33%). Subgroup analysis showed that MetS was independently associated with an increased risk of severe KOA that needed total knee arthroplasty (RR = 1.16, 95% CI: 1.03~1.30, p = 0.02), but not total symptomatic KOA (RR = 0.84, 95% CI: 0.65~1.08, p = 0.18). Stratified analyses suggested that MetS was independently associated with an increased risk of KOA in women (RR = 1.23, 95% CI: 1.03~1.47, p = 0.02), but not in men (RR = 0.90, 95% CI: 0.70~1.14, p = 0.37).ConclusionsCurrent evidence from prospective cohort studies did not support MetS was an independent risk factor of overall KOA in general population. However, MetS may be associated with an increased risk of severe KOA in general population, or overall KOA risk in women.

Highlights

Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities including abdominal adiposity, insulin resistance, hypertension, and dyslipidemia [1]
Pooled results showed that MetS was not significant associated with an increased risk of knee osteoarthritis (KOA) after controlling of factors including body mass index
Subgroup analysis showed that MetS was independently associated with an increased risk of severe KOA that needed total knee arthroplasty (RR = 1.16, 95% confidence intervals (CIs): 1.03~1.30, p = 0.02), but not total symptomatic KOA (RR = 0.84, 95% CI: 0.65~1.08, p = 0.18)

Summary

Introduction

Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities including abdominal adiposity, insulin resistance, hypertension, and dyslipidemia [1]. Accumulating evidence suggests that MetS is related to the pathogenesis of many chronic diseases, such as cardiovascular diseases [2] and cancer [3]. Subsequent observational studies suggest a strong association between MetS and KOA [8,13]. Most of these studies are cross-sectional, and body mass index (BMI), a confirmed risk factor for KOA [14], was not adjusted [15]. The sequential relationship between MetS and KOA remains undetermined. We aimed to perform a meta-analysis of prospective cohort studies to evaluate whether MetS is an independent risk factor for KOA. Cross-sectional studies suggest an association between metabolic syndrome (MetS) and knee osteoarthritis (KOA). We performed a meta-analysis to evaluate whether MetS is an independent risk factor for KOA

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