Correlation between metabolic syndrome and knee osteoarthritis: data from the Korean National Health and Nutrition Examination Survey (KNHANES)

BMC Public Health

Kwan Kyu Park¹  Yoo Jung Park¹  Woo Suk Lee¹  Ik Hwan Yang¹  Chang Dong Han¹ 

[1] Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

关键词: Osteoarthritis;    Knee;    Metabolic syndrome;   

Others  :  1162080
DOI  :  10.1186/1471-2458-13-603

 received in 2012-10-16, accepted in 2013-06-18,  发布年份 2013

【 摘 要 】

Background

This study was designed to investigate the correlations of knee osteoarthritis (OA) with metabolic syndrome (MetS) and MetS parameters in Korean subjects.

Methods

This study included data from 270 subjects with knee OA and 1964 control subjects with a mean age of 54.56 (SD 11.53) years taken from the Korean National Health and Nutritional Examination Survey (KNHANES) 2008. Multivariate logistic regression analysis was conducted to examine possible associations for knee OA with MetS and MetS parameters.

Results

MetS was shown to be associated with an increased risk of knee OA in female subjects in unadjusted analysis (OR 1.798, 95% CI 1.392, 2.322), but this significance disappeared when adjusted for confounding factors (OR 1.117, 95% CI 0.805, 1.550). No significant association between MetS and knee OA was found in male subjects. Among parameters of MetS, only high waist circumference (WC) in female subjects was significantly associated with an increased prevalence of knee OA, even after adjusting for confounding factors, while no other significant associations were found in both male and female subjects.

Conclusion

We found that WC was associated with knee OA in female subjects, but neither MetS nor any parameters thereof were shown to be associated with knee OA in the Korean subjects of this study. Although we found no relationship between a pre-inflammatory state of MetS and knee OA, we believe further investigation of this relationship in various aspects is warranted, as MetS may also be a risk factor for complications in knee OA related procedures.

【 授权许可】

   
2013 Han et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Callaghan JJ: The adult knee. Philadelphia: Lippincott Williams & Wilkins; 2003.
• [2]Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, et al.: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998, 41(5):778-799.
• [3]Engstrom G, Gerhardsson DeVerdier M, Rollof J, Nilsson PM, Lohmander LS: C-reactive protein, metabolic syndrome and incidence of severe hip and knee osteoarthritis. A population-based cohort study. Osteoarthr Cartil 2009, 17(2):168-173.
• [4]Iannone F, Lapadula G: Obesity and inflammation–targets for OA therapy. Curr Drug Targets 2010, 11(5):586-598.
• [5]Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002, 287(3):356-359.
• [6]Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen MR, Groop L: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001, 24(4):683-689.
• [7]Trevisan M, Liu J, Bahsas FB, Menotti A: Syndrome X and mortality: a population-based study Risk Factor and Life Expectancy Research Group. Am J Epidemiol 1998, 148(10):958-966.
• [8]Gandhi R, Razak F, Tso P, Davey JR, Mahomed NN: Asian Ethnicity and the Prevalence of Metabolic Syndrome in the Osteoarthritic Total Knee Arthroplasty Population. J Arthroplasty 2010, 25(3):416-419.
• [9]Gandhi R, Razak F, Tso P, Davey JR, Mahomed NN: Metabolic Syndrome and the Incidence of Symptomatic Deep Vein Thrombosis Following Total Knee Arthroplasty. J Rheumatol 2009, 36(10):2298-2301.
• [10]Browning RC, Kram R: Effects of obesity on the biomechanics of walking at different speeds. Med Sci Sports Exerc 2007, 39(9):1632-1641.
• [11]Messier SP: Obesity and osteoarthritis: disease genesis and nonpharmacologic weight management. Med Clin North Am 2009, 93(1):145-159.
• [12]Otterness IG, Swindell AC, Zimmerer RO, Poole AR, Ionescu M, Weiner E: An analysis of 14 molecular markers for monitoring osteoarthritis: segregation of the markers into clusters and distinguishing osteoarthritis at baseline. Osteoarthr Cartil 2000, 8(3):180-185.
• [13]Spector TD, Hart DJ, Nandra D, Doyle DV, Mackillop N, Gallimore JR, Pepys MB: Low-level increases in serum C-reactive protein are present in early osteoarthritis of the knee and predict progressive disease. Arthritis Rheum 1997, 40(4):723-727.
• [14]Van Loan MD, Johnson HL, Barbieri TF: Effect of weight loss on bone mineral content and bone mineral density in obese women. Am J Clin Nutr 1998, 67(4):734-738.
• [15]Sharif M, Shepstone L, Elson CJ, Dieppe PA, Kirwan JR: Increased serum C reactive protein may reflect events that precede radiographic progression in osteoarthritis of the knee. Ann Rheum Dis 2000, 59(1):71-74.
• [16]Hotamisligil GS: Inflammation and metabolic disorders. Nature 2006, 444(7121):860-867.
• [17]Findlay DM: Vascular pathology and osteoarthritis. Rheumatology (Oxford) 2007, 46(12):1763-1768.
• [18]Kim HM, Kim DJ, Jung IH, Park C, Park J: Prevalence of the metabolic syndrome among Korean adults using the new International Diabetes Federation definition and the new abdominal obesity criteria for the Korean people. Diabetes Res Clin Pract 2007, 77(1):99-106.
• [19]Expert Panel on Detection: Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001, 285(19):2486-2497.
• [20]Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, et al.: Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007, 75(1):72-80.
• [21]Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, et al.: Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003, 26(11):3160-3167.
• [22]Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, Whelton PK, He J: Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 2005, 365(9468):1398-1405.
• [23]Katz R, Wong ND, Kronmal R, Takasu J, Shavelle DM, Probstfield JL, Bertoni AG, Budoff MJ, O‘Brien KD: Features of the metabolic syndrome and diabetes mellitus as predictors of aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis. Circulation 2006, 113(17):2113-2119.
• [24]Shiwaku K, Anuurad E, Enkhmaa B, Nogi A, Kitajima K, Yamasaki M, Yoneyama T, Oyunsuren T, Yamane Y: Predictive values of anthropometric measurements for multiple metabolic disorders in Asian populations. Diabetes Res Clin Pract 2005, 69(1):52-62.
• [25]Arai H, Yamamoto A, Matsuzawa Y, Saito Y, Yamada N, Oikawa S, Mabuchi H, Teramoto T, Sasaki J, Nakaya N, et al.: Prevalence of metabolic syndrome in the general Japanese population in 2000. J Atheroscler Thromb 2006, 13(4):202-208.
• [26]Park MJ, Boston BA, Oh M, Jee SH: Prevalence and Trends of Metabolic Syndrome Among Korean Adolescents: From the Korean NHANES Survey, 1998–2005. J Pediatr 2009, 155(4):529-534.
• [27]Hoang KC, Le TV, Wong ND: The metabolic syndrome in East Asians. J Cardiometab Syndr 2007, 2(4):276-282.
• [28]Haffner SM, Bauer RL: The association of obesity and glucose and insulin concentrations with bone density in premenopausal and postmenopausal women. Metab Clin Exp 1993, 42(6):735-738.
• [29]Simopoulou T, Malizos KN, Iliopoulos D, Stefanou N, Papatheodorou L, Ioannou M, Tsezou A: Differential expression of leptin and leptin‘s receptor isoform (Ob-Rb) mRNA between advanced and minimally affected osteoarthritic cartilage; effect on cartilage metabolism. Osteoarthr Cartil 2007, 15(8):872-883.
• [30]Gualillo O: Further evidence for leptin involvement in cartilage homeostases. Osteoarthr Cartil 2007, 15(8):857-860.
• [31]Ettinger WH, Davis MA, Neuhaus JM, Mallon KP: Long-term physical functioning in persons with knee osteoarthritis from NHANESI: Effects of comorbid medical conditions . J Clin Epidemiol 1994, 47(7):809-815.
• [32]Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C: Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord 2001, 25(5):622-627.
• [33]Cho HJ, Chang CB, Kim KW, Park JH, Yoo JH, Koh IJ, Kim TK: Gender and prevalence of knee osteoarthritis types in elderly Koreans. J Arthroplasty 2011, 26(7):994-999.
• [34]Park KK, Chang CB, Kang YG, Seong SC, Kim TK: Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients. J Bone Joint Surg Br 2007, 89(5):604-608.
• [35]Kim YH, Sohn KS, Kim JS: Range of motion of standard and high-flexion posterior stabilized total knee prostheses. A prospective, randomized study. J Bone Joint Surg Am 2005, 87(7):1470-1475.
• [36]Messier SP, Loeser RF, Mitchell MN, Valle G, Morgan TP, Rejeski WJ, Ettinger WH: Exercise and weight loss in obese older adults with knee osteoarthritis: a preliminary study. J Am Geriatr Soc 2000, 48(9):1062-1072.
• [37]Goldring MB: Osteoarthritis and cartilage: the role of cytokines. Curr Rheumatol Rep 2000, 2(6):459-465.
• [38]Singh G, Miller JD, Lee FH, Pettitt D, Russell MW: Prevalence of cardiovascular disease risk factors among US adults with self-reported osteoarthritis: data from the Third National Health and Nutrition Examination Survey. Am J Manag Care 2002, 8(15 Suppl):S383-S391.
• [39]Onat A, Hergenc G, Turkmen S, Yazici M, Sari I, Can G: Discordance between insulin resistance and metabolic syndrome: features and associated cardiovascular risk in adults with normal glucose regulation. Metab Clin Exp 2006, 55(4):445-452.
• [40]Muraki S, Oka H, Akune T, Mabuchi A, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, et al.: Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: the ROAD study. Osteoarthr Cartil 2009, 17(9):1137-1143.