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Scherzer ZA, Alvarez C, Renner JB, Murphy LB, Schwartz TA, Jordan JM, Golightly YM, Nelson AE. Effects of Comorbid Cardiovascular Disease and Diabetes on Hand Osteoarthritis, Pain, and Functional State Transitions: The Johnston County Osteoarthritis Project. J Rheumatol 2020; 47:1541-1549. [PMID: 32062598 DOI: 10.3899/jrheum.191075] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study is to examine the course of hand osteoarthritis (HOA) and its relationship with cardiovascular disease (CVD) and diabetes (DM). METHODS Data were collected at 3 timepoints from 845 Johnston County Osteoarthritis Project participants (two-thirds women, one-third African Americans, mean age 60 yrs) with and without HOA, CVD, or DM. A diagnosis of radiographic HOA (rHOA) required a Kellgren-Lawrence severity grade of ≥ 2 in at least 3 joints in each hand. A 4-state progressive model included transitions based on rHOA and pain or function as defined using the Australian/Canadian HOA Index (AUSCAN). Markov multistate models estimated HR (aHR) and 95% CI for associations between DM or CVD and specific state transitions, adjusting for baseline and time-varying covariates. RESULTS Participants with DM (vs those without DM) were more likely to experience worsening pain with rHOA. Individuals who had or developed CVD (vs those who did not) were significantly less likely to experience symptomatic improvement, regardless of rHOA status. Those with DM or CVD (vs those without these comorbidities) were less likely to experience improvement in function, although this was statistically significant only for those with DM and no rHOA. CONCLUSION Overall, having or developing DM and/or CVD reduced the likelihood of symptomatic and functional improvement over time, suggesting an effect of comorbid CVD and DM on the clinical and radiographic course of HOA. Additional studies are needed to confirm these findings.
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Affiliation(s)
- Zachary A Scherzer
- Z.A. Scherzer, BS, Medical Student, Oakland University William Beaumont School of Medicine, Rochester, Missouri, and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carolina Alvarez
- C. Alvarez, MS, Statistician, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jordan B Renner
- J.B. Renner, MD, Professor of Radiology and Allied Health Sciences, Thurston Arthritis Research Center, and Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Louise B Murphy
- L.B. Murphy, PhD, Senior Service Fellow/Epidemiologist, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Todd A Schwartz
- T.A. Schwartz, DrPH, Associate Professor of Biostatistics, Thurston Arthritis Research Center, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joanne M Jordan
- J.M. Jordan, MD, MPH, Joseph P. Archie, Jr. Eminent Professor of Medicine and Vice Dean for Faculty Affairs and Leadership Development, Thurston Arthritis Research Center, and Department of Medicine, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yvonne M Golightly
- Y.M. Golightly, PT, PhD, Assistant Professor of Epidemiology, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amanda E Nelson
- A.E. Nelson, MD, MSCR, Associate Professor of Medicine, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Hussain SM, Dawson C, Wang Y, Tonkin AM, Chou L, Wluka AE, Cicuttini FM. Vascular Pathology and Osteoarthritis: A Systematic Review. J Rheumatol 2019; 47:748-760. [PMID: 31154415 DOI: 10.3899/jrheum.181236] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Vascular pathology (changes in blood vessels) and osteoarthritis (OA) are both common chronic conditions associated with aging and obesity, but whether vascular pathology is a risk factor for OA is unclear. The aim of this study was to systematically review the evidence for an association between vascular pathology and risk of joint-specific OA. METHODS Scopus, Ovid Medline, and EMBASE were searched from inception to February 2019. MeSH terms and keywords were used to identify studies examining the association between vascular pathology and OA. Two reviewers independently extracted the data and assessed the methodological quality. Qualitative evidence synthesis was performed. RESULTS Fifteen studies with high (n = 3), fair (n = 3), or low (n = 9) quality were included. Features of vascular pathology included atherosclerosis, vascular stiffness, and endothelial dysfunction in different vascular beds. There was evidence for an association between vascular pathology and risk of hand OA in women but not men, and between vascular pathology and risk of knee OA in both men and women. Only 2 studies examined hip OA showing no association between vascular pathology and risk of hip OA. CONCLUSION There is evidence suggesting an association between vascular pathology and risk of hand and knee OA, with a potential causal relationship for knee OA. Based on the limited evidence, it is hard to conclude an association for hip OA. Further stronger evidence is needed to determine whether there is a causal relationship.
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Affiliation(s)
- Sultana Monira Hussain
- From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia.,S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors
| | - Chloe Dawson
- From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia.,S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors
| | - Yuanyuan Wang
- From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia.,S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors
| | - Andrew M Tonkin
- From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia.,S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors
| | - Louisa Chou
- From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia.,S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors
| | - Anita E Wluka
- From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia.,S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors
| | - Flavia M Cicuttini
- From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia. .,S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors.
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Baudart P, Louati K, Marcelli C, Berenbaum F, Sellam J. Association between osteoarthritis and dyslipidaemia: a systematic literature review and meta-analysis. RMD Open 2017; 3:e000442. [PMID: 29435358 PMCID: PMC5706481 DOI: 10.1136/rmdopen-2017-000442] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES We aimed to investigate the prevalence of dyslipidemia in patients with osteoarthritis (OA) and whether OA and dyslipidemia are associated. METHODS We performed a systematic literature review and a meta-analysis, including cross-sectional, cohort and case-control studies, to assess the number of patients with OA and/or dyslipidemia. We calculated the mean (±SD) prevalence of dyslipidemia in patients with and without OA and the risk of dyslipidemia (OR, 95% CI) among patients with OA. RESULTS From 605 articles screened, 48 were included in the analysis (describing 29 cross-sectional, 10 cohort and 9 case-control studies). The mean prevalence of dyslipidemia was 30.2%±0.6% among 14 843 patients with OA and 8.0%±0.1% among 196 168 without OA. The risk of dyslipidemia was greater with than without OA overall (OR 1.98,95% CI 1.43 to 2.75, p<0.0001) and with knee OA (OR 2.27, 1.33 to 3.89, p=0.003) and hand OA (OR 2.12, 1.46 to 3.07), p<0.0001). CONCLUSION The risk of dyslipidemia was twofold greater with than without OA, so lipid disturbances could be a risk factor for OA. Such a result supports the individualisation of the metabolic syndrome-associated OA phenotype.
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Affiliation(s)
- Pauline Baudart
- Department of Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
- Department of Rheumatology, Caen Teaching Hospital, Caen, France
| | - Karine Louati
- Department of Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
- Sorbonne University, UPMC Univ Paris 06, Paris, France
| | - Christian Marcelli
- Department of Rheumatology, Caen Teaching Hospital, Caen, France
- Normandy University, Caen, France
- UNICAEN, COMETE, Caen, France
- Inserm, U 1075 COMETE, Caen, France
| | - Francis Berenbaum
- Department of Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
- Sorbonne University, UPMC Univ Paris 06, Paris, France
- INSERM UMR_S938, Paris, France
| | - Jérémie Sellam
- Department of Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
- Sorbonne University, UPMC Univ Paris 06, Paris, France
- INSERM UMR_S938, Paris, France
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