Open AccessAssociations of Comorbid Conditions and Transitions Across States of Knee Osteoarthritis in a Community‐Based Cohort
Author(s) -
Golightly Yvonne M.,
Alvarez Carolina,
Arbeeva Liubov S.,
Cleveland Rebecca J.,
Schwartz Todd A.,
Renner Jordan B.,
Murphy Louise B.,
Callahan Leigh F.,
Jordan Joanne M.,
Nelson Amanda E.
Publication year - 2021
Publication title -
acr open rheumatology
Language(s) - English
Resource type - Journals
ISSN - 2578-5745
DOI - 10.1002/acr2.11287
Subject(s) - medicine , hazard ratio , asymptomatic , cohort , obesity , osteoarthritis , cohort study , physical therapy , confidence interval , pathology , alternative medicine
Objective To examine relationships between knee osteoarthritis (KOA) and obesity, diabetes mellitus (DM), and cardiovascular disease (CVD). Methods Associations of time‐dependent obesity, DM, and CVD with KOA transition states over approximately 18 years were examined among 4093 participants from a community‐based cohort. Transition states were 1 ) no knee symptoms and no radiographic KOA (rKOA; Kellgren‐Lawrence grade ≥2 in at least one knee), 2 ) asymptomatic rKOA, 3 ) knee symptoms only, 4 ) symptomatic rKOA (sxKOA; rKOA and symptoms in same knee). Markov multistate models estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for associations between comorbid conditions and transitions across states, adjusting for baseline age, sex, race, education, enrollment cohort, birth year, and time‐dependent knee injury history. Results At baseline, 40% of participants had obesity, 13% had DM, and 22% had CVD (mean age = 61 years; 34% Black; 37% male). Compared with those without obesity, those with obesity had a higher hazard of worsening from no rKOA/no symptoms to asymptomatic rKOA (aHR = 1.7; 95% CI = 1.3‐2.2) and from knee symptoms to sxKOA (aHR = 1.7; 95% CI = 1.3‐2.3), as well as a lower hazard of symptom resolution from sxKOA to asymptomatic rKOA (aHR = 0.5 [95% = CI 0.4‐0.7]). Compared with those without CVD, those with CVD had a higher hazard of worsening from no rKOA/symptoms to knee symptoms (aHR = 1.5; 95% CI = 1.1‐2.1). DM was not associated with transitions of rKOA. Conclusion Prevention of obesity and CVD may limit the development or worsening of rKOA and symptoms.