Diabetes Not Associated with Knee OA Risk

A recent study found no association between diabetes mellitus (DM) and higher levels of biomarkers of abnormal glucose metabolism and incident radiographic knee osteoarthritis (RKOA). 

Researchers evaluated 987 patients (mean age, 60.6 years; mean body mass index [BMI], 29.1 kg/m2) from the Multicenter Osteoarthritis Study (MOST) who did not have RKOA at baseline; 9.5% of patients had diabetes at baseline. They measured serum fasting glucose and insulin resistance (homeostasis model of assessment [HOMA‐IR]) at baseline. DM status was self-reported or determined by use of medication or fasting glucose >126 mg/dL. Follow-ups were conducted at 30, 60, and 84 months, at which time patients were assessed for incident RKOA. At final follow-up, knee OA cumulative incidence was 23.3%. 

In unadjusted analyses, researchers observed associations between fasting glucose (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.02-1.28, P=0.021) and HOMA-IR (OR 1.13, 95% CI 1.01-1.27, P=0.033) and knee OA. When adjusting for sex, age, race, and clinic site location—but not BMI—these associations were still seen (fasting glucose OR 1.14, 95% CI 1.01-1.27, P=0.031; HOMA-IR OR 1.13, 95% CI 1-1.27, P=0.042). 

When adjusting for BMI, however, researchers found no correlation between incident RKOA and baseline DM, or levels of fasting glucose and HOMA-IR, overall and for male patients. When analyzing female patients, there was an inverse association between HOMA-IR and incident RKOA (adjusted OR 0.80, 95% CI 0.69‐0.94; p=0.005). 

“Contrary to our hypothesis, after adjustment for BMI (a strong risk factor for both diabetes mellitus and knee OA) we did not find increased odds of incident radiographic knee OA in participants with diabetes mellitus nor in participants with higher baseline levels of fasting glucose and HOMA-IR,” the researchers wrote. 

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Sources: Arthritis Care & Research, MedPage Today