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Individuals with high bone mass have an increased prevalence of radiographic knee osteoarthritis

Individuals with high bone mass have an increased prevalence of radiographic knee osteoarthritis
Individuals with high bone mass have an increased prevalence of radiographic knee osteoarthritis
We previously reported an association between high bone mass (HBM) and a bone-forming phenotype of radiographic hip osteoarthritis (OA). As knee and hip OA have distinct risk factors, in this study we aimed to determine (i) whether HBM is also associated with knee OA, and (ii) whether the HBM knee OA phenotype demonstrates a similar pattern of radiographic features to that observed at the hip.

HBM cases (defined by DXA BMD Z-scores) from the UK-based HBM study were compared with unaffected family controls and general population controls from the Chingford and Hertfordshire cohort studies. A single blinded observer graded AP weight-bearing knee radiographs for features of OA (Kellgren–Lawrence score, osteophytes, joint space narrowing (JSN), sclerosis) using an atlas. Analyses used logistic regression, adjusting a priori for age and gender, and additionally for BMI as a potential mediator of the HBM–OA association, using Stata v12.

609 HBM knees in 311 cases (mean age 60.8 years, 74% female) and 1937 control knees in 991 controls (63.4 years, 81% female) were analysed. The prevalence of radiographic knee OA, defined as Kellgren–Lawrence grade ? 2, was increased in cases (31.5% vs. 20.9%), with age and gender adjusted OR [95% CI] 2.38 [1.81, 3.14], p < 0.001. The association between HBM and osteophytosis was stronger than that for JSN, both before and after adjustment for BMI which attenuated the ORs for knee OA and osteophytes in cases vs. controls by approximately 50%.

Our findings support a positive association between HBM and knee OA. This association was strongest for osteophytes, suggesting HBM confers a general predisposition to a subtype of OA characterised by increased bone formation.
osteoarthritis, dxa, bone mineral density, high bone mass
8756-3282
171-179
Hardcastle, S.A.
5d3e434f-9f5c-4044-8f6e-753fa8748cde
Dieppe, P.
293f54b1-2f1a-4dd1-ad56-88ab75dab64e
Gregson, C.L.
fc84c2dd-c427-486f-a212-3e3549cb5cdf
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Spector, T.D.
87d1f285-3f22-4c9a-b006-d65cfda6d3e0
Hart, D.J.
00e78191-ce14-4b5f-a720-9f1bb51b2b62
Edwards, M.H.
b81ff294-1d16-4a1b-af14-9374c5989d4c
Dennison, E.M.
ee647287-edb4-4392-8361-e59fd505b1d1
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Sayers, A.
c384c18c-29d4-4e10-9ff8-76eb9d7b78fd
Williams, M.
cb14ede8-6813-493f-870b-e0cc586f3b90
Davey Smith, G.
cb29a020-3ad3-4bcd-95dc-a1a43d4fe26f
Tobias, J.H.
de2ae2cb-8547-475a-98e0-9d5169b8deb7
Hardcastle, S.A.
5d3e434f-9f5c-4044-8f6e-753fa8748cde
Dieppe, P.
293f54b1-2f1a-4dd1-ad56-88ab75dab64e
Gregson, C.L.
fc84c2dd-c427-486f-a212-3e3549cb5cdf
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Spector, T.D.
87d1f285-3f22-4c9a-b006-d65cfda6d3e0
Hart, D.J.
00e78191-ce14-4b5f-a720-9f1bb51b2b62
Edwards, M.H.
b81ff294-1d16-4a1b-af14-9374c5989d4c
Dennison, E.M.
ee647287-edb4-4392-8361-e59fd505b1d1
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Sayers, A.
c384c18c-29d4-4e10-9ff8-76eb9d7b78fd
Williams, M.
cb14ede8-6813-493f-870b-e0cc586f3b90
Davey Smith, G.
cb29a020-3ad3-4bcd-95dc-a1a43d4fe26f
Tobias, J.H.
de2ae2cb-8547-475a-98e0-9d5169b8deb7

Hardcastle, S.A., Dieppe, P., Gregson, C.L., Arden, N.K., Spector, T.D., Hart, D.J., Edwards, M.H., Dennison, E.M., Cooper, C., Sayers, A., Williams, M., Davey Smith, G. and Tobias, J.H. (2015) Individuals with high bone mass have an increased prevalence of radiographic knee osteoarthritis. Bone, 71, 171-179. (doi:10.1016/j.bone.2014.10.015). (PMID:25445455)

Record type: Article

Abstract

We previously reported an association between high bone mass (HBM) and a bone-forming phenotype of radiographic hip osteoarthritis (OA). As knee and hip OA have distinct risk factors, in this study we aimed to determine (i) whether HBM is also associated with knee OA, and (ii) whether the HBM knee OA phenotype demonstrates a similar pattern of radiographic features to that observed at the hip.

HBM cases (defined by DXA BMD Z-scores) from the UK-based HBM study were compared with unaffected family controls and general population controls from the Chingford and Hertfordshire cohort studies. A single blinded observer graded AP weight-bearing knee radiographs for features of OA (Kellgren–Lawrence score, osteophytes, joint space narrowing (JSN), sclerosis) using an atlas. Analyses used logistic regression, adjusting a priori for age and gender, and additionally for BMI as a potential mediator of the HBM–OA association, using Stata v12.

609 HBM knees in 311 cases (mean age 60.8 years, 74% female) and 1937 control knees in 991 controls (63.4 years, 81% female) were analysed. The prevalence of radiographic knee OA, defined as Kellgren–Lawrence grade ? 2, was increased in cases (31.5% vs. 20.9%), with age and gender adjusted OR [95% CI] 2.38 [1.81, 3.14], p < 0.001. The association between HBM and osteophytosis was stronger than that for JSN, both before and after adjustment for BMI which attenuated the ORs for knee OA and osteophytes in cases vs. controls by approximately 50%.

Our findings support a positive association between HBM and knee OA. This association was strongest for osteophytes, suggesting HBM confers a general predisposition to a subtype of OA characterised by increased bone formation.

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More information

Accepted/In Press date: 23 October 2014
e-pub ahead of print date: 30 October 2014
Published date: February 2015
Keywords: osteoarthritis, dxa, bone mineral density, high bone mass
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 374166
URI: http://eprints.soton.ac.uk/id/eprint/374166
ISSN: 8756-3282
PURE UUID: c4c6204f-90f1-4234-8e79-408ee0b94136
ORCID for E.M. Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 09 Feb 2015 10:59
Last modified: 18 Mar 2024 02:45

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Contributors

Author: S.A. Hardcastle
Author: P. Dieppe
Author: C.L. Gregson
Author: N.K. Arden
Author: T.D. Spector
Author: D.J. Hart
Author: M.H. Edwards
Author: E.M. Dennison ORCID iD
Author: C. Cooper ORCID iD
Author: A. Sayers
Author: M. Williams
Author: G. Davey Smith
Author: J.H. Tobias

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