Background Pathogenesis of osteoarthritis may have a strong metabolic component. Thus, alterations in glucose metabolism such as diabetes mellitus may be linked to the development of osteoarthritis.
Objectives To evaluate if diabetes mellitus is an independent risk factor for severe osteoarthritis.
Methods Population-based cohort study with a random sample of 927 men and women aged 40 to 80 years followed over 20 years (1990-2010) at the City of Bruneck/Northern Italy. Hazard ratios for arthroplasty were calculated in diabetic and non- diabetic subjects by using age, sex and body mass index-adjusted as well as multivariable models.
Results Rates of arthroplasty were 17.7 (9.4-30.2)/1000 person-years in diabetic and 5.3 (4.1-6.6)/1000 person-years in non-diabetic subjects (P<0.001). Diabetes was found as an independent predictor of arthroplasty: Hazard ratios (95%CI) for arthroplasty in patients with diabetes mellitus were 3.8 (2.1-6.8; P<0.001) in the unadjusted model and 2.1 (1.1-3.8; P=0.023) in the model adjusted for age, body mass index and other putative risk predictors for OA. Moreover, diabetic patients had more severe symptoms of OA (pain, function and total scores) and ultrasound signs of inflammation (effusion and synovitis; P<0.01 each).
Conclusions Diabetes mellitus predicts the development of severe OA. This association is independent of age and body mass index, which are the best- established risk factors for OA to date. Our findings strengthen the concept of a strong metabolic component in the pathogenesis of OA and suggest that effective management of OA needs to include the prevention and treatment of diabetes mellitus.
Disclosure of Interest None Declared
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