Diabetes is a risk factor for knee osteoarthritis progression

Area of Science:

• Orthopedics
• Metabolic Health
• Radiology

Background:

• Metabolic factors like obesity, diabetes, hypertension, and dyslipidemia are increasingly implicated in osteoarthritis (OA) pathophysiology.
• Metabolic syndrome (MetS), a cluster of these factors, may exacerbate OA.
• Understanding these links is crucial for managing knee OA progression.

Purpose of the Study:

• To investigate the impact of metabolic factors and MetS on radiographic progression in knee osteoarthritis.
• To assess the annualised rate of joint space narrowing (JSN) in the medial tibiofemoral compartment.

Main Methods:

• 559 patients over 50 with symptomatic knee OA were analyzed from the SEKOIA trial (placebo arm).
• Diabetes, hypertension, dyslipidemia, and obesity (BMI >30 kg/m²) were assessed at baseline.
• MetS was defined by ≥3 metabolic factors. Radiographic JSN was measured annually for up to 3 years.

Main Results:

• Mean annualised JSN was significantly greater in patients with type 2 diabetes compared to those without (0.26 vs. 0.14 mm; P=0.001).
• This association persisted after adjusting for confounding factors (P=0.018).
• Type 2 diabetes predicted JSN in males but not females; MetS and other factors showed no association with JSN.

Conclusions:

• Type 2 diabetes is a significant predictor of joint space reduction in men with established knee OA.
• Metabolic syndrome and other individual metabolic factors were not associated with radiographic knee OA progression in this cohort.