Risk factors associated with degenerative glenohumeral osteoarthritis
Ravi Prakash1, Rashmi Pathak1, Ziyi Chen2
1Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.
Objective:
Glenohumeral (GH) osteoarthritis (OA) is the third most common large joint disease, after hip and knee OA. This study aimed to identify risk factors for GH OA.
Methods:
We used data from the Dallas Shoulder cohort, including individuals aged 40-85. Those with confirmed GH OA based on X-ray were cases, and those without were controls. Univariate, least absolute shrinkage and selection operator and multivariate analyses identified risk factors, including age, body mass index (BMI), sex, work-related shoulder problems, shoulder disability, dislocation, previous trauma, surgery, smoking, hypertension, diabetes, depression, heart disease, OA, night pain and overall sleep quality.
Results:
A total of 1827 cases and 1556 controls were identified for GH OA. In univariate analysis, significant associations with GH OA were found for increasing age (>40 to ≤50: OR 3.29, 95% CI 2.44 to 4.45; >50 to ≤60: OR 5.90, 95% CI 4.49 to 7.77; >60 to ≤70: OR 12.18, 95% CI 9.22 to 16.08 and >70: OR 16.54, 95% CI 12.47 to 21.94), higher BMI (≤19: OR 1.44, 95% CI 1.01 to 2.04; >25 to ≤30: OR 1.57, 95% CI 1.32 to 1.86; >30 to ≤35: OR 1.85, 95% CI 1.54 to 2.22 and >35: OR 1.77, 95% CI 1.28 to 2.45), prior shoulder injury (OR 1.30; 95% CI 1.12 to 1.50), shoulder surgery history (OR 0.71; 95% CI 0.57 to 0.87), shoulder pain at night (OR 1.35; 95% CI 1.07 to 1.70) and hypertension (OR 0.70; 95% CI 0.60 to 0.81). In multivariate analysis, significant associations remained for age (>40 to ≤50: OR 2.99, 95% CI 2.21 to 4.06; >50 to ≤60: OR 5.48, 95% CI 4.14 to 7.23; >60 to ≤70: OR 11.22, 95% CI 8.44 to 14.88 and >70: OR 16.65, 95% CI 12.45 to 22.17), BMI (≤19: OR 1.49, 95% CI 1.01 to 2.20; >25 to ≤30: OR 1.45, 95% CI 1.20 to 1.77; >30 to ≤35: OR 1.70, 95% CI 1.39 to 2.09 and >35: OR 1.78, 95% CI 1.25 to 2.55) and previous shoulder trauma (OR 0.80; 95% CI 0.68 to 0.94).
Conclusion:
We identified increasing age and higher BMI as factors associated with GH OA. Due to the large sample size, many risk factors were assessed. Since the shoulder is not a weight-bearing joint, the BMI-GH OA link is likely molecular and systemic, warranting further investigation.
Level Of Evidence:
Prognostic level III.
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