Exploring the relationship between allostatic load and osteoarthritis: A cross-sectional analysis from the North West...

Cumulative stress-response system dysregulation, known as allostatic load (AL), is suggested as a possible mechanism that may connect upstream health determinants with OA. Our objective was to evaluate the cross-sectional association between AL and the presence of OA.

This cross-sectional study used Stage Two (2004-2006) data from the North West Adelaide Health Study (NWAHS), a population-based cohort study. Osteoarthritis and joint pain were defined using self-report and medication data. Allostatic load was a composite index of nine equally-weighted biomarkers; systolic and diastolic blood pressures, waist-hip ratio, body mass index, total cholesterol, high-density lipoprotein, glycated haemoglobin, interleukin 6 and tumour necrosis factor alpha. Binary logistic regression models estimated the association between AL and OA, with adjustment for demographic, health behaviour and comorbidity covariates.

Overall, 1600 participants were eligible for inclusion in the analysis. The OA group (n ​= ​459) and the group without arthritis (n ​= ​1151) had mean AL scores of 3.96 (SD 2.3) and 2.68 (SD 2.0), respectively. In adjusted analyses, each one-unit increase in AL was associated with a 12 ​% increased odds of OA presence (OR ​= ​1.12, 95 ​% CI 1.04, 1.19, P ​= ​0.002). There was a similar 11 ​% increase in odds of the presence of self-reported joint pain for every one-unit increase in AL score (OR ​= ​1.11, 95 ​% CI 1.04, 1.18, P ​= ​0.001).

There is a cross-sectional association between AL and the presence of OA and self-reported joint pain. Further investigations are warranted using longitudinal data.