The Relationship Between Hip/Knee Osteoarthritis and Risk for Incident Diabetes

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Hip or knee osteoarthritis is a clinically relevant and potentially modifiable risk factor for the development of type 2 diabetes.
Hip or knee osteoarthritis is a clinically relevant and potentially modifiable risk factor for the development of type 2 diabetes.

According to a population-based cohort study published in Diabetologia, hip and knee osteoarthritis independently predict incident diabetes in people aged 55 years and older, partly because of walking limitation.

To determine the relationship between hip and knee osteoarthritis and incident diabetes, researchers followed 16,362 people (average age, 68 years) who were free of diabetes at baseline for a median of 13.5 years. Of all participants, 1637 (10%) had hip osteoarthritis, 2431 (15%) had knee osteoarthritis, and 3908 (24%) met the criteria for walking limitation, meaning they reported having difficulty standing or walking in the previous 3 months.

Of all participants, 3539 (22%) developed diabetes. An individual was more likely to develop diabetes if they were a man living in a low-income area, had higher body mass index, were hypertensive, and had comorbidities and symptomatic knee and hip osteoarthritis and walking limitation.

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After controlling for confounding factors such as income, primary care exposure, cardiovascular disease, and prior hypertension, the researchers found that bilateral hip or knee osteoarthritis was significantly associated with a 16% to 25% increased risk for incident diabetes. They also observed a significant relationship between number of hip/knee joints with osteoarthritis and incident diabetes. The hazard ratio for 2 vs no osteoarthritic hips was 1.25 (P <.01), and the hazard ratio for 2 vs no osteoarthritic knees was 1.16 (P <.01).

Furthermore, it was concluded that about 37% of the effect of bilateral hip osteoarthritis and about 46% of the effect of bilateral knee osteoarthritis was mediated by walking limitation.

Several study limitations were reported, including that certain confounders could not be measured because of the observational nature of this study.

In summarizing their findings, the researchers wrote, "Increased attention to management of hip and knee osteoarthritis with a view to improving mobility has the potential to reduce risk of incident diabetes."

Reference

Kendzerska T, King LK, Lipscombe L, Croxford R, Stanaitis I, Hawker GA. The impact of hip and knee osteoarthritis on the subsequent risk of incident diabetes: a population-based cohort study [published online August 8, 2018]. Diabetologia. doi: 10.1007/s00125-018-4703-2

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