Diabetes Linked With OA
Written by Editor   
Thursday, August 06, 2015 12:00 AM

Diabetes may be an independent contributor to osteoarthritis (OA), and vice versa, a literature review and meta-analysis has suggested.  This analysis demonstrates an association between diabetes and OA.

Among 5,788 patients with diabetes, the mean prevalence of OA was 29.5%, while among 645,089 patients with OA, the prevalence of diabetes was 14.4%  In addition, the risk of OA was increased among patients with diabetes compared with the nondiabetic population, and the risk of diabetes was elevated in the OA population , the researchers reported.

A classification system for OA has recently been proposed in which patients are categorized as having age-related, metabolic syndrome-related, and post-traumatic OA. 

In metabolic syndrome-related OA, the mechanical stress of excess weight can contribute to knee OA but does not explain the observed association between obesity and hand OA, so "some systemic factors may participate in the pathogenic process.”  Epidemiologic studies have confirmed an association between OA and the metabolic syndrome, but whether the individual components of the syndrome, such as hypertension, hyperlipidemia, or diabetes, contribute further or independently has not been determined and studies have had conflicting results.

Among the patients with diabetes, the prevalence of OA was 17% for the knee, 12% for the hip, and 38% for the hands. This strong association with hand OA "highlights the metabolic and systemic nature of hand OA," the authors noted.  Among the 12 studies that adjusted for BMI, seven found that diabetes was an independent risk factor for OA.  The risks for OA among diabetes patients were statistically significant for the knee and the hands.

This analysis demonstrates an association between diabetes and OA, but not causality, the authors cautioned.  Further studies will be needed to explore the possible roles of inflammatory mediators and oxidative stress on joint inflammation and of insulin resistance in the development of osteophytes. Whether diabetes also independently predicts the severity of OA also remains to be seen.  But if the findings of this analysis are confirmed, "new preventive and/or curative modalities based on glycemia control could be tested in OA,” the authors concluded.

Source:  http://www.medpagetoday.com/Rheumatology/Arthritis/52823