O13. Impact of Components of the Metabolic Syndrome on Progression of Knee Osteoarthritis in the Sekoia Study

Abstract

Objective: Recent studies have suggested that components of the metabolic syndrome might be involved in the pathophysiology of osteoarthritis (OA). However, their impact on joint space narrowing in patients with established OA is unknown. We investigated the impact of each component of the metabolic syndrome on knee joint space narrowing. Material and Methods: 559 men and women aged over 50 years with clinical knee OA (K&L 2-3) were recruited to the placebo arm of the SEKOIA study (98 centres; 18 countries). The presence or absence of type 2 diabetes, hypertension, and hyperlipidaemia was determined at baseline interview. Height and weight were measured and BMI calculated. Minimal tibiofemoral joint space on plain radiographs of the knee was assessed by two independent readers at baseline and then yearly for up to 3 years. Results: The mean(SD) age of participants was 62.8(7.5) years. A total of 43.8 % had a BMI>30, 6.6 % had type 2 diabetes, 45.1 % hypertension and 27.6 % hyperlipidaemia. Those with type 2 diabetes had significantly faster rates of joint space loss over the duration of the study than those without (0.26 and 0.14 mm/year, respectively; p=0.01). This relationship also held true for an annualised assessment of joint space narrowing. No evidence of an association was found between the remaining components of the metabolic syndrome (obesity, hypertension and hyperlipidaemia) and the rate joint space narrowing. The relationship between type 2 diabetes and joint space loss remained statistically significant after adjustment forBMI. When sexes were examined separately, type 2 diabetes was a significant predictor of joint space loss in men but not women. Conclusion: Type 2 diabetes was a predictor of the rate of joint space narrowing in individuals with established knee OA. No such relationships were found for obesity, hypertension, and hyperlipidaemia. Further studies are required to replicate these findings and to explore a biological explanation.