Diabetes Is an Independent Predictor for Severe Osteoarthritis: Results from a longitudinal cohort study

Georg Schett; Arndt Kleyer; Carlo Perricone; Enijad Sahinbegovic; Annamaria Iagnocco; Jochen Zwerina; Rolando Lorenzini; Franz Aschenbrenner; Francis Berenbaum; Maria-Antonietta D’Agostino; Johann Willeit; Stefan Kiechl

doi:10.2337/dc12-0924

Original Research

Diabetes Is an Independent Predictor for Severe Osteoarthritis

Results from a longitudinal cohort study

Georg Schett, MD¹ ⇓,
Arndt Kleyer, MD¹,
Carlo Perricone, MD²,
Enijad Sahinbegovic, MD¹,
Annamaria Iagnocco, MD²,
Jochen Zwerina, MD¹,
Rolando Lorenzini, MD³,⁴,
Franz Aschenbrenner, MD³,⁴,
Francis Berenbaum, MD⁵,
Maria-Antonietta D’Agostino, MD⁶,
Johann Willeit, MD⁷ and
Stefan Kiechl, MD⁷ ⇓

¹Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
²Department of Rheumatology, Sapienza University of Rome, Rome, Italy
³Department of Radiology, Bruneck Hospital, Bruneck, Italy
⁴Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy
⁵Department of Rheumatology, Assistance Publique–Hôpitaux de Paris Saint-Antoine and Pierre and Marie Curie University, Paris, France
⁶Department of Rheumatology, Universite Paris Ouest-Versailles-Saint Quentin en Yvelines, Paris, France
⁷Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

Corresponding authors: Georg Schett, georg.schett{at}uk-erlangen.de, and Stefan Kiechl, stefan.kiechl{at}i-med.ac.at.

Diabetes Care 2013 Feb; 36(2): 403-409. https://doi.org/10.2337/dc12-0924

Abstract

OBJECTIVE To evaluate if type 2 diabetes is an independent risk predictor for severe osteoarthritis (OA).

RESEARCH DESIGN AND METHODS Population-based cohort study with an age- and sex-stratified random sample of 927 men and women aged 40–80 years and followed over 20 years (1990–2010).

RESULTS Rates of arthroplasty (95% CI) were 17.7 (9.4–30.2) per 1,000 person-years in patients with type 2 diabetes and 5.3 (4.1–6.6) per 1,000 person-years in those without (P < 0.001). Type 2 diabetes emerged as an independent risk predictor for arthroplasty: hazard ratios (95% CI), 3.8 (2.1–6.8) (P < 0.001) in an unadjusted analysis and 2.1 (1.1–3.8) (P = 0.023) after adjustment for age, BMI, and other risk factors for OA. The probability of arthroplasty increased with disease duration of type 2 diabetes and applied to men and women, as well as subgroups according to age and BMI. Our findings were corroborated in cross-sectional evaluation by more severe clinical symptoms of OA and structural joint changes in subjects with type 2 diabetes compared with those without type 2 diabetes.

CONCLUSIONS Type 2 diabetes predicts the development of severe OA independent of age and BMI. Our findings strengthen the concept of a strong metabolic component in the pathogenesis of OA.

Received May 12, 2012.
Accepted July 24, 2012.

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