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Original Research

Diabetes Is an Independent Predictor for Severe Osteoarthritis

Results from a longitudinal cohort study

  1. Georg Schett, MD1⇓,
  2. Arndt Kleyer, MD1,
  3. Carlo Perricone, MD2,
  4. Enijad Sahinbegovic, MD1,
  5. Annamaria Iagnocco, MD2,
  6. Jochen Zwerina, MD1,
  7. Rolando Lorenzini, MD3,4,
  8. Franz Aschenbrenner, MD3,4,
  9. Francis Berenbaum, MD5,
  10. Maria-Antonietta D’Agostino, MD6,
  11. Johann Willeit, MD7 and
  12. Stefan Kiechl, MD7⇓
  1. 1Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
  2. 2Department of Rheumatology, Sapienza University of Rome, Rome, Italy
  3. 3Department of Radiology, Bruneck Hospital, Bruneck, Italy
  4. 4Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy
  5. 5Department of Rheumatology, Assistance Publique–Hôpitaux de Paris Saint-Antoine and Pierre and Marie Curie University, Paris, France
  6. 6Department of Rheumatology, Universite Paris Ouest-Versailles-Saint Quentin en Yvelines, Paris, France
  7. 7Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
  1. 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
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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.
  • © 2013 by the American Diabetes Association.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

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Diabetes Care: 44 (4)

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Diabetes Is an Independent Predictor for Severe Osteoarthritis
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
Diabetes Care Feb 2013, 36 (2) 403-409; DOI: 10.2337/dc12-0924

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Diabetes Is an Independent Predictor for Severe Osteoarthritis
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
Diabetes Care Feb 2013, 36 (2) 403-409; DOI: 10.2337/dc12-0924
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