RT Journal Article SR Electronic T1 Diabetes Is an Independent Predictor for Severe Osteoarthritis JF Diabetes Care JO Diabetes Care FD American Diabetes Association SP DC_120924 DO 10.2337/dc12-0924 A1 Schett, Georg A1 Kleyer, Arndt A1 Perricone, Carlo A1 Sahinbegovic, Enijad A1 Iagnocco, Annamaria A1 Zwerina, Jochen A1 Lorenzini, Rolando A1 Aschenbrenner, Franz A1 Berenbaum, Francis A1 D’Agostino, Maria-Antonietta A1 Willeit, Johann A1 Kiechl, Stefan YR 2012 UL http://care.diabetesjournals.org/content/early/2012/10/02/dc12-0924.abstract AB 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.