Clinical Comorbidity Phenotype in Knee Osteoarthritis Is Associated With Higher Intensity Scores
-
Aicha Ben Tekaya
,
Ons Hamdi
,
Leila Rouached
,
Mehdi Bellil
,
Afef Slimi
,
Selma Bouden
,
Olfa Saidane
,
Rawdha Tekaya
,
Ines Mahmoud
,
Leila Abdelmoula
Abstract
Knee osteoarthritis (OA) is a common osteoarticular disease. Its prevalence increases with age, as well as the coexistence of other chronic diseases. Recent research has revealed an association between OA and cardiovascular diseases. However, the association between knee OA and comorbidities has not been fully studied. Therefore, the purpose of this study was to investigate the association between knee OA and comorbidities. In this cross-sectional study, patients with knee OA were enrolled. Sociodemographic data, as well as comorbidities, were collected. Grading of knee OA was performed using the Kellgren-Lawrence (KL) grading system. The functional impact of knee OA was assessed by KOOS-Physical Function Shortform (KOOS-PS). This study assessed 104 patients with knee OA (10 men and 94 women). The mean age was 65.83±11.08 years. Mean VAS pain was 6.56±1.72. Mean KOOS-PS was 15.58±6.73. Up to 81 patients (77.9%) had severe knee OA, according to the KL grading system. Comorbidity was noted in 92 cases (88%). The most frequent comorbidities were obesity (62.5%), hypertension (61.5%), and dyslipidemia (43.3%). Comorbidities in knee OA were associated with age (P=0.04), axial deviation in the sagittal plane (P=0.01), neuropathic pain component (P=0.02), and VAS pain (P=0.04). Our study also showed a significant correlation between comorbidities and structural grading of knee OA (P=0.04). However, comorbidities were not correlated with the KOOS-PS score (P=0.06). The accumulation of comorbidities is significantly associated with higher intensity scores in knee OA. Physicians should additionally pay close attention to the prevention and treatment of comorbidities in the routine management of OA.
1. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2197-223.
2. Dell’Isola A, Allan R, Smith SL, Marreiros SSP, Steultjens M. Identification of clinical phenotypes in knee osteoarthritis: a systematic review of the literature. BMC Musculoskelet Disord 2016;17:425.
3. Karsdal MA, Bihlet A, Byrjalsen I, Alexandersen P, Ladel C, Michaels M, et al. OA phenotypes, rather than disease stage, drive structural progression – identification of structural progressors from 2 phase III randomized clinical studies with symptomatic knee OA. Osteoarthritis Cartilage 2015;23:550-8.
4. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2163-96.
5. Hall AJ, Stubbs B, Mamas MA, Myint PK, Smith TO. Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis. Eur J Prev Cardiolog 2016;23:938-46.
6. Kerkhof HJM, Lories RJ, Meulenbelt I, Jonsdottir I, Valdes AM, Arp P, et al. A genome-wide association study identifies an osteoarthritis susceptibility locus on chromosome 7q22. Arthritis Rheum 2010;62:499-510.
7. Hochberg MC, Lethbridge-Cejku M, Tobin JD. Bone mineral density and osteoarthritis: data from the Baltimore Longitudinal Study of Aging. Osteoarthritis Cartilage 2004;12:S45-8.
8. Iannone F, Lapadula G. Obesity and inflammation--targets for OA therapy. Curr Drug Targets 2010;11:586-98.
9. Stubbs B, Hurley M, Smith T. What are the factors that influence physical activity participation in adults with knee and hip osteoarthritis? A systematic review of physical activity correlates. Clin Rehabil 2015;29:80-94.
10. Stubbs B, Aluko Y, Myint PK, Smith TO. Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis. Age Ageing 2016;45:228-35.
11. Williams MF, London DA, Husni EM, Navaneethan S, Kashyap SR. Type 2 diabetes and osteoarthritis: a systematic review and meta-analysis. J Diabetes Complications 2016;30:944-50.
12. Veronese N, Stubbs B, Solmi M, Smith TO, Noale M, Schofield P, et al. Knee osteoarthritis and risk of hypertension: A longitudinal cohort Ssudy. Rejuvenation Res 2018;21:15-21.
13. Niu J, Clancy M, Aliabadi P, Vasan R, Felson DT. The metabolic syndrome, its components and knee osteoarthritis (OA): The Framingham OA study. Arthritis Rheumatol 2017;69:1194-203.
14. Lee B, Yang S, Kwon S, Choi K, Kim W. Association between metabolic syndrome and knee osteoarthritis: A cross-sectional Nationwide survey study. J Rehabil Med 2019;51:464-70.
15. Omorou AY, Achit H, Wieczorek M, Pouchot J, Fautrel B, Rat AC, et al. Impact of comorbidities and functional impairment on 5-year loss of health utility in patients with lower-limb osteoarthritis in the KHOALA cohort. Qual Life Res 2019;28:3047-54.
16. Le Clanche S, Bonnefont-Rousselot D, Sari-Ali E, Rannou F, Borderie D. Inter-relations between osteoarthritis and metabolic syndrome: A common link? Biochimie 2016;121:238-52.
17. Kluzek S, Newton JL, Arden NK. Is osteoarthritis a metabolic disorder? Br Med Bull 2015;115:111-21.
18. Han CD, Yang IH, Lee WS, Park YJ, Park KK. Correlation between metabolic syndrome and knee osteoarthritis: data from the Korean National Health and Nutrition Examination Survey (KNHANES). BMC Public Health 2013;13:603.
19. Gurkirpal S, Jeffery M, Fleur H, Dan Pettitt D, Mason WR. Prevalence of Cardiovascular Disease Risk Factors Among US Adults With Self-Reported Osteoarthritis: Data from the Third National Health and Nutrition Examination Survey. Am J Manag Care 2002;8:383-91.
20. Visser AW, Ioan-Facsinay A, de Mutsert R, Widya RL, Loef M, de Roos A, et al. Adiposity and hand osteoarthritis: The Netherlands Epidemiology of Obesity study. Arthritis Res Ther 2014;16:R19.
21. Frey N, Hügle T, Jick SS, Meier CR, Spoendlin J. Type II diabetes mellitus and incident osteoarthritis of the hand: a population-based case-control analysis. Osteoarthritis Cartilage 2016;24:1535-40.
22. Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, et al. EULAR Evidence-Based Recommendations for the Diagnosis of Knee Osteoarthritis. Ann Rheum Dis 2010;69:483-9.
23. Kohn MD, Sassoon AA, Fernando ND. Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clin Orthop Relat Res 2016;474:1886-93.
24. Chatila N, Pereira B, Maarrawi J, Dallel R. Validation of a new arabic version of the neuropathic pain diagnostic questionnaire (DN4). Pain Pract 2017;17:78-87.
25. Perruccio AV, Stefan Lohmander L, Canizares M, Tennant A, Hawker GA, Conaghan PG, et al. The development of a short measure of physical function for knee OA KOOS-Physical Function Shortform (KOOS-PS) – an OARSI/OMERACT initiative. Osteoarthritis Cartilage 2008;16:542-50.
26. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra MA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019;27:1578-89.
27. Calders P, Van Ginckel A. Presence of comorbidities and prognosis of clinical symptoms in knee and/or hip osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2018;47:805-13.
28. Kovari E, Kaposi A, Bekes G, Kiss Z, Kurucz R, Mandl P, et al. Comorbidity clusters in generalized osteoarthritis among female patients: A cross-sectional study. Semin Arthritis Rheum 2020;50:183-91.
29. Kim WB, Kim BR, Kim SR, Han EY, Nam KW, Lee SY, et al. Comorbidities in patients with end-stage knee OA: prevalence and fffect on physical function. Arch Phys Med Rehabil 2019;100:2063-70.
30. Breedveld FC. Osteoarthritis - the impact of a serious disease. Rheumatology (Oxford) 2004;43:i4-8.
31. Marshall DA, Liu X, Barnabe C, Yee K, Faris PD, Barber C, et al. Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada. BMJ Open 2019;9:e033334.
32. Ettinger WH, Fried LP, Harris T, Shemanski L, Schulz R, Robbins J, et al. Self-reported causes of physical disability in older people: The cardiovascular health study. J Am Geriatr Soc 1994;42:1035-44.
33. Engström G, Verdier MG de, Rollof J, Nilsson PM, Lohmander LS. C-reactive protein, metabolic syndrome and incidence of severe hip and knee osteoarthritis. A population-based cohort study. Osteoarthritis Cartilage 2009;17:168-73.
34. Yoshimura N, Muraki S, Oka H, Kawaguchi H, Nakamura K, Akune T. Association of knee osteoarthritis with the accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance in japanese men and women: The ROAD Study. J Rheumatol 2011;38:921-30.
35. Louati K, Vidal C, Berenbaum F, Sellam J. Association between diabetes mellitus and osteoarthritis: systematic literature review and meta-analysis. RMD Open 2015;1:e000077.
36. Eymard F, Parsons C, Edwards MH, Petit-Dop F, Reginster J-Y, Bruyère O, et al. Diabetes is a risk factor for knee osteoarthritis progression. Osteoarthritis Cartilage 2015;23:851-9.
37. Berenbaum F. Diabetes-induced osteoarthritis: from a new paradigm to a new phenotype. Ann Rheum Dis 2011;70:1354-6.
38. Sinclair AJ, Abdelhafiz AH, Rodríguez-Mañas L. Frailty and sarcopenia - newly emerging and high impact complications of diabetes. J Diabetes Complications 2017;31:1465-73.
39. Eitner A, Pester J, Vogel F, Marintschev I, Lehmann T, Hofmann GO, et al. Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus. Pain 2017;158:1743-53.
40. Rosa SC, Gonçalves J, Judas F, Mobasheri A, Lopes C, Mendes AF. Impaired glucose transporter-1 degradation and increased glucose transport and oxidative stress in response to high glucose in chondrocytes from osteoarthritic versus normal human cartilage. Arthritis Res Ther 2009;11:R80.
41. Athanasiou KA, Fleischli JG, Bosma J, Laughlin TJ, Zhu CF, Agrawal CM, et al. Effects of diabetes mellitus on the biomechanical properties of human ankle cartilage. Clin Orthop Relat Res 1999; 368:182-9.
42. Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, et al. Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidaemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: a 3-year follow-up of the ROAD study. Osteoarthritis Cartilage 2012;20:1217-26.
43. Zhang Y, Wang J, Liu X. Association between hypertension and risk of knee osteoarthritis. Medicine (Baltimore) 2017;96:e7584.
44. Howard RG, Samuels J, Gyftopoulos S, Krasnokutsky S, Leung J, Swearingen CJ, et al. Presence of gout is associated with increased prevalence and severity of knee osteoarthritis. J Clin Rheumatol 2015;21:63-71.
45. Bevis M, Marshall M, Rathod T, Roddy E. The association between gout and radiographic hand, knee and foot osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2016;17:169.
46. Hart DJ, Doyle DV, Spector TD. Association between metabolic factors and knee osteoarthritis in women: The Chingford Study. J Rheumatol 1995;22:1118-23.
47. Al-Arfaj AS. Radiographic osteoarthritis and serum cholesterol. Saudi Med J 2003;24:745-7.
48. Courties A, Gualillo O, Berenbaum F, Sellam J. Metabolic stress-induced joint inflammation and osteoarthritis. Osteoarthritis Cartilage 2015;23:1955-65.
49. Reijman M, Pols HAP, Bergink AP, Hazes JMW, Belo JN, Lievense AM, et al. Body mass index associated with onset and progression of osteoarthritis of the knee but not of the hip: The Rotterdam Study. Ann Rheum Dis 2007;66:158-62.
50. Yusuf E, Bijsterbosch J, Slagboom PE, Rosendaal FR, Huizinga TWJ, Kloppenburg M. Body mass index and alignment and their interaction as risk factors for progression of knees with radiographic signs of osteoarthritis. Osteoarthritis Cartilage 2011;19:1117-22.
51. Brouwer GM, Tol AWV, Bergink AP, Belo JN, Bernsen RMD, Reijman M, et al. Association between valgus and varus alignment and the development and progression of radiographic osteoarthritis of the knee. Arthritis Rheum 2007;56:1204-11.
52. Felson DT, Goggins J, Niu J, Zhang Y, Hunter DJ. The effect of body weight on progression of knee osteoarthritis is dependent on alignment. Arthritis Rheum 2004;50:3904-9.
53. Larsen P, Engberg AS, Motahar I, Ostgaard SE, Elsoe R. Obesity Influences the Knee Injury and Osteoarthritis Outcome Score. Joints 2019;7:008-12.
54. Kadam U, Jordan K, Croft P. Clinical comorbidity in patients with osteoarthritis: a case-control study of general practice consulters in England and Wales. Ann Rheum Dis 2004;63:408-14.
55. Karasik D, Kiel DP, Kiely DK, Cupples LA, Wilson PWF, O’Donnell CJ, et al. Abdominal aortic calcification and exostoses at the hand and lumbar spine: The Framingham Study. Calcif Tissue Int 2006;78:1-8.
56. Lee MY, Kim WJ, Kang YJ, Jung YM, Kang YM, Suk K, et al. Z39Ig is expressed on macrophages and may mediate inflammatory reactions in arthritis and atherosclerosis. J Leukoc Biol 2006;80:922-8.
57. Kim HS, Shin JS, Lee J, Lee YJ, Kim M, Bae YH, et al. Association between knee osteoarthritis, cardiovascular risk factors, and the Framingham risk score in south koreans: A cross-sectional study. PLoS One 2016;11:e0165325.
58. Rathbun AM, Stuart EA, Shardell M, Yau MS, Baumgarten M, Hochberg MC. Dynamic effects of depressive symptoms on osteoarthritis knee pain. Arthritis Care Res (Hoboken) 2018;70:80-8.
59. Zambon S, Siviero P, Denkinger M, Limongi F, Castell MV, Pas S van der, et al. Role of Osteoarthritis, comorbidity, and pain in determining functional limitations in older populations: European project on osteoarthritis. Arthritis Care Res (Hoboken) 2016;68:801-10.
2. Dell’Isola A, Allan R, Smith SL, Marreiros SSP, Steultjens M. Identification of clinical phenotypes in knee osteoarthritis: a systematic review of the literature. BMC Musculoskelet Disord 2016;17:425.
3. Karsdal MA, Bihlet A, Byrjalsen I, Alexandersen P, Ladel C, Michaels M, et al. OA phenotypes, rather than disease stage, drive structural progression – identification of structural progressors from 2 phase III randomized clinical studies with symptomatic knee OA. Osteoarthritis Cartilage 2015;23:550-8.
4. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2163-96.
5. Hall AJ, Stubbs B, Mamas MA, Myint PK, Smith TO. Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis. Eur J Prev Cardiolog 2016;23:938-46.
6. Kerkhof HJM, Lories RJ, Meulenbelt I, Jonsdottir I, Valdes AM, Arp P, et al. A genome-wide association study identifies an osteoarthritis susceptibility locus on chromosome 7q22. Arthritis Rheum 2010;62:499-510.
7. Hochberg MC, Lethbridge-Cejku M, Tobin JD. Bone mineral density and osteoarthritis: data from the Baltimore Longitudinal Study of Aging. Osteoarthritis Cartilage 2004;12:S45-8.
8. Iannone F, Lapadula G. Obesity and inflammation--targets for OA therapy. Curr Drug Targets 2010;11:586-98.
9. Stubbs B, Hurley M, Smith T. What are the factors that influence physical activity participation in adults with knee and hip osteoarthritis? A systematic review of physical activity correlates. Clin Rehabil 2015;29:80-94.
10. Stubbs B, Aluko Y, Myint PK, Smith TO. Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis. Age Ageing 2016;45:228-35.
11. Williams MF, London DA, Husni EM, Navaneethan S, Kashyap SR. Type 2 diabetes and osteoarthritis: a systematic review and meta-analysis. J Diabetes Complications 2016;30:944-50.
12. Veronese N, Stubbs B, Solmi M, Smith TO, Noale M, Schofield P, et al. Knee osteoarthritis and risk of hypertension: A longitudinal cohort Ssudy. Rejuvenation Res 2018;21:15-21.
13. Niu J, Clancy M, Aliabadi P, Vasan R, Felson DT. The metabolic syndrome, its components and knee osteoarthritis (OA): The Framingham OA study. Arthritis Rheumatol 2017;69:1194-203.
14. Lee B, Yang S, Kwon S, Choi K, Kim W. Association between metabolic syndrome and knee osteoarthritis: A cross-sectional Nationwide survey study. J Rehabil Med 2019;51:464-70.
15. Omorou AY, Achit H, Wieczorek M, Pouchot J, Fautrel B, Rat AC, et al. Impact of comorbidities and functional impairment on 5-year loss of health utility in patients with lower-limb osteoarthritis in the KHOALA cohort. Qual Life Res 2019;28:3047-54.
16. Le Clanche S, Bonnefont-Rousselot D, Sari-Ali E, Rannou F, Borderie D. Inter-relations between osteoarthritis and metabolic syndrome: A common link? Biochimie 2016;121:238-52.
17. Kluzek S, Newton JL, Arden NK. Is osteoarthritis a metabolic disorder? Br Med Bull 2015;115:111-21.
18. Han CD, Yang IH, Lee WS, Park YJ, Park KK. Correlation between metabolic syndrome and knee osteoarthritis: data from the Korean National Health and Nutrition Examination Survey (KNHANES). BMC Public Health 2013;13:603.
19. Gurkirpal S, Jeffery M, Fleur H, Dan Pettitt D, Mason WR. Prevalence of Cardiovascular Disease Risk Factors Among US Adults With Self-Reported Osteoarthritis: Data from the Third National Health and Nutrition Examination Survey. Am J Manag Care 2002;8:383-91.
20. Visser AW, Ioan-Facsinay A, de Mutsert R, Widya RL, Loef M, de Roos A, et al. Adiposity and hand osteoarthritis: The Netherlands Epidemiology of Obesity study. Arthritis Res Ther 2014;16:R19.
21. Frey N, Hügle T, Jick SS, Meier CR, Spoendlin J. Type II diabetes mellitus and incident osteoarthritis of the hand: a population-based case-control analysis. Osteoarthritis Cartilage 2016;24:1535-40.
22. Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, et al. EULAR Evidence-Based Recommendations for the Diagnosis of Knee Osteoarthritis. Ann Rheum Dis 2010;69:483-9.
23. Kohn MD, Sassoon AA, Fernando ND. Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clin Orthop Relat Res 2016;474:1886-93.
24. Chatila N, Pereira B, Maarrawi J, Dallel R. Validation of a new arabic version of the neuropathic pain diagnostic questionnaire (DN4). Pain Pract 2017;17:78-87.
25. Perruccio AV, Stefan Lohmander L, Canizares M, Tennant A, Hawker GA, Conaghan PG, et al. The development of a short measure of physical function for knee OA KOOS-Physical Function Shortform (KOOS-PS) – an OARSI/OMERACT initiative. Osteoarthritis Cartilage 2008;16:542-50.
26. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra MA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019;27:1578-89.
27. Calders P, Van Ginckel A. Presence of comorbidities and prognosis of clinical symptoms in knee and/or hip osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2018;47:805-13.
28. Kovari E, Kaposi A, Bekes G, Kiss Z, Kurucz R, Mandl P, et al. Comorbidity clusters in generalized osteoarthritis among female patients: A cross-sectional study. Semin Arthritis Rheum 2020;50:183-91.
29. Kim WB, Kim BR, Kim SR, Han EY, Nam KW, Lee SY, et al. Comorbidities in patients with end-stage knee OA: prevalence and fffect on physical function. Arch Phys Med Rehabil 2019;100:2063-70.
30. Breedveld FC. Osteoarthritis - the impact of a serious disease. Rheumatology (Oxford) 2004;43:i4-8.
31. Marshall DA, Liu X, Barnabe C, Yee K, Faris PD, Barber C, et al. Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada. BMJ Open 2019;9:e033334.
32. Ettinger WH, Fried LP, Harris T, Shemanski L, Schulz R, Robbins J, et al. Self-reported causes of physical disability in older people: The cardiovascular health study. J Am Geriatr Soc 1994;42:1035-44.
33. Engström G, Verdier MG de, Rollof J, Nilsson PM, Lohmander LS. C-reactive protein, metabolic syndrome and incidence of severe hip and knee osteoarthritis. A population-based cohort study. Osteoarthritis Cartilage 2009;17:168-73.
34. Yoshimura N, Muraki S, Oka H, Kawaguchi H, Nakamura K, Akune T. Association of knee osteoarthritis with the accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance in japanese men and women: The ROAD Study. J Rheumatol 2011;38:921-30.
35. Louati K, Vidal C, Berenbaum F, Sellam J. Association between diabetes mellitus and osteoarthritis: systematic literature review and meta-analysis. RMD Open 2015;1:e000077.
36. Eymard F, Parsons C, Edwards MH, Petit-Dop F, Reginster J-Y, Bruyère O, et al. Diabetes is a risk factor for knee osteoarthritis progression. Osteoarthritis Cartilage 2015;23:851-9.
37. Berenbaum F. Diabetes-induced osteoarthritis: from a new paradigm to a new phenotype. Ann Rheum Dis 2011;70:1354-6.
38. Sinclair AJ, Abdelhafiz AH, Rodríguez-Mañas L. Frailty and sarcopenia - newly emerging and high impact complications of diabetes. J Diabetes Complications 2017;31:1465-73.
39. Eitner A, Pester J, Vogel F, Marintschev I, Lehmann T, Hofmann GO, et al. Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus. Pain 2017;158:1743-53.
40. Rosa SC, Gonçalves J, Judas F, Mobasheri A, Lopes C, Mendes AF. Impaired glucose transporter-1 degradation and increased glucose transport and oxidative stress in response to high glucose in chondrocytes from osteoarthritic versus normal human cartilage. Arthritis Res Ther 2009;11:R80.
41. Athanasiou KA, Fleischli JG, Bosma J, Laughlin TJ, Zhu CF, Agrawal CM, et al. Effects of diabetes mellitus on the biomechanical properties of human ankle cartilage. Clin Orthop Relat Res 1999; 368:182-9.
42. Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, et al. Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidaemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: a 3-year follow-up of the ROAD study. Osteoarthritis Cartilage 2012;20:1217-26.
43. Zhang Y, Wang J, Liu X. Association between hypertension and risk of knee osteoarthritis. Medicine (Baltimore) 2017;96:e7584.
44. Howard RG, Samuels J, Gyftopoulos S, Krasnokutsky S, Leung J, Swearingen CJ, et al. Presence of gout is associated with increased prevalence and severity of knee osteoarthritis. J Clin Rheumatol 2015;21:63-71.
45. Bevis M, Marshall M, Rathod T, Roddy E. The association between gout and radiographic hand, knee and foot osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2016;17:169.
46. Hart DJ, Doyle DV, Spector TD. Association between metabolic factors and knee osteoarthritis in women: The Chingford Study. J Rheumatol 1995;22:1118-23.
47. Al-Arfaj AS. Radiographic osteoarthritis and serum cholesterol. Saudi Med J 2003;24:745-7.
48. Courties A, Gualillo O, Berenbaum F, Sellam J. Metabolic stress-induced joint inflammation and osteoarthritis. Osteoarthritis Cartilage 2015;23:1955-65.
49. Reijman M, Pols HAP, Bergink AP, Hazes JMW, Belo JN, Lievense AM, et al. Body mass index associated with onset and progression of osteoarthritis of the knee but not of the hip: The Rotterdam Study. Ann Rheum Dis 2007;66:158-62.
50. Yusuf E, Bijsterbosch J, Slagboom PE, Rosendaal FR, Huizinga TWJ, Kloppenburg M. Body mass index and alignment and their interaction as risk factors for progression of knees with radiographic signs of osteoarthritis. Osteoarthritis Cartilage 2011;19:1117-22.
51. Brouwer GM, Tol AWV, Bergink AP, Belo JN, Bernsen RMD, Reijman M, et al. Association between valgus and varus alignment and the development and progression of radiographic osteoarthritis of the knee. Arthritis Rheum 2007;56:1204-11.
52. Felson DT, Goggins J, Niu J, Zhang Y, Hunter DJ. The effect of body weight on progression of knee osteoarthritis is dependent on alignment. Arthritis Rheum 2004;50:3904-9.
53. Larsen P, Engberg AS, Motahar I, Ostgaard SE, Elsoe R. Obesity Influences the Knee Injury and Osteoarthritis Outcome Score. Joints 2019;7:008-12.
54. Kadam U, Jordan K, Croft P. Clinical comorbidity in patients with osteoarthritis: a case-control study of general practice consulters in England and Wales. Ann Rheum Dis 2004;63:408-14.
55. Karasik D, Kiel DP, Kiely DK, Cupples LA, Wilson PWF, O’Donnell CJ, et al. Abdominal aortic calcification and exostoses at the hand and lumbar spine: The Framingham Study. Calcif Tissue Int 2006;78:1-8.
56. Lee MY, Kim WJ, Kang YJ, Jung YM, Kang YM, Suk K, et al. Z39Ig is expressed on macrophages and may mediate inflammatory reactions in arthritis and atherosclerosis. J Leukoc Biol 2006;80:922-8.
57. Kim HS, Shin JS, Lee J, Lee YJ, Kim M, Bae YH, et al. Association between knee osteoarthritis, cardiovascular risk factors, and the Framingham risk score in south koreans: A cross-sectional study. PLoS One 2016;11:e0165325.
58. Rathbun AM, Stuart EA, Shardell M, Yau MS, Baumgarten M, Hochberg MC. Dynamic effects of depressive symptoms on osteoarthritis knee pain. Arthritis Care Res (Hoboken) 2018;70:80-8.
59. Zambon S, Siviero P, Denkinger M, Limongi F, Castell MV, Pas S van der, et al. Role of Osteoarthritis, comorbidity, and pain in determining functional limitations in older populations: European project on osteoarthritis. Arthritis Care Res (Hoboken) 2016;68:801-10.
| Files | ||
| Issue | Vol 60, No 2 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v60i2.8824 | |
| Keywords | ||
| Knee osteoarthritis Comorbidity Metabolic syndrome Cardiovascular disease | ||
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How to Cite
1.
Ben Tekaya A, Hamdi O, Rouached L, Bellil M, Slimi A, Bouden S, Saidane O, Tekaya R, Mahmoud I, Abdelmoula L. Clinical Comorbidity Phenotype in Knee Osteoarthritis Is Associated With Higher Intensity Scores. Acta Med Iran. 2022;60(2):120-128.
