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Ann Rheum Dis. Mar 1999; 58(3): 151–155.
PMCID: PMC1752846

Osteoarthrosis of the knee in men and women in association with overweight, smoking, and hormone therapy

Abstract

OBJECTIVES—The aim was to examine the relation between osteoarthrosis of the knee leading to prosthetic surgery among men and women and overweight, smoking, and hormone therapy.
METHODS—A case-referent study was performed with a study base of all men and women, born 1921-1938, living in 14 counties in Sweden during 1991-95. The cases (n=625) were identified through the Swedish Knee Arthroplasty Register. The referents (n=548) were randomly selected through the central population register from the same counties. Detailed information on general health status, height, weight, smoking habits, medication, use of hormones, specific physical loads from occupation and housework, and sports activities was collected by a telephone interview and a postal questionnaire. The cases were classified in terms of high, medium or low/non-exposure to the factors studied, according to the distribution of variables among the referents.
RESULTS—Women with high body mass index (BMI) at the age of 40 had a relative risk of 9.2 (95%CI 5.3, 16.0) of developing severe knee osteoarthrosis later in life, and for men at the same age the relative risk was 3.9 (95%CI 2.3, 6.4). Smokers were less likely to develop severe knee osteoarthrosis compared with non-smokers. Oestrogen therapy for women over 50 showed an increased relative risk of 1.8 (95%CI 1.2, 2.6), while use of oral contraceptives did not influence the risk .
CONCLUSION—Overweight is a risk factor for knee osteoarthrosis leading to prosthetic surgery in men and women, with the strongest relation for women. Oestrogen therapy after 50 increased the relative risk, while smoking decreased it.

Keywords: body mass index; life style factors; oestrogen therapy; relative risk

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Selected References

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  • Felson DT, Anderson JJ, Naimark A, Hannan MT, Kannel WB, Meenan RF. Does smoking protect against osteoarthritis? Arthritis Rheum. 1989 Feb;32(2):166–172. [PubMed]
  • Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol. 1988 Jul;128(1):179–189. [PubMed]
  • Samanta A, Jones A, Regan M, Wilson S, Doherty M. Is osteoarthritis in women affected by hormonal changes or smoking? Br J Rheumatol. 1993 May;32(5):366–370. [PubMed]
  • Cooper C, McAlindon T, Snow S, Vines K, Young P, Kirwan J, Dieppe P. Mechanical and constitutional risk factors for symptomatic knee osteoarthritis: differences between medial tibiofemoral and patellofemoral disease. J Rheumatol. 1994 Feb;21(2):307–313. [PubMed]
  • Davis MA, Ettinger WH, Neuhaus JM. Obesity and osteoarthritis of the knee: evidence from the National Health and Nutrition Examination Survey (NHANES I). Semin Arthritis Rheum. 1990 Dec;20(3 Suppl 1):34–41. [PubMed]
  • Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med. 1988 Jul 1;109(1):18–24. [PubMed]
  • Rosner IA, Goldberg VM, Moskowitz RW. Estrogens and osteoarthritis. Clin Orthop Relat Res. 1986 Dec;(213):77–83. [PubMed]
  • Spector TD, Brown GC, Silman AJ. Increased rates of previous hysterectomy and gynaecological operations in women with osteoarthritis. BMJ. 1988 Oct 8;297(6653):899–900. [PMC free article] [PubMed]
  • Felson DT. The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum. 1990 Dec;20(3 Suppl 1):42–50. [PubMed]
  • Kohatsu ND, Schurman DJ. Risk factors for the development of osteoarthrosis of the knee. Clin Orthop Relat Res. 1990 Dec;(261):242–246. [PubMed]
  • Hannan MT, Felson DT, Anderson JJ, Naimark A, Kannel WB. Estrogen use and radiographic osteoarthritis of the knee in women. The Framingham Osteoarthritis Study. Arthritis Rheum. 1990 Apr;33(4):525–532. [PubMed]
  • Knutson K, Lewold S, Robertsson O, Lidgren L. The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976-1992. Acta Orthop Scand. 1994 Aug;65(4):375–386. [PubMed]
  • Miettinen O. Estimability and estimation in case-referent studies. Am J Epidemiol. 1976 Feb;103(2):226–235. [PubMed]
  • MANTEL N, HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed]
  • Stewart AL. The reliability and validity of self-reported weight and height. J Chronic Dis. 1982;35(4):295–309. [PubMed]
  • Felson DT. Does excess weight cause osteoarthritis and, if so, why? Ann Rheum Dis. 1996 Sep;55(9):668–670. [PMC free article] [PubMed]
  • Davis MA, Neuhaus JM, Ettinger WH, Mueller WH. Body fat distribution and osteoarthritis. Am J Epidemiol. 1990 Oct;132(4):701–707. [PubMed]
  • Manninen P, Riihimäki H, Heliövaara M, Mäkelä P. Overweight, gender and knee osteoarthritis. Int J Obes Relat Metab Disord. 1996 Jun;20(6):595–597. [PubMed]
  • Davis MA, Ettinger WH, Neuhaus JM. The role of metabolic factors and blood pressure in the association of obesity with osteoarthritis of the knee. J Rheumatol. 1988 Dec;15(12):1827–1832. [PubMed]
  • Hochberg MC, Lethbridge-Cejku M, Scott WW, Jr, Reichle R, Plato CC, Tobin JD. The association of body weight, body fatness and body fat distribution with osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging. J Rheumatol. 1995 Mar;22(3):488–493. [PubMed]
  • Nevitt MC, Felson DT. Sex hormones and the risk of osteoarthritis in women: epidemiological evidence. Ann Rheum Dis. 1996 Sep;55(9):673–676. [PMC free article] [PubMed]
  • Spector TD, Nandra D, Hart DJ, Doyle DV. Is hormone replacement therapy protective for hand and knee osteoarthritis in women?: The Chingford Study. Ann Rheum Dis. 1997 Jul;56(7):432–434. [PMC free article] [PubMed]
  • Oliveria SA, Felson DT, Klein RA, Reed JI, Walker AM. Estrogen replacement therapy and the development of osteoarthritis. Epidemiology. 1996 Jul;7(4):415–419. [PubMed]
  • Vingård E, Alfredsson L, Malchau H. Lifestyle factors and hip arthrosis. A case referent study of body mass index, smoking and hormone therapy in 503 Swedish women. Acta Orthop Scand. 1997 Jun;68(3):216–220. [PubMed]
  • Lindsay R, Hart DM, Aitken JM, MacDonald EB, Anderson JB, Clarke AC. Long-term prevention of postmenopausal osteoporosis by oestrogen. Evidence for an increased bone mass after delayed onset of oestrogen treatment. Lancet. 1976 May 15;1(7968):1038–1041. [PubMed]
  • Radin EL. Mechanical aspects of osteoarthrosis. Bull Rheum Dis. 1976;26(7):862–865. [PubMed]
  • Dieppe P, Cushnaghan J, Young P, Kirwan J. Prediction of the progression of joint space narrowing in osteoarthritis of the knee by bone scintigraphy. Ann Rheum Dis. 1993 Aug;52(8):557–563. [PMC free article] [PubMed]
  • SILBERBERG M, SILBERBERG R. Modifying action of estrogen on the evolution of osteoarthrosis in mice of different ages. Endocrinology. 1963 Mar;72:449–451. [PubMed]
  • Tsai CL, Liu TK. Estradiol-induced knee osteoarthrosis in ovariectomized rabbits. Clin Orthop Relat Res. 1993 Jun;(291):295–302. [PubMed]

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