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Osteoarthritis Cartilage. 2014 Feb;22(2):190-6. doi: 10.1016/j.joca.2013.11.008. Epub 2013 Nov 28.

High plasma levels of vitamin C and E are associated with incident radiographic knee osteoarthritis.

Author information

  • 1Division of Rheumatology, UCSF, San Francisco, CA, USA.
  • 2Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA.
  • 3NIHR Musculoskeletal BRU, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
  • 4Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, USA.
  • 5Department of Epidemiology, University of Iowa, Iowa City, IA, USA.
  • 6Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • 7USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
  • 8Department of Medicine, University of California at Davis Medical School, Sacramento, CA, USA.
  • 9Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA. Electronic address:



Previous studies suggest that the antioxidants vitamins C and E may protect against development of knee osteoarthritis (OA). We examined the association of circulating levels of vitamin C and E with incident whole knee radiographic OA (WKROA).


We performed a nested case-control study of incident WKROA in MOST, a cohort of 3,026 men and women aged 50-79 years with, or at high risk of, knee OA. Incident cases were knees without either tibiofemoral (TF) or patellofemoral (PF) OA at baseline that developed TF and/or PF OA by 30-month follow-up. Two control knees per case were selected from those eligible for WKROA that did not develop it. Vitamin C and E (alpha-tocopherol) assays were done on baseline supernatant plasma (PCA) and serum samples, respectively. We examined the association of gender-specific tertiles of vitamin C and E with incident WKROA using logistic regression with GEE, adjusting for age, gender, and obesity.


Subjects without WKROA at baseline who were in the highest tertile of vitamin C had a higher incidence of WKROA [adjusted OR = 2.20 (95% CI: 1.12-4.33); P-value = 0.021], with similar results for the highest tertile of vitamin E [adjusted OR = 1.89 (1.02-3.50); P-value = 0.042], compared to those in the lowest tertiles. P-values for the trend of vitamin C and E tertiles and incident WKROA were 0.019 and 0.030, respectively.


Higher levels of circulating vitamin C and E did not provide protection against incident radiographic knee OA, and may be associated with an increased risk of knee OA.

Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.


Antioxidants; Knee osteoarthritis; Vitamin C; Vitamin E

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