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J Clin Endocrinol Metab. 2014 Sep;99(9):3177-83. doi: 10.1210/jc.2014-1043. Epub 2014 Apr 29.

Association between metabolic syndrome, radiographic knee osteoarthritis, and intensity of knee pain: results of a national survey.

Author information

1
Department of Education and Training, Seoul National University Hospital, Seoul 110-744, South Korea; and Jangseong Public Health Center, Jangseong 515-800, South Korea.

Abstract

CONTEXT:

Although osteoarthritis (OA) has been suggested as another component of metabolic syndrome (MetS), weight-independent associations between MetS and knee OA or intensity of arthritic knee pain remain unclear.

OBJECTIVE:

The objective of the study was to evaluate the above associations and suggest possible mechanisms.

DESIGN AND SETTING:

This was a cross-sectional study using the fifth Korean National Health and Nutrition Examination Survey (2010).

PARTICIPANTS:

A total of 2363 adults (≥50 y of age) who had completed both laboratory examinations and an evaluation for radiographic knee OA participated in the study.

MAIN OUTCOME AND MEASURES:

Radiographic knee OA was defined as a Kellgren/Lawrence grade of 2 or greater, and the intensity of arthritic knee pain was assessed using a self-reported numeric rating scale. MetS was diagnosed based on National Cholesterol Education Program-Adult Treatment Panel III criteria, and insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance index.

RESULTS:

In a multivariable logistic regression analysis, MetS was associated with radiographic knee OA (adjusted odds ratio 1.49; 95% confidence interval 1.23-1.79; P < .001). This association was not changed significantly after further adjusting for homeostasis model assessment-estimated insulin resistance but became nonsignificant after adjusting for weight or body mass index. Age-, sex-, and weight (or body mass index)-adjusted mean score of knee pain was significantly higher in subjects with more components of MetS (P for trend = .010 or .035, respectively).

CONCLUSIONS:

The association between MetS and radiographic knee OA can be largely explained by an excessive weight but not by insulin resistance, a key pathophysiology of MetS. Because accumulation of MetS components appears to be associated with a higher intensity of knee pain, independently of weight, appropriate treatment for MetS may be helpful for subjects with knee pain.

PMID:
24780047
DOI:
10.1210/jc.2014-1043
[Indexed for MEDLINE]

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