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Osteoarthritis Cartilage. 2014 Aug;22(8):1120-8. doi: 10.1016/j.joca.2014.06.007. Epub 2014 Jun 24.

Prevalence of radiographic hip osteoarthritis is increased in high bone mass.

Author information

1
Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK. Electronic address: Sarah.Hardcastle@bristol.ac.uk.
2
Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK; University of Exeter Medical School, Exeter, UK.
3
Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK.
4
Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK; Chromatic Innovation Limited, 23 Chesham St, Leamington Spa, CV31 1JS, UK.
5
Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
6
Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Arthritis Research UK (ARUK) Centre for Sports, Exercise and Osteoarthritis, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
7
Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
8
Department of Radiology, Royal United Hospital Bath NHS Trust, Bath, UK.
9
Department of Radiology, Royal Glamorgan Hospital, Cwm Taf Health Board, Llantrisant, Wales, UK.
10
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
11
Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK.
12
Department of Radiology, North Bristol NHS Trust, Bristol, UK.
13
MRC Integrative Epidemiology Unit, University of Bristol, UK.

Abstract

OBJECTIVE:

Epidemiological studies have shown an association between increased bone mineral density (BMD) and osteoarthritis (OA), but whether this represents cause or effect remains unclear. In this study, we used a novel approach to investigate this question, determining whether individuals with High Bone Mass (HBM) have a higher prevalence of radiographic hip OA compared with controls.

DESIGN:

HBM cases came from the UK-based HBM study: HBM was defined by BMD Z-score. Unaffected relatives of index cases were recruited as family controls. Age-stratified random sampling was used to select further population controls from the Chingford and Hertfordshire cohort studies. Pelvic radiographs were pooled and assessed by a single observer blinded to case-control status. Analyses used logistic regression, adjusted for age, gender and body mass index (BMI).

RESULTS:

530 HBM hips in 272 cases (mean age 62.9 years, 74% female) and 1702 control hips in 863 controls (mean age 64.8 years, 84% female) were analysed. The prevalence of radiographic OA, defined as Croft score ≥3, was higher in cases compared with controls (20.0% vs 13.6%), with adjusted odds ratio (OR) [95% CI] 1.52 [1.09, 2.11], P = 0.013. Osteophytes (OR 2.12 [1.61, 2.79], P < 0.001) and subchondral sclerosis (OR 2.78 [1.49, 5.18], P = 0.001) were more prevalent in cases. However, no difference in the prevalence of joint space narrowing (JSN) was seen (OR 0.97 [0.72, 1.33], P = 0.869).

CONCLUSIONS:

An increased prevalence of radiographic hip OA and osteophytosis was observed in HBM cases compared with controls, in keeping with a positive association between HBM and OA and suggesting that OA in HBM has a hypertrophic phenotype.

KEYWORDS:

DXA; Epidemiology; Osteoarthritis; Osteoporosis; Radiology

PMID:
24971870
PMCID:
PMC4147962
DOI:
10.1016/j.joca.2014.06.007
[Indexed for MEDLINE]
Free PMC Article
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