Metabolic syndrome and knee osteoarthritis
Associations between the number of metabolic
syndrome components and risk of knee osteoarthritis
and severe knee osteoarthritis
467
In men, however, the risk of knee OA only increased
in subjects with 5 metabolic syndrome components,
compared with subjects with no metabolic syndrome
components (OR = 1.80, 95% CI = 1.06–3.08, p-
value = 0.031 and OR = 1.82, 95% CI = 1.05–3.17, p-
value = 0.033, respectively, for models 1 and 2).
In women, the risk of knee OA and severe knee OA
increased as the number of metabolic syndrome com-
ponents increased (Table III). In the univariate analysis
of risk of knee OA, the highest OR was observed
in subjects with 4 metabolic syndrome components
(OR = 4.85, 95% CI = 3.54–6.65, p-value < 0.001). The
same results were observed in model 1 (OR = 2.63,
95% CI = 1.89–3.66, p-value < 0.001) and model 2
(OR = 2.45, 95% = CI 1.75–3.43, p-value < 0.001).
However, in the univariate analysis of risk factors
of severe knee OA, the highest OR was observed
in subjects with 5 metabolic syndrome components
(OR = 5.47, 95% CI = 3.54–8.44, p-value < 0.001). In
model 1, the highest OR was observed in subjects with
5 metabolic syndrome components (OR = 2.81, 95%
CI = 1.77–4.46, p-value < 0.001). However, in model
2, the highest OR was observed in subjects with 4
metabolic syndrome components (OR = 2.51, 95%
CI = 1.67–3.78, p-value < 0.001).
Associations between each component of metabolic
syndrome and knee osteoarthritis and severe knee
osteoarthritis
In women, hypertension was associated with an increased
risk of knee OA (OR = 2.28, 95% CI = 1.96–2.65, p-value
< 0.001; OR = 1.96, 95% CI = 1.68–2.29, p-value < 0.001;
and OR = 1.25, 95% CI = 1.06–1.47, p-value = 0.009, re-
spectively, in the univariate analysis with models 1 and
2) and severe knee OA (OR = 2.54, 95% CI = 2.15–3.00,
p-value < 0.001; OR = 2.18, 95% CI = 1.84–2.59, p-value
< 0.001; and OR = 1.36, 95% CI = 1.14–1.62, p-value
< 0.001; respectively; for univariate analysis in models 1
and 2) (Table IV). Abdominal obesity showed the same re-
sults for risk of knee OA (OR = 2.19, 95% CI = 1.88–2.55,
p-value < 0.001; OR = 1.85, 95% CI = 1.58–2.17, p-value
< 0.001; and OR = 1.89, 95% CI = 1.60–2.23,
p-value < 0.001; respectively; for univa-
Table IV. Odds ratio for development of knee osteoarthritis (OA) and severe knee
osteoarthritis in accordance with each metabolic syndrome component
riate analysis in models 1 and 2) and severe
knee OA (OR = 2.29, 95% CI = 7.96–2.68,
Univariate
analysis
Model 1 a
Model 2
p-value < 0.001; OR = 1.92, 95% CI = 1.64–
Components
OR (95% CI)
OR (95% CI)
OR (95% CI)
2.26, p-value < 0.001; and OR = 2.00, 95%
Osteoarthritis
CI = 1.68–2.38, p-value < 0.001; respectively;
Men
0.92 (0.75–1.13)
0.93 (0.76–1.15)
Hyperglycaemia (n = 439) c 1.00 (0.82–1.22)
in
univariate analysis with models 1 and 2).
1.52 (1.25–1.86)*** 1.51 (1.23–1.86)*** 1.33 (1.07–1.66)*
Hypertension (n = 614) c
In
men, hypertension was associated with
Abdominal obesity (n = 321) c 1.62 (1.32–1.98)*** 1.63 (1.31–2.02)*** 1.59 (1.27–2.00)***
c
an
increased
risk of knee OA in the univa-
1.07 (0.87–1.30)
1.12 (0.91–1.38)
1.04 (0.84–1.29)
Low HDL (n = 326)
0.72 (0.60–0.88)*** 0.64 (0.52–0.78)*** 0.82 (0.66–1.01)
High TG (n = 287) c
riate analysis (OR = 1.52, 95% CI = 1.25–
Women
1.86, p-value < 0.001), model 1 (OR = 1.51,
Hyperglycaemia (n = 893) c 1.64 (1.43–1.88)*** 1.23 (1.06–1.43** 1.13 (0.97–1.32)
c
95%
CI = 1.23–1.86, p-value < 0.001), and
2.28 (1.96–2.65)*** 1.96 (1.68–2.29)*** 1.25 (1.06–1.47)**
Hypertension (n = 1,471)
Abdominal obesity (n = 999) c 2.19 (1.88–2.55)*** 1.85 (1.58–2.17)*** 1.89 (1.60–2.23)***
model 2 (OR = 1.33, 95% CI = 1.07–1.66,
1.47 (1.27–1.71)*** 1.32 (1.12–1.56)** 1.13 (1.95–1.35)
Low HDL (n = 1,284) c
p-value = 0.012). Hypertension was also
1.18 (1.02–1.37)* 0.88 (0.74–1.04)
0.89 (0.75–1.05)
High TG (n = 712) c
associated with an increased risk of se-
Severe osteoarthritis
vere knee OA in model 1 (OR = 1.40,
Men
0.80 (0.61–1.04)
0.82 (0.63–1.07)
Hyperglycaemia (n = 178) d 0.85 (0.66–1.10)
95% CI = 1.03–1.90, p-value = 0.033).
1.37 (1.02–1.83)
1.40 (1.03–1.90)* 1.20 (0.88–1.63)
Hypertension (n = 266) d
Abdominal obesity was associated with an
d
1.62 (1.22–2.15)*** 1.56 (1.17–2.08)**
Abdominal obesity (n = 143) 1.54 (1.17–2.03)
increased risk of knee OA in the univariate
1.04 (0.79–1.37)
1.12 (0.84–1.50)
1.03 (0.76–1.39)
Low HDL (n = 137) d
0.65 (0.49–0.85)
0.59 (0.44–0.79)*** 0.79 (0.58–1.06)
High TG (n = 114) d
analysis (OR = 1.62, 95% CI = 1.32–1.98,
Women
p-value< 0.001), model 1 (OR = 1.63,
d
1.07 (0.90–1.27)
Hyperglycaemia (n = 614) 1.60 (1.37–1.87)*** 1.16 (0.98–1.37)
95% CI = 1.31–2.02, p-value < 0.001), and
Hypertension (n = 1,043) d 2.54 (2.15–3.00)*** 2.18 (1.84–2.59)*** 1.36 (1.14–1.62)***
Abdominal obesity (n = 722) d 2.29 (7.96–2.68)*** 1.92 (1.64–2.26)*** 2.00 (1.68–2.38)***
model 2 (OR = 1.59, 95% CI = 1.27–2.00,
1.47 (1.26–1.71)*** 1.29 (1.08–1.54)** 1.08 (0.90–1.30)
Low HDL (n = 887) d
p-value = 0.012). It was also associated
1.23 (1.05–1.44)* 0.92 (0.77–1.11)
0.98 (0.79–1.14)
High TG (n = 494) d
with an increased risk of severe knee OA in
*p < 0.05, **p < 0.01, ***p < 0.001. p< 0.05 was considered statistically significant.
a
Model 1 was adjusted for age group.
models 1 (OR = 1.62, 95% CI = 1.22–2.15,
b
Model 2 was adjusted for age group, education, smoking, alcohol consumption, and physical
p-value
< 0.001) and 2 (OR = 1.56, 95%
activities.
c
Number of subjects with knee OA and each metabolic syndrome component.
CI = 1.17–2.08,
p-value = 0.003).
d
Number of subjects with severe knee OA and each metabolic syndrome component.
Odds ratio was in comparison with knee OA and severe knee OA individuals with no component
In men, hypertriglyceridemia was as-
of metabolic syndrome.
sociated with a reduced risk of knee OA in
HDL: high-density lipoprotein; TG: triglycerides; OR: odds ratio.
b
J Rehabil Med 51, 2019