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Osteoarthritis and the Risk of Mortality

Osteoarthritis (OA) affects 27 million Americans but its affect on mortality is uncertain. A recent study shows that while self-reported OA does not increase mortality, radiographic OA of the knee (RKOA) is associated with higher mortality related to CVD, diabetes and renal disease.

An analysis of adults in the 1988–94 and 1999–2010 National Health and Nutrition Examination Survey (NHANES) data looked at age related, self-reported and radiographic knee OA (RKOA) defined as Kellgren–Lawrence score ≥2. 

Among a sample of 51938 participants, 2589 of them had knee X-rays, with a prevalence of 6.6%. By contrast self-reported OA was seen in 40.6%. The latter was not associated with mortality.

RKOA was associated with an increased risk of mortality from cardiovascular diseases (CVD) {HR 1.43 [95% confidence interval (CI): 1.32, 1.64]}, diabetes [HR 2.04 (1.87, 2.23)] and renal diseases [HR 1.14 (1.04, 1.25)].  Conversely RKOA was associated with a reduced risk of cancer mortality [HR 0.88 (0.80, 0.96)].

Those diagnosed with early RKOA onset (before age 40) had a higher risk of mortality from all causes [HR 1.53 (1.43, 1.65)] and from diabetes [HR 7.18 (5.45, 9.45)].

Obese participants with RKOA were at increased risk of mortality from CVD [HR 1.89 (1.56, 2.29)] and from diabetes [HR: 3.42 (3.01, 3.88)].


The author has no conflicts of interest to disclose related to this subject

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