Metabolic Syndrome In Egyptian Patients with Primary Knee Osteoarthritis
DOI:
https://doi.org/10.12970/2310-9874.2013.01.01.2Keywords:
Egyptian, WOMAC, Kellgren-Lawrence, Osteoarthritis, Metabolic syndrome.Abstract
Introduction: Osteoarthritis (OA) is among the most common musculoskeletal disorders affecting millions of people throughout different races in different ages and sexes
Aim: The aim of the present study was to determine the prevalence of Metabolic Syndrome (MetS) in a group of Egyptian patients with primary knee Osteoarthritis (OA) and to detect its relation to the clinical, functional and radiographic findings.
Patients and methods: The present study included 380 patients (150 males, 230 females) diagnosed as having primary knee OA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess disease specific self-reported disability. X-rays were classified according to the Kellgren–Lawrence (KL) radiographic rating scale. 400 (260females, 140 males) apparently healthy volunteers without knee OA were used as control group.
Results: MetS was prevalent in 53.7 % of the studied OA patients, in the control group was 37.3% of (P: <0.001). The prevalence of individual MetS components included 68.7 % for abdominal obesity, 66.8 % for hypertension, 36.1 % for hyperglycemia, 52.1 % for elevated triglycerides and 49.2 % for low high density lipoprotein (HDL). Patients with MetS had significantly higher body mass index (BMI) (P: 0.0013), longer disease duration (P: 0.021), more pain (P: 0.007), more stiffness (P: 0.043), worse functional impairment scores(P: 0.017) and advanced radiological progress (P:0.0001).
Conclusions: MetS is prevalent in patients with primary knee OA. It is associated with poor clinical performance and advanced radiological changes. The most common component of MetS in our study is abdominal obesity.
References
Suri P, Morgenroth DC, Hunter DJ. Epidemiology of osteoarthritis and associated comorbidities. PM R 2012; 4(5 Suppl): S10-9.
Kapoor M, Martel-Pelletier J, Lajeunesse D, Pelletier JP, Fahmi H. Role of proinflammatory cytokines in the pathophysiology of osteoarthritis. Nat Rev Rheumatol 2011; 7: 33-42. http://dx.doi.org/10.1038/nrrheum.2010.196
Rai MF, Sandell LJ. Inflammatory mediators: tracing links between obesity and osteoarthritis. Crit Rev Eukaryot Gene Expr 2011; 21: 131-42. http://dx.doi.org/10.1615/CritRevEukarGeneExpr.v21.i2.30
Gkretsi V, Simopoulou T, Tsezou A. Lipid metabolism and osteoarthritis: lessons from atherosclerosis. Prog Lipid Res 2011; 50: 133-40. http://dx.doi.org/10.1016/j.plipres.2010.11.001
Issa RI, Griffin TM. Pathobiology of obesity and osteoarthritis: integrating biomechanics and inflammation. Pathobiol Aging Age Relat Dis 2012 9; 2(2012) doi:pii: 17470.
Yusuf E. Metabolic factors in osteoarthritis: obese people do not walk on their hands. Arthritis Res Ther 2012; 14: 123.
Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage 2013; 21: 16-21. http://dx.doi.org/10.1016/j.joca.2012.11.012
Gheita TA, El-Fishawy HS, Nasrallah MM, Hussein H. Insulin resistance and metabolic syndrome in primary gout: relation to punched-out erosions. Int J Rheum Dis 2012; 15: 521-5. http://dx.doi.org/10.1111/1756-185X.12007
Gheita TA, Raafat HA, Sayed S, El-Fishawy H, Nasrallah MM, Abdel-Rasheed E. Metabolic syndrome and insulin resistance comorbidity in systemic lupus erythematosus. Effect on carotid intima-media thickness. Z Rheumatol 2013; 72: 172-7. http://dx.doi.org/10.1007/s00393-012-1058-9
Zayed S H, Younis G, Bader R, Amin A. Prevalence of preclinical renal dysfunction in obese Egyptian patients with primary knee osteoarthritis, preliminary data. The Egyptian Rheumatologist, In Press, Corrected Proof, Available online 6 August 2013.
Zhuo Q, Yang W, Chen J, Wang Y. Metabolic syndrome meets osteoarthritis. Nat Rev Rheumatol 2012; 8: 729-37. http://dx.doi.org/10.1038/nrrheum.2012.135
Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29: 1039-49. http://dx.doi.org/10.1002/art.1780290816
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15: 1833-40.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, et al. American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52. http://dx.doi.org/10.1161/CIRCULATIONAHA.105.169404
Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16: 494-502. http://dx.doi.org/10.1136/ard.16.4.494
Puenpatom RA, Victor TW. Increased Prevalence of Metabolic Syndrome in Individuals with Osteoarthritis: An Analysis of NHANES III Data. Postgrad Med 2009; 121: 9-20. http://dx.doi.org/10.3810/pgm.2009.11.2073
Yoshimura N, Muraki S, Oka H, Kawaguchi H, Nakamura K, Akune T. Association of knee osteoarthritis with the accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance in Japanese men and women: the ROAD study. J Rheumatol 2011; 38: 921-30. http://dx.doi.org/10.3899/jrheum.100569
Engström G, Gerhardsson de Verdier M, Rollof J, Nilsson PM, Lohmander LS. C-reactive protein, metabolic syndrome and incidence of severe hip and knee osteoarthritis. A population-based cohort study. Osteoarthritis Cartilage 2009; 17: 168-73. http://dx.doi.org/10.1016/j.joca.2008.07.003
Dahaghin S, Bierma-Zeinstra SM, Koes BW, Hazes JM, Pols HA. Do metabolic factors add to the effect of overweight on hand osteoarthritis? The Rotterdam Study. Ann Rheum Dis 2007; 66: 916-20. http://dx.doi.org/10.1136/ard.2005.045724
Griffin TM, Huebner JL, Kraus VB, Yan Z, Guilak F. Induction of osteoarthritis and metabolic inflammation by a very high fat diet in mice: effects of short-term exercise. Arthritis Rheum 2012; 64: 443-53. http://dx.doi.org/10.1002/art.33332