Linking diabetes to worsening knee osteoarthritis symptoms and disability: evidence from the osteoarthritis initiative

糖尿病与膝骨关节炎症状加重和残疾之间的关联:来自骨关节炎倡议的证据

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Abstract

OBJECTIVE: To examine the impact of baseline diabetes mellitus (DM) on longitudinal knee symptoms and disability in participants with knee osteoarthritis (OA). METHODS: This was a secondary analysis using publicly available data from a longitudinal study design (Osteoarthritis Initiative). Data from 4,796 participants (45-79 years of age) were obtained, and only participants with grade ≥2 in either knee, using the Kellgren and Lawrence grading at baseline, were included in the current analysis. Based on self-reported DM, the participants were categorized into two groups: knee OA and DM or knee OA only. Symptoms and disability were measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale and pain severity across 7- and 30-days at seven visits from baseline to 96 months of follow up. RESULTS: A total of 2,486 participants were included and categorized into knee OA and DM (n = 221) and knee OA only (n = 2,265). The longitudinal analyses results (n = 2,483) showed that participants with knee OA and DM had significantly increased knee symptoms over time using the WOMAC total score [beta (B) = 3.20, p = 0.004], WOMAC pain subscale (B = 0.71, p = 0.003), WOMAC stiffness subscale (B = 0.22, p = 0.036), and WOMAC disability subscale (B = 2.26, p = 0.005) compared with participants with knee OA only. Knee OA and DM was not associated with increased knee pain severity over a 7-day period (B = 0.28, p = 0.10) and over a 30-day period (B = 0.20, p = 0.23) when compared to knee OA only. CONCLUSION: This longitudinal cohort study provides evidence supporting the association between baseline DM and increased knee symptoms and disability among individuals with knee OA.

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