The Relationship Between Osteoarthritis and Osteoporosis in the General Population: the Chingford Study

Overview

Journal Ann Rheum Dis

Specialty Rheumatology

Date 1994 Mar 1

PMID 8154931

Citations 99

Authors

D J Hart

I Mootoosamy

D V Doyle

T D Spector

Affiliations

Soon will be listed here.

Abstract

Objective: A total of 979 women from the Chingford general population survey were studied to examine the hypothesis that osteoarthritis (OA) and osteoporosis are inversely related.

Methods: All women had radiographs of the hands and knees. A total of 579 also had AP radiographs of the lumbar spine which were graded for the presence of osteophytes. All women had bone densitometry performed at the lumbar spine (L1-L4) and femoral neck. Mean bone densities (BMD) were compared between those with disease and those with no disease at any other sites. All results were adjusted for age and body mass index (BMI).

Results: All OA groups had significantly higher bone density than controls at the lumbar spine. For distal interphalangeal (DIP) OA (n = 140) the difference was +5.8% (+3.0, +8.6), for carpometacarpal (CMC) OA (n = 160) +3.0% (+0.1, +5.9), for knee OA (n = 118) +7.6% (+4.3, +10.9), and lumbar spine OA (LSOA) (n = 194) +7.8% (+6.0, +8.8). Those with generalised OA (GOA n = 22), a combination of knee, DIP and CMC OA had an increase of +9.3 (+2.0, +16.6). For the femoral neck BMD was also increased significantly ranging from +2.5% for the CMC, +6.2% for the knee and +6.3% in the lumbar spine OA group. The risk of knee OA for women in the top tertile of BMD was 2.13 (1.15-3.93). Additional adjustment for other confounders such as smoking, alcohol, exercise, HRT, social class and spine osteophytes did not alter the results.

Conclusions: These results suggest that small increases in BMD are present in middle aged women with early radiological OA of the hands, knees and lumbar spine. These data support the hypothesis that the two conditions are inversely related, although the mechanisms remain unclear.

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References

Foss M, Byers P . Bone density, osteoarthrosis of the hip, and fracture of the upper end of the femur. Ann Rheum Dis. 1972; 31(4):259-64. PMC: 1005923. DOI: 10.1136/ard.31.4.259. View

Radin E, Paul I, Rose R . Role of mechanical factors in pathogenesis of primary osteoarthritis. Lancet. 1972; 1(7749):519-22. DOI: 10.1016/s0140-6736(72)90179-1. View

Dequeker J . The relationship between osteoporosis and osteoarthritis. Clin Rheum Dis. 1985; 11(2):271-96. View

Pogrund H, Rutenberg M, Makin M, ROBIN G, Steinberg R, Bloom R . Osteoarthritis of the hand and osteoporosis. Clin Orthop Relat Res. 1986; (203):239-43. View

Price T, Hesp R, Mitchell R . Bone density in generalized osteoarthritis. J Rheumatol. 1987; 14(3):560-2. View

Cooper C, Poll V, McLaren M, Daunt S, Cawley M . Alterations in appendicular skeletal mass in patients with rheumatoid, psoriatic, and osteoarthropathy. Ann Rheum Dis. 1988; 47(6):481-4. PMC: 1003550. DOI: 10.1136/ard.47.6.481. View

Spector T, Campion G . Generalised osteoarthritis: a hormonally mediated disease. Ann Rheum Dis. 1989; 48(6):523-7. PMC: 1003804. DOI: 10.1136/ard.48.6.523. View

McAlindon T, Dieppe P . Osteoarthritis: definitions and criteria. Ann Rheum Dis. 1989; 48(7):531-2. PMC: 1003807. DOI: 10.1136/ard.48.7.531. View

Ala-Kokko L, Baldwin C, Moskowitz R, Prockop D . Single base mutation in the type II procollagen gene (COL2A1) as a cause of primary osteoarthritis associated with a mild chondrodysplasia. Proc Natl Acad Sci U S A. 1990; 87(17):6565-8. PMC: 54577. DOI: 10.1073/pnas.87.17.6565. View

10.

Sowers M, Zobel D, Weissfeld L, Hawthorne V, Carman W . Progression of osteoarthritis of the hand and metacarpal bone loss. A twenty-year followup of incident cases. Arthritis Rheum. 1991; 34(1):36-42. DOI: 10.1002/art.1780340106. View

11.

Cooper C, Cook P, Osmond C, Fisher L, Cawley M . Osteoarthritis of the hip and osteoporosis of the proximal femur. Ann Rheum Dis. 1991; 50(8):540-2. PMC: 1004483. DOI: 10.1136/ard.50.8.540. View

12.

Spector T, Brennan P, Harris P, Studd J, Silman A . Does estrogen replacement therapy protect against rheumatoid arthritis?. J Rheumatol. 1991; 18(10):1473-6. View

13.

Morrison N, Yeoman R, Kelly P, Eisman J . Contribution of trans-acting factor alleles to normal physiological variability: vitamin D receptor gene polymorphism and circulating osteocalcin. Proc Natl Acad Sci U S A. 1992; 89(15):6665-9. PMC: 49563. DOI: 10.1073/pnas.89.15.6665. View

14.

Spector T, Hart D . How serious is knee osteoarthritis?. Ann Rheum Dis. 1992; 51(10):1105-6. PMC: 1012412. DOI: 10.1136/ard.51.10.1105. View

15.

Spector T, Dacre J, Harris P, Huskisson E . Radiological progression of osteoarthritis: an 11 year follow up study of the knee. Ann Rheum Dis. 1992; 51(10):1107-10. PMC: 1012413. DOI: 10.1136/ard.51.10.1107. View

16.

Spector T, Hart D, Byrne J, Harris P, Dacre J, Doyle D . Definition of osteoarthritis of the knee for epidemiological studies. Ann Rheum Dis. 1993; 52(11):790-4. PMC: 1005190. DOI: 10.1136/ard.52.11.790. View

17.

Roh Y, Dequeker J, MULIER J . Bone mass in osteoarthrosis, measured in vivo by photon absorption. J Bone Joint Surg Am. 1974; 56(3):587-91. View