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High femoral-neck bone mineral density predicts knee, hip OA
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Femoral neck bone mineral density can predict knee and hip radiographic osteoarthritis, and vertebral fractures are a risk factor for hand radiographic osteoarthritis, according to data published in Arthritis & Rheumatology.
“The inverse relation between osteoporosis and osteoarthritis has been described extensively in the past decades,” Arjan P. Bergink, MD, of Erasmus Medical Center, and colleagues wrote. “However, almost no data is available on the relationship between [bone mineral density] and incidence or progression of hip and hand OA. A previous review concluded that the relationship between OA and [osteoporosis] is elusive and that especially longitudinal studies show no clear relation between OA and [osteoporosis].”
Following their previous studies — Rotterdam 1 and Rotterdam 2 — Bergink and colleagues aimed to evaluate the longitudinal link between bone mineral density and the incidence and progression of knee, hip and hand osteoarthritis, as well as the relationship between prevalent vertebral and nonvertebral fractures and osteoarthritis among elderly men and women. To accomplish this, the researchers constructed age- and sex-specific quartiles of baseline femoral-neck bone mineral density for a total of 4,154 participants of the two previous studies.
The researchers scored radiographs for the incidence and progression of knee and hip osteoarthritis, as well as the incidence of hand osteoarthritis. In addition, they scored prevalent vertebral fractures using the McCloskey/Kanis method. They reported prevalent nonvertebral fractures through baseline interview.
According to the researchers, participants in the highest quartile of femoral-neck bone mineral density demonstrated an increased risk for incident knee radiographic osteoarthritis (OR = 1.58; 95% CI, 1.14-2.18), compared to the lowest quartile. These patients also had a heightened risk for incident hip radiographic osteoarthritis (OR = 1.57; 95%CI: 1.06 to 2.32). The researchers found no significant relationship between high femoral-neck bone mineral density and the progression of knee or hip radiographic osteoarthritis, or the incidence of hand radiographic osteoarthritis. Vertebral and nonvertebral fractures were also not related to the incidence or progression of knee or hip radiographic osteoarthritis. However, vertebral fractures were associated with incident hand radiographic osteoarthritis (OR = 1.74; 95% CI, 1.02-2.98).
“The present large longitudinal study confirms earlier studies and thus provides strong evidence that high [femoral-neck bone mineral density] is a prognostic risk factor for the development of subsequent radiographic knee and hip OA,” Bergink and colleagues wrote. “No evidence was provided for high [femoral-neck bone mineral density] as a prognostic risk factor for progression of radiographic knee or hip, or for the incidence of radiographic hand OA. However, a significant higher risk of progression of hip [radiographic] OA was found foreach [standard deviation] increase in [femoral-neck bone mineral density].”
The researchers also noted, “The protective effect of vertebral fractures for the incidence or progression of radiographic knee OA could not be confirmed by the present study, but vertebral fractures were found to be a risk factor for the incidence of hand OA.” – by Jason Laday
Disclosure: Bergink reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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