Patients with high fasting blood glucose at risk for worse knee osteoarthritis symptoms
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In patients with radiographic knee osteoarthritis and comorbid central sensitization, those with higher baseline fasting blood glucose levels demonstrate worse knee symptoms, according to data published in Arthritis Research & Therapy.
“Knee symptoms derived from [knee OA (KOA)] are a global social burden; therefore, controlling these symptoms contributes to improving individual health status as well as reducing the societal impact,” Daisuke Chiba, MD, of the department of orthopedic surgery at the Hirosaki University Graduate School of Medicine, in Japan, and colleagues wrote. “Although there are various mechanisms underlying knee pain in patients with KOA, hyperglycemic conditions in diabetes mellitus (DM) have been reported to exert cellular and molecular effects on the nociceptive pathway, thereby intensifying pain.”
To investigate the connection between blood glucose levels and knee OA symptoms, Chiba and colleagues conducted a retrospective study of patients with a Kellgren-Lawrence grade of two or more in each knee. Individuals were excluded if they received oral analgesics and underwent a total knee arthroplasty, or if they had a history of rheumatoid arthritis, cancer or mental illness.
Included patients completed surveys to evaluate their knee symptoms, featuring evaluations on pain, symptoms, sports and recreation, and knee-related quality of life. Each participant also completed surveys intended to measure overall health symptoms. To measure blood glucose levels at baseline, the researchers collected fasting blood samples.
A total of 297 patients were eligible and included in the analysis. Of those, 48 were categorized as demonstrating central sensitization comorbidity. According to the researchers, there was no correlation between fasting blood glucose levels and knee symptoms in patients without central sensitization comorbidity. However, for those with central sensitization, fasting blood glucose levels at baseline were negatively associated with pain symptoms (P = .003), daily activities (P = .003) and sports involvement (P = .007).
“Higher [fasting blood glucose (FBG)] levels at [baseline (BL)] worsened knee symptoms in the patients with radiographic KOA and comorbid [central sensitization (CS)] during 1-year follow-up,” Chiba and colleagues wrote. "In contrast, FBG levels were not longitudinally associated with knee symptoms in patients with radiographic KOA without CS.
“For subjects with radiographic KOA, the CS comorbidity was negatively associated with KOOS scores at BL,” they added. “However, CS itself did not affect the longitudinal changes in KOOS. Therefore, comorbid CS worsened knee symptoms in the population with radiographic KOA only when their FBG was elevated.”
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