The relationship between osteoarthritis and osteoporosis in the general population: the Chingford Study.

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.

[1]  Daniel Levy,et al.  Bone mineral density and knee osteoarthritis in elderly men and women. The Framingham Study. , 1993, Arthritis and rheumatism.

[2]  T. Spector,et al.  Definition of osteoarthritis of the knee for epidemiological studies. , 1993, Annals of the rheumatic diseases.

[3]  T. Spector,et al.  Radiographic assessment of osteoarthritis in population studies: whither Kellgren and Lawrence? , 1993, Osteoarthritis and cartilage.

[4]  T. Spector,et al.  How serious is knee osteoarthritis? , 1992, Annals of the rheumatic diseases.

[5]  T. Spector,et al.  Radiological progression of osteoarthritis: an 11 year follow up study of the knee. , 1992, Annals of the rheumatic diseases.

[6]  M. Hochberg,et al.  Factors associated with osteoarthritis of the hand in males: data from the Baltimore Longitudinal Study of Aging. , 1991, American journal of epidemiology.

[7]  A. Silman,et al.  Does estrogen replacement therapy protect against rheumatoid arthritis? , 1991, The Journal of rheumatology.

[8]  C. Cooper,et al.  Osteoarthritis of the hip and osteoporosis of the proximal femur. , 1991, Annals of the rheumatic diseases.

[9]  R. Moskowitz,et al.  Single base mutation in the type II procollagen gene (COL2A1) as a cause of primary osteoarthritis associated with a mild chondrodysplasia. , 1990, Proceedings of the National Academy of Sciences of the United States of America.

[10]  E. Orwoll,et al.  The impact of osteophytic and vascular calcifications on vertebral mineral density measurements in men. , 1990, The Journal of clinical endocrinology and metabolism.

[11]  T. Spector.  The fat on the joint: osteoarthritis and obesity. , 1990, Journal of Rheumatology.

[12]  Dacre Je,et al.  THE AUTOMATIC ASSESSMENT OF KNEE RADIOGRAPHS IN OSTEOARTHRITIS USING DIGITAL IMAGE ANALYSIS , 1989 .

[13]  P. Dieppe,et al.  Osteoarthritis: definitions and criteria. , 1989, Annals of the rheumatic diseases.

[14]  T. Spector,et al.  Generalised osteoarthritis: a hormonally mediated disease. , 1989, Annals of the rheumatic diseases.

[15]  M. Cawley,et al.  Alterations in appendicular skeletal mass in patients with rheumatoid, psoriatic, and osteoarthropathy. , 1988, Annals of the rheumatic diseases.

[16]  N. Wald.  UK Smoking Statistics , 1988 .

[17]  T. Price,et al.  Bone density in generalized osteoarthritis. , 1987, The Journal of rheumatology.

[18]  R. Steinberg,et al.  Osteoarthritis of the hand and osteoporosis. , 1986, Clinical orthopaedics and related research.

[19]  J Dequeker,et al.  The relationship between osteoporosis and osteoarthritis. , 1985, Clinics in rheumatic diseases.

[20]  P. Tothill,et al.  Bone mass in nodal primary generalised osteoarthrosis. , 1984, Annals of the rheumatic diseases.

[21]  V. M. Martin,et al.  Copper--an index of erosive activity? , 1978, Rheumatology and rehabilitation.

[22]  J. Dequeker,et al.  Bone mass in osteoarthrosis, measured in vivo by photon absorption. , 1974, The Journal of bone and joint surgery. American volume.

[23]  P. Byers,et al.  Bone density, osteoarthrosis of the hip, and fracture of the upper end of the femur. , 1972, Annals of the rheumatic diseases.

[24]  I. Paul,et al.  Role of mechanical factors in pathogenesis of primary osteoarthritis. , 1972, Lancet.

[25]  L. Kazis,et al.  AIMS2. The content and properties of a revised and expanded Arthritis Impact Measurement Scales Health Status Questionnaire. , 1992, Arthritis and rheumatism.

[26]  M. Sowers,et al.  Progression of osteoarthritis of the hand and metacarpal bone loss. A twenty-year followup of incident cases. , 1991, Arthritis and rheumatism.

[27]  J. Dacre,et al.  The automatic assessment of knee radiographs in osteoarthritis using digital image analysis. , 1989, British journal of rheumatology.

[28]  G. Hall,et al.  Letter: Malignant hyperthermia: a human and procine stress syndrome? , 1975, Lancet.