Hand osteoarthritis in older women is associated with carotid and coronary atherosclerosis: The AGES Reykjavik study

Landspitalinn University Hospital, Department of Rheumatology, Iceland.
Annals of the rheumatic diseases (Impact Factor: 10.38). 12/2008; 68(11):1696-700. DOI: 10.1136/ard.2008.096289
Source: PubMed


There is evidence that atherosclerosis may contribute to the initiation or progression of osteoarthritis. To test this hypothesis, the presence and severity of hand osteoarthritis (HOA) was compared with markers of atherosclerotic vascular disease in an elderly population. Patients and
The AGES Reykjavik Study is a population-based multidisciplinary study of ageing in the elderly population of Reykjavik. In a study of 2264 men (mean age 76 years; SD 6) and 3078 women (mean age 76 years; SD 6) the severity of HOA, scored from photographs, was compared with measures of atherosclerosis. These included carotid intimal thickness and plaque severity, coronary calcifications (CAC) and aortic calcifications and reported cardiac and cerebrovascular events.
After adjustment for confounders, both carotid plaque severity and CAC were significantly associated with HOA in women, with an odds ratio of 1.42 (95% CI 1.14 to 1.76, p = 0.002) for having CAC and 1.25 (95% CI 1.04 to 1.49, p = 0.016) for having moderate or severe carotid plaques. Both carotid plaques and CAC also exhibited significant linear trends in relation to HOA severity in women in the whole AGES Reykjavik cohort (p<0.001 and p = 0.027, respectively, for trend). No significant associations were seen in men. Despite this evidence of increased atherosclerosis, women with HOA did not report proportionally more previous cardiovascular or cerebrovascular events.
The results indicate a linear association between the severity of HOA and atherosclerosis in older women. The pathological process of HOA seems to have some components in common with atherosclerosis. Prospective studies may help elucidate the possible mechanisms of this relationship.

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Available from: Helgi Jonsson, Oct 28, 2015
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    • "Cardiovascular diseases (CVD) and osteoarthritis (OA) often cooccur [1] and individually impact adversely on disease-specific symptoms and poor health [2] [3]. Yet, their common co-occurrence suggests that there might be shared causal links [4] [5] [6], as well as shared consequences in relation to overall health [7] [8]. Individual studies, for example of CVD or OA, tend to focus on specific outcomes, which often use a main symptom characteristic as a rationale for distinguishing from broader limitations of disease and health. "
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    ABSTRACT: Objectives Non-cardiovascular comorbidity is common in cardiovascular disease (CVD) populations but its influence on chest pain (CP) and shortness of breath (SOB) symptom-specific physical limitations is unknown. We wanted to test the a priori hypothesis that an unrelated comorbidity would influence symptom-specific physical limitations and to investigate this impact in different severities of CVD. Method and results The study was based on 5426 patients from ten family practices, organised into eight a priori exclusive severity groups: (i) no CVD or osteoarthritis (OA) (reference), (ii) index hypertension, ischaemic heart disease (IHD) and heart failure (HF) without OA, (iii) index OA without CVD and (iv) same CVD groups with comorbid OA. The measure of CP physical limitations was Seattle Angina Questionnaire and for SOB physical limitations was the Kansas City Cardiomyopathy Questionnaire. Adjusted baseline associations between the cohorts and symptom-specific physical limitations were assessed using linear regression methods. In the study population, 1443 (27%) reported CP and 2097 (39%) SOB. CP and SOB physical limitations increased with CVD severity in the index and comorbid groups. Compared with the respective index CVD group, the CP physical limitation scores for comorbid CVD groups with OA were lower by: − 14.7 (95% CI − 21.5, 7.8) for hypertension, − 5.5 (− 10.4, − 0.7) for IHD and − 22.1 (− 31.0, − 6.7) for HF. For SOB physical limitations, comorbid scores were lower by: − 9.2 (− 13.8, − 4.6) for hypertension, − 6.4 (− 11.1, − 1.8) for IHD and − 8.8 (− 19.3, 1.65) for HF. Conclusions CP and SOB are common symptoms, and OA increases the CVD symptom-specific physical limitations additively. Comorbidity interventions need to be developed for CVD specific health outcomes.
    Full-text · Article · Jul 2014 · International Journal of Cardiology
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    • "To our knowledge, this study is the first to show an association between the amount of fat and its abdominal distribution with hand OA. Other studies showed associations between OA of the hands and obesity-related co-morbidities: Jonsson and colleagues demonstrated that hand OA and atherosclerosis were associated in older women; both carotid plaques and coronary calcifications showed a linear association with hand OA severity [26]. Hoeven and colleagues confirmed this observation in a population aged 55 years and older; they showed an association of atherosclerosis and OA of the DIP and MCP joints in women, independent of cardiovascular risk factors [27]. "
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    ABSTRACT: Obesity, usually characterized by the body mass index (BMI), is a risk factor for hand osteoarthritis (OA). We investigated whether adipose tissue and abdominal fat distribution are associated with hand OA. The Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort aged 45 to 65 years, including 5315 participants (53% women, median BMI 29.9 kg/m2). Fat percentage and fat mass (FM) (kg) were estimated using bioelectrical impedance analysis. The waist-to-hip ratio (WHR) was calculated. In 1721 participants, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (cm2) were assessed using abdominal MR imaging. Hand OA was defined according to the ACR criteria.Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association of fat percentage, FM, WHR, VAT and SAT with hand OA using logistic regression analyses per standard deviation, stratified by sex and adjusted for age. Hand OA was present in 8% of men and 20% of women. Fat percentage was associated with hand OA in men (OR 1.34 (95%CI 1.11 to 1.61)) and women (OR 1.26 (1.05 to 1.51)), as was FM. WHR was associated with hand OA in men (OR 1.45 (1.13 to 1.85)), and to a lesser extent in women (OR 1.17 (1.00 to 1.36)). Subgroup analysis revealed that VAT was associated with hand OA in men (OR1.33 (1.01 to 1.75)). This association increased after additional adjustment for FM (OR 1.51 (1.13 to 2.03)). Fat percentage, FM and WHR were associated with hand OA. VAT was associated with hand OA in men, suggesting involvement of visceral fat in hand OA.
    Full-text · Article · Jan 2014 · Arthritis research & therapy
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    • "Recently, there has been substantial interest in the relationship between various arthritic disorders in relation to cardiovascular morbidity [43]. Some studies have shown an association between OA and cardiovascular morbidity and mortality [44], and it has been suggested that atherosclerosis may contribute to the initiation or progression of OA [45,46]. An association between arterial stiffness and hand OA has been found, but the significant individual relationship was largely attributable to the confounding effect of age [43]. "
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    ABSTRACT: Knowledge about the prevalence and consequences of osteoarthritis (OA) in the Norwegian population is limited. This study has been designed to gain a greater understanding of musculoskeletal pain in the general population with a focus on clinically and radiologically confirmed OA, as well as risk factors, consequences, and management of OA. The Musculoskeletal pain in Ullensaker STudy (MUST) has been designed as an observational study comprising a population-based postal survey and a comprehensive clinical examination of a sub-sample with self-reported OA (MUST OA cohort). All inhabitants in Ullensaker municipality, Norway, aged 40 to 79 years receive the initial population-based postal survey questionnaire with questions about life style, general health, musculoskeletal pain, self-reported OA, comorbidities, health care utilisation, medication use, and functional ability. Participants who self-report OA in their hip, knee and/or hand joints are asked to attend a comprehensive clinical examination at Diakonhjemmet Hospital, Oslo, including a comprehensive medical examination, performance-based functional tests, different imaging modalities, cardiovascular assessment, blood and urine samples, and a number of patient-reported questionnaires including five OA disease specific instruments. Data will be merged with six national data registries. A subsample of those who receive the questionnaire has previously participated in postal surveys conducted in 1990, 1994, and 2004 with data on musculoskeletal pain and functional ability in addition to demographic characteristics and a number of health related factors. This subsample constitutes a population based cohort with 20 years follow-up. This protocol describes the design of an observational population-based study that will involve the collection of data from a postal survey on musculoskeletal pain, and a comprehensive clinical examination on those with self-reported hand, hip and/or knee OA. These data, in addition to data from national registries, will provide unique insights into clinically and radiologically confirmed OA with respect to risk factors, consequences, and management.
    Full-text · Article · Jul 2013 · BMC Musculoskeletal Disorders
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