Both osteoarthritis (OA) and metabolic syndrome (MetS) are associated with obesity and it may therefore not be unexpected to see increased prevalence of OA in patients with MetS and vice versa.
On the other hand, given the negative impact of OA on physical activity levels, it may also not be unreasonable to assume that individuals with OA may be more likely to present with weight gain and features of the MetS.
Finally, both OA and obesity have been associated with low levels of systemic inflammation, another factor that may promote metabolic abnormalities in these patients.
But how close is the relationship between OA and MetS in the general population?
This question was recently addressed by Rajitkanok Punepatom and colleagues from Chadds Ford, PA, in a paper just published in Postgraduate Medicine.
This study examined whether having OA predicts the presence of MetS in the National Health and Nutrition Examination Survey (NHANES) III, a representative sample of the general US population. The data set included 7714 subjects, of whom 975 subjects had OA.
Metabolic syndrome was present in 59% of the OA population and 23% of the population without OA with each of the 5 cardiovascular risk factors that comprise MetS being more prevalent in the OA population: hypertension (75% vs 38%), abdominal obesity (63% vs 38%), hyperglycemia (30% vs 13%), elevated triglycerides (47% vs 32%), and low high-density lipoprotein cholesterol (44% vs 38%).
The association between OA and MetS was strongest in younger subjects, where having OA at age 44 years was associated with an over 5-fold increased risk of MetS - a relationship that remained significant despite adjustment for body weight and other confounders.
This, not entirely unexpected association between OA and MetS, particularly in younger individuals, has a number of important clinical implications:
1) Cardiovascular risk factors should be routinely assessed and addressed in younger individuals presenting with OA.
2) Vice versa, assessment of joint health should perhaps be a routine part of assessment in younger patients presenting with signs of MetS.
3) It is likely that the common presentation of OA in patients presenting with MetS can be a significant barrier to increasing physical activity and weight management and therefore likely needs to be specifically addressed with appropriate physical and medical treatments.
AMS
Ottawa, Ontario
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