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Effects of Comorbid Cardiovascular Disease and Diabetes Mellitus on Hand Osteoarthritis, Pain, and Functional State Transitions
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10 01 2020
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Source: J Rheumatol. 47(10):1541-1549
[PDF-470.86 KB]
Details:
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Alternative Title:J Rheumatol
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Personal Author:
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Description:Objective:
The purpose of this study is to examine the course of hand osteoarthritis (HOA) and its relationship with cardiovascular disease (CVD) and diabetes (DM).
Methods:
Data were collected at 3 time points from 845 Johnston County Osteoarthritis Project participants (2/3 women, 1/3 African-Americans, mean age 60 years) with and without HOA, CVD, or DM. A diagnosis of radiographic hand osteoarthritis (rHOA) required a Kellgren-Lawrence severity grade of ≥2 in at least 3 joints in each hand. A four-state progressive model included transitions based on rHOA and pain or function as defined using the Australian CANadian Osteoarthritis Hand Index (AUSCAN). Markov multi-state models estimated hazard ratios and 95% confidence intervals (aHR [95%]) for associations between DM or CVD and specific state transitions, adjusting for baseline and time-varying covariates.
Results:
Participants with DM (vs those without DM) were more likely to experience worsening pain with rHOA. Individuals who had or developed CVD (vs those who did not) were significantly less likely to experience symptomatic improvement, regardless of rHOA status. Those with DM or CVD (vs those without these comorbidities) were less likely to experience improvement in function, although this was statistically significant only for those with DM and no rHOA.
Conclusion:
Overall, having or developing DM and/or CVD reduced the likelihood of symptomatic and functional improvement over time, suggesting an impact of comorbid CVD and DM on the clinical and radiographic course of HOA. Additional studies are needed to confirm these findings.
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Source:
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Pubmed ID:32062598
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Pubmed Central ID:PMC7429254
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Funding:
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Volume:47
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Issue:10
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