Prevalence of radiographic hip osteoarthritis is increased in high bone mass

Journal article

Objective: Epidemiological studies have shown an association between increased bone mineral density (BMD) and osteoarthritis (OA), but whether this represents cause or effect remains unclear. In this study, we used a novel approach to investigate this question, determining whether individuals with High Bone Mass (HBM) have a higher prevalence of radiographic hip OA compared with controls. Design: HBM cases came from the UK-based HBM study: HBM was defined by BMD Z-score. Unaffected relatives of index cases were recruited as family controls. Age-stratified random sampling was used to select further population controls from the Chingford and Hertfordshire cohort studies. Pelvic radiographs were pooled and assessed by a single observer blinded to case-control status. Analyses used logistic regression, adjusted for age, gender and body mass index (BMI). Results: 530 HBM hips in 272 cases (mean age 62.9 years, 74% female) and 1702 control hips in 863 controls (mean age 64.8 years, 84% female) were analysed. The prevalence of radiographic OA, defined as Croft score ≥3, was higher in cases compared with controls (20.0% vs 13.6%), with adjusted odds ratio (OR) [95% CI] 1.52 [1.09, 2.11], P = 0.013. Osteophytes (OR 2.12 [1.61, 2.79], P < 0.001) and subchondral sclerosis (OR 2.78 [1.49, 5.18], P = 0.001) were more prevalent in cases. However, no difference in the prevalence of joint space narrowing (JSN) was seen (OR 0.97 [0.72, 1.33], P = 0.869). Conclusions: An increased prevalence of radiographic hip OA and osteophytosis was observed in HBM cases compared with controls, in keeping with a positive association between HBM and OA and suggesting that OA in HBM has a hypertrophic phenotype. © 2014 The Authors.

Authors: Hardcastle, SA; Dieppe, P; Gregson, C; Hunter, D; Thomas, G

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: W.B. Saunders Ltd
• Journal: Osteoarthritis and Cartilage
• Volume: 22
• Issue: 8
• Pages: 1120-1128
• Publication date: 2014-08-01
• DOI: 10.1016/j.joca.2014.06.007
• EISSN: 1522-9653
• ISSN: 1063-4584
• Language: English
• Keywords: Osteoarthritis; DXA; Epidemiology; Osteoporosis; Radiology