Objectives. Our aim was to determine the risk of diabetes among osteoarthritis (OA) cases in a prospective longitudinal study. Methods. Administrative health records of 577,601 randomly selected individuals from British Columbia, Canada, from 1991 to 2009, were analyzed. OA and diabetes cases were identified by checking physician’s visits and hospital records. From 1991 to 1996 we documented 19,143 existing OA cases and selected one non-OA individual matched by age, sex, and year of administrative records. Poisson regression and Cox proportional hazards models were fitted to estimate the effects after adjusting for available sociodemographic and medical factors. Results. At baseline, the mean age of OA cases was 61 years and 60.5% were women. Over 12 years of mean follow-up, the incidence rate (95% CI) of diabetes was 11.2 (10.90–11.50) per 1000 person years. Adjusted RRs (95% CI) for diabetes were 1.27 (1.15–1.41), 1.21 (1.08–1.35), 1.16 (1.04–1.28), and 0.99 (0.86–1.14) for younger women (age 20–64 years), older women (age ≥ 65 years), younger men, and older men, respectively. Conclusion. Younger adults and older women with OA have increased risks of developing diabetes compared to their age-sex matched non-OA counterparts. Further studies are needed to confirm these results and to elucidate the potential mechanisms. 1. Introduction Diabetes mellitus is a common chronic health condition worldwide. It is predicted that the global prevalence of this disease among adults will rise from 6.4% in 2010 to 7.7% by 2030 [1]. Diabetes affects an estimated 8.3% of Americans and 8.8% of Canadians [2, 3], resulting in severe damage to the cardiovascular system, kidneys, eyes, and other organs. Metabolic syndrome is a group of conditions such as hypertension, hyperlipidemia, obesity, and elevated blood glucose that are linked with diabetes [4]. Other common risk factors for diabetes include age, sex, family history, ethnicity, socioeconomic status (SES), heart disease, history of gestational diabetes, physical inactivity, alcohol consumption, and diet [5, 6]. As the prevalence of diabetes has risen, it has been imperative to identify determinants beyond these traditional risk factors. Studies have shown that the increased risk of diabetes is caused in part by physical inactivity and that physically active individuals have lower rates of the disease [6, 7]. In addition, muscle strength was found to be significantly lower among adults with type 2 diabetes [8]. Osteoarthritis (OA) is the most common type of rheumatic disease and a leading cause of disability [9–11].
References
[1]
J. E. Shaw, R. A. Sicree, and P. Z. Zimmet, “Global estimates of the prevalence of diabetes for 2010 and 2030,” Diabetes Research and Clinical Practice, vol. 87, no. 1, pp. 4–14, 2010.
[2]
L. L. Lipscombe and J. E. Hux, “Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based study,” The Lancet, vol. 369, no. 9563, pp. 750–756, 2007.
[3]
Centers for Disease Control and Prevention, National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, Centers for Disease Control and Prevention, Atlanta, Ga, USA, 2011.
[4]
S. M. Grundy, J. I. Cleeman, S. R. Daniels et al., “Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement,” Circulation, vol. 112, no. 17, pp. 2735–2752, 2005.
[5]
R. Dyck, C. Karunanayake, P. Pahwa et al., “Prevalence, risk factors and co-morbidities of diabetes among adults in rural Saskatchewan: the influence of farm residence and agriculture-related exposures,” BMC Public Health, vol. 13, no. 1, article 7, 2013.
[6]
A. H. Auchincloss, A. V. D. Roux, M. S. Mujahid, M. Shen, A. G. Bertoni, and M. R. Carnethon, “Neighborhood resources for physical activity and healthy foods and incidence of type 2 diabetes mellitus: the multi-ethnic study of atherosclerosis,” Archives of Internal Medicine, vol. 169, no. 18, pp. 1698–1704, 2009.
[7]
J. C. Sieverdes, X. Sui, D.-C. Lee et al., “Physical activity, cardiorespiratory fitness and the incidence of type 2 diabetes in a prospective study of men,” British Journal of Sports Medicine, vol. 44, no. 4, pp. 238–244, 2010.
[8]
S. W. Park, B. H. Goodpaster, E. S. Strotmeyer et al., “Decreased muscle strength and quality in older adults with type 2 diabetes: the health, aging, and body composition study,” Diabetes, vol. 55, no. 6, pp. 1813–1818, 2006.
[9]
D. T. Felson and Y. Zhang, “An update on the epidemiology of knee and hip osteoarthritis with a view to prevention,” Arthritis & Rheumatism, vol. 41, no. 8, pp. 1343–1355, 1998.
[10]
R. C. Lawrence, C. G. Helmick, F. C. Arnett, et al., “Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States,” Arthritis & Rheumatology, vol. 41, pp. 778–799, 1998.
[11]
R. C. Lawrence, D. T. Felson, C. G. Helmick et al., “Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II,” Arthritis & Rheumatism, vol. 58, no. 1, pp. 26–35, 2008.
[12]
J. A. Kopec, M. M. Rahman, J.-M. Berthelot, et al., “Descriptive epidemiology of osteoarthritis in British Columbia, Canada,” The Journal of Rheumatology, vol. 34, no. 2, pp. 386–393, 2007.
[13]
D. J. Hunter, “Osteoarthritis,” Best Practice & Research Clinical Rheumatology, vol. 25, pp. 801–814, 2011.
[14]
D. D. Dunlop, L. M. Manheim, J. Song, and R. W. Chang, “Arthritis prevalence and activity limitations in older adults,” Arthritis & Rheumatism, vol. 44, no. 1, pp. 212–221, 2001.
[15]
P. Suri, D. C. Morgenroth, and D. J. Hunter, “Epidemiology of osteoarthritis and associated comorbidities,” PM&R, vol. 4, no. 5, pp. S10–S19, 2012.
[16]
J. M. Hootman, C. A. Macera, S. A. Ham, C. G. Helmick, and J. E. Sniezek, “Physical activity levels among the general US adult population and in adults with and without arthritis,” Arthritis Care & Research, vol. 49, no. 1, pp. 129–135, 2003.
[17]
J. Lee, J. Song, J. M. Hootman, et al., “Obesity and other modifiable factors for physical inactivity measured by accelerometer in adults with knee osteoarthritis,” Arthritis Care & Research, vol. 65, no. 1, pp. 53–61, 2013.
[18]
F. Berenbaum, “Diabetes-induced osteoarthritis: from a new paradigm to a new phenotype,” Annals of the Rheumatic Diseases, vol. 70, no. 8, pp. 1354–1356, 2011.
[19]
E. Yusuf, “Metabolic factors in osteoarthritis: obese people do not walk on their hands,” Arthritis Research and Therapy, vol. 14, no. 4, article 123, 2012.
[20]
P. Pottie, N. Presle, B. Terlain, P. Netter, D. Mainard, and F. Berenbaum, “Obesity and osteoarthritis: more complex than predicted!,” Annals of the Rheumatic Diseases, vol. 65, no. 11, pp. 1403–1405, 2006.
[21]
M. T. Velasquez and J. D. Katz, “Osteoarthritis: another component of metabolic syndrome?” Metabolic Syndrome and Related Disorders, vol. 8, no. 4, pp. 295–305, 2010.
[22]
G. Engstr？m, M. Gerhardsson de Verdier, J. Rollof, P. M. Nilsson, and L. S. Lohmander, “C-reactive protein, metabolic syndrome and incidence of severe hip and knee osteoarthritis. A population-based cohort study,” Osteoarthritis and Cartilage, vol. 17, no. 2, pp. 168–173, 2009.
[23]
M. Sowers, C. A. Karvonen-Gutierrez, R. Palmieri-Smith, J. A. Jacobson, Y. Jiang, and J. A. Ashton-Miller, “Knee osteoarthritis in obese women with cardiometabolic clustering,” Arthritis Care and Research, vol. 61, no. 10, pp. 1328–1336, 2009.
[24]
R. M. Palmieri-Smith, A. C. Thomas, C. Karvonen-Gutierrez, and M. F. Sowers, “Isometric quadriceps strength in women with mild, moderate, and severe knee osteoarthritis,” The American Journal of Physical Medicine and Rehabilitation, vol. 89, no. 7, pp. 541–548, 2010.
[25]
C. Slemenda, D. K. Heilman, K. D. Brandt et al., “Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women?” Arthritis & Rheumatology, vol. 41, no. 11, pp. 1951–1959, 1998.
[26]
M. Nieves-Plaza, L. E. Castro-Santana, Y. M. Font, A. M. Mayor, and L. M. Vilá, “Association of hand or knee osteoarthritis with diabetes mellitus in a population of hispanics from Puerto Rico,” Journal of Clinical Rheumatology, vol. 19, no. 1, pp. 1–6, 2013.
[27]
D. J. Hart, D. V. Doyle, and T. D. Spector, “Association between metabolic factors and knee osteoarthritis in women: the Chingford study,” The Journal of Rheumatology, vol. 22, no. 6, pp. 1118–1123, 1995.
[28]
M. A. Cimmino and M. Cutolo, “Plasma glucose concentration in symptomatic osteoarthritis: a clinical and epidemiological survey,” Clinical and Experimental Rheumatology, vol. 8, no. 3, pp. 251–257, 1990.
[29]
E. Nüesch, P. Dieppe, S. Reichenbach, S. Williams, S. Iff, and P. Jüni, “All cause and disease specific mortality in patients with knee or hip osteoarthritis: Population based cohort study,” BMJ, vol. 342, no. 7798, p. 638, 2011.
[30]
M. C. Hochberg, “Mortality in osteoarthritis,” Clinical and Experimental Rheumatology, vol. 26, no. 5, supplement 51, pp. S120–S124, 2008.
[31]
British Columbia Ministry of Health, Medical Services Plan (MSP) Payment Information File. Discharge Abstract Database (Hospital Separations). Consolidation File (MSP Registration & Premium Billing). Population Data BC. Data Extract. MOH, 2008, http://www.popdata.bc.ca/data.
[32]
M. M. Rahman, J. A. Kopec, E. C. Sayre et al., “Effect of sociodemographic factors on surgical consultations and hip or knee replacements among patients with osteoarthritis in British Columbia, Canada,” Journal of Rheumatology, vol. 38, no. 3, pp. 503–509, 2011.
M. E. Charlson, P. Pompei, K. L. Ales, and C. R. MacKenzie, “A new method of classifying prognostic comorbidity in longitudinal studies: development and validation,” Journal of Chronic Diseases, vol. 40, no. 5, pp. 373–383, 1987.
[35]
R. A. Deyo, D. C. Cherkin, and M. A. Ciol, “Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases,” Journal of Clinical Epidemiology, vol. 45, no. 6, pp. 613–619, 1992.
[36]
Y. Béland, “Canadian community health survey—methodological overview,” Health Reports, vol. 13, no. 3, pp. 9–14, 2002.
[37]
G. Chen, N. Khan, R. Walker, and H. Quan, “Validating ICD coding algorithms for diabetes mellitus from administrative data,” Diabetes Research and Clinical Practice, vol. 89, no. 2, pp. 189–195, 2010.
[38]
D. A. Southern, B. Roberts, A. Edwards et al., “Validity of administrative data claim-based methods for identifying individuals with diabetes at a population level,” Canadian Journal of Public Health, vol. 101, no. 1, pp. 61–64, 2010.
[39]
L. M. Lix, M. S. Yogendran, S. Y. Shaw, C. Burchill, C. Metge, and R. Bond, “Population-based data sources for chronic disease surveillance,” Chronic Diseases in Canada, vol. 29, no. 1, pp. 31–38, 2008.
[40]
M. M. Rahman, J. Aghanjanian, J. A. Kopec, and J. Cibere, “Validation of osteoarthritis diagnosis in administrative data using a clinically and radiologically defined population-based cohort of osteoarthritis,” Osteoarthritis Cartilage, vol. 16, supplement 4, p. S150, 2008.
[41]
A. Vanasse, M. Demers, A. Hemiari, and J. Courteau, “Obesity in Canada: where and how many?” International Journal of Obesity, vol. 30, no. 4, pp. 677–683, 2006.
