High Bone Mass is associated with bone-forming features of osteoarthritis in non-weight bearing joints independent of body mass index

Gregson, C.L., Hardcastle, S.A., Murphy, A., Faber, B., Fraser, W.D., Williams, M., Davey Smith, G. and Tobias, J.H. (2017) High Bone Mass is associated with bone-forming features of osteoarthritis in non-weight bearing joints independent of body mass index. Bone, 97. 306–313. ISSN 8756-3282

[img]
Preview
PDF (Accepted manuscript) - Submitted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (1009kB) | Preview

    Abstract

    Objectives: High Bone Mass (HBM) is associated with (a) radiographic knee osteoarthritis (OA), partly mediated by increased BMI, and (b) pelvic enthesophytes and hip osteophytes, suggestive of a bone-forming phenotype. We aimed to establish whether HBM is associated with radiographic features of OA in non weight-bearing (hand) joints, and whether such OA demonstrates a bone-forming phenotype. Methods: HBM cases (BMD Z-scores ≥+3.2) were compared with family controls. A blinded assessor graded all PA hand radiographs for: osteophytes (0-3), joint space narrowing (JSN)(0-3), subchondral sclerosis (0-1), at the index Distal Interphalangeal Joint (DIPJ) and 1st Carpometacarpal Joint (CMCJ), using an established atlas. Analyses used a random effects logistic regression model, adjusting a priori for age and gender. Mediating roles of BMI and bone turnover markers (BTMs) were explored by further adjustment. Results: 314 HBM cases (mean age 61.1years, 74% female) and 183 controls (54.3years, 46% female) were included. Osteophytes (grade≥1) were more common in HBM (DIPJ: 67% vs. 45%, CMCJ: 69% vs. 50%), with adjusted OR [95% CI] 1.82 [1.11, 2.97], p=0.017 and 1.89 [1.19, 3.01], p=0.007 respectively; no differences were seen in JSN. Further adjustment for BMI failed to attenuate ORs for osteophytes in HBM cases vs. controls; DIPJ 1.72 [1.05, 2.83], p=0.032, CMCJ 1.76 [1.00, 3.06], p=0.049. Adjustment for BTMs (concentrations lower amongst HBM cases) did not attenuate ORs. Conclusions: HBM is positively associated with OA in non weight-bearing joints, independent of BMI. HBMassociated OA is characterised by osteophytes, consistent with a bone-forming phenotype, rather than JSN reflecting cartilage loss. Systemic factors (e.g. genetic architecture) which govern HBM may also increase bone-forming OA risk.

    Item Type: Article
    Uncontrolled Keywords: osteoarthritis,osteophyte,bone,hand,epidemiology,x-ray
    Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
    Depositing User: Pure Connector
    Date Deposited: 11 Jan 2017 00:06
    Last Modified: 09 Apr 2019 11:51
    URI: https://ueaeprints.uea.ac.uk/id/eprint/61994
    DOI: 10.1016/j.bone.2017.01.005

    Actions (login required)

    View Item