Individuals with High Bone Mass have increased progression of radiographic and clinical features of knee osteoarthritis.

April Hartley; Sarah A Hardcastle; Lavinia Paternoster; Eugene  McCloskey; Kenneth E S Poole; Muhammad Kassim Javaid; Mo Aye; Katie Moss; Raquel Granell; Jenny Gregory; Martin Williams; Jonathan H Tobias; Celia L Gregson

doi:10.1016/j.joca.2020.03.020

Individuals with High Bone Mass have increased progression of radiographic and clinical features of knee osteoarthritis.

April Hartley^*, Sarah A Hardcastle, Lavinia Paternoster, Eugene McCloskey, Kenneth E S Poole, Muhammad Kassim Javaid, Mo Aye, Katie Moss, Raquel Granell, Jenny Gregory, Martin Williams, Jonathan H Tobias, Celia L Gregson

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

OBJECTIVE: High bone mass (HBM) is associated with an increased prevalence of radiographic knee OA (kOA), characterized by osteophytosis. We aimed to determine if progression of radiographic kOA, and its sub-phenotypes, is increased in HBM and whether observed changes are clinically relevant.

DESIGN: A cohort with and without HBM (L1 and/or total hip bone mineral density Z-score≥+3.2) had knee radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Medial/lateral tibial/femoral osteophyte and medial/lateral joint space narrowing (JSN) grades were summed and Δosteophytes, ΔJSN derived. Pain, function and stiffness were quantified using the WOMAC questionnaire. Associations between HBM status and sub-phenotype progression were determined using multivariable linear/poisson regression, adjusting for age, sex, height, baseline sub-phenotype grade, menopause, education and total body fat mass (TBFM). Generalized estimating equations accounted for individual-level clustering.

RESULTS: 169 individuals had repeated radiographs, providing 330 knee images; 63% had HBM, 73% were female, mean (SD) age was 58 (12) years. Whilst HBM was not clearly associated with overall Kellgren-Lawrence measured progression (RR = 1.55 [0.56.4.32]), HBM was positively associated with both Δosteophytes and ΔJSN individually (adjusted mean differences between individuals with and without HBM 0.45 [0.01.0.89] and 0.15 [0.01.0.29], respectively). HBM individuals had higher WOMAC knee pain scores (β = 7.42 [1.17.13.66]), largely explained by adjustment for osteophyte score (58% attenuated) rather than JSN (30% attenuated) or TBFM (16% attenuated). The same pattern was observed for symptomatic stiffness and functional limitation.

CONCLUSIONS: HBM is associated with osteophyte progression, which appears to contribute to increased reported pain, stiffness and functional loss.

Original language	English
Pages (from-to)	1180-1190
Number of pages	11
Journal	Osteoarthritis and Cartilage
Early online date	14 May 2020
DOIs	https://doi.org/10.1016/j.joca.2020.03.020
Publication status	Published - 1 Sept 2020

Bibliographical note

Keywords

osteoarthritis
progression
high bone mass
BMD
WOMAC
health-related quality of life

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10.1016/j.joca.2020.03.020

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This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://www.sciencedirect.com/science/article/abs/pii/S1063458420310219. Please refer to any applicable terms of use of the publisher.
Accepted author manuscript, 466 KBLicence: CC BY-NC-ND

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Dr Lavinia Paternoster
- lavinia.paternosterbristol.acuk
- Bristol Medical School (PHS) - Associate Professor in Genetic Epidemiology
- Bristol Population Health Science Institute
- MRC Integrative Epidemiology Unit
Person: Academic , Member

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Hartley, A., Hardcastle, S. A., Paternoster, L., McCloskey, E., Poole, K. E. S., Javaid, M. K., Aye, M., Moss, K., Granell, R., Gregory, J., Williams, M., Tobias, J. H., & Gregson, C. L. (2020). Individuals with High Bone Mass have increased progression of radiographic and clinical features of knee osteoarthritis. Osteoarthritis and Cartilage, 1180-1190. https://doi.org/10.1016/j.joca.2020.03.020

@article{6f03c13e559b41dda7d75e3cd08d8eb7,

title = "Individuals with High Bone Mass have increased progression of radiographic and clinical features of knee osteoarthritis.",

abstract = "OBJECTIVE: High bone mass (HBM) is associated with an increased prevalence of radiographic knee OA (kOA), characterized by osteophytosis. We aimed to determine if progression of radiographic kOA, and its sub-phenotypes, is increased in HBM and whether observed changes are clinically relevant.DESIGN: A cohort with and without HBM (L1 and/or total hip bone mineral density Z-score≥+3.2) had knee radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Medial/lateral tibial/femoral osteophyte and medial/lateral joint space narrowing (JSN) grades were summed and Δosteophytes, ΔJSN derived. Pain, function and stiffness were quantified using the WOMAC questionnaire. Associations between HBM status and sub-phenotype progression were determined using multivariable linear/poisson regression, adjusting for age, sex, height, baseline sub-phenotype grade, menopause, education and total body fat mass (TBFM). Generalized estimating equations accounted for individual-level clustering.RESULTS: 169 individuals had repeated radiographs, providing 330 knee images; 63% had HBM, 73% were female, mean (SD) age was 58 (12) years. Whilst HBM was not clearly associated with overall Kellgren-Lawrence measured progression (RR = 1.55 [0.56.4.32]), HBM was positively associated with both Δosteophytes and ΔJSN individually (adjusted mean differences between individuals with and without HBM 0.45 [0.01.0.89] and 0.15 [0.01.0.29], respectively). HBM individuals had higher WOMAC knee pain scores (β = 7.42 [1.17.13.66]), largely explained by adjustment for osteophyte score (58% attenuated) rather than JSN (30% attenuated) or TBFM (16% attenuated). The same pattern was observed for symptomatic stiffness and functional limitation.CONCLUSIONS: HBM is associated with osteophyte progression, which appears to contribute to increased reported pain, stiffness and functional loss.",

keywords = "osteoarthritis, progression, high bone mass, BMD, WOMAC, health-related quality of life",

author = "April Hartley and Hardcastle, {Sarah A} and Lavinia Paternoster and Eugene McCloskey and Poole, {Kenneth E S} and Javaid, {Muhammad Kassim} and Mo Aye and Katie Moss and Raquel Granell and Jenny Gregory and Martin Williams and Tobias, {Jonathan H} and Gregson, {Celia L}",

year = "2020",

month = sep,

day = "1",

doi = "10.1016/j.joca.2020.03.020",

language = "English",

pages = "1180--1190",

journal = "Osteoarthritis and Cartilage",

issn = "1063-4584",

publisher = "W.B. Saunders",

}

Hartley, A, Hardcastle, SA, Paternoster, L, McCloskey, E, Poole, KES, Javaid, MK, Aye, M, Moss, K, Granell, R, Gregory, J, Williams, M, Tobias, JH & Gregson, CL 2020, 'Individuals with High Bone Mass have increased progression of radiographic and clinical features of knee osteoarthritis.', Osteoarthritis and Cartilage, pp. 1180-1190. https://doi.org/10.1016/j.joca.2020.03.020

TY - JOUR

T1 - Individuals with High Bone Mass have increased progression of radiographic and clinical features of knee osteoarthritis.

AU - Hartley, April

AU - Hardcastle, Sarah A

AU - Paternoster, Lavinia

AU - McCloskey, Eugene

AU - Poole, Kenneth E S

AU - Javaid, Muhammad Kassim

AU - Aye, Mo

AU - Moss, Katie

AU - Granell, Raquel

AU - Gregory, Jenny

AU - Williams, Martin

AU - Tobias, Jonathan H

AU - Gregson, Celia L

PY - 2020/9/1

Y1 - 2020/9/1

N2 - OBJECTIVE: High bone mass (HBM) is associated with an increased prevalence of radiographic knee OA (kOA), characterized by osteophytosis. We aimed to determine if progression of radiographic kOA, and its sub-phenotypes, is increased in HBM and whether observed changes are clinically relevant.DESIGN: A cohort with and without HBM (L1 and/or total hip bone mineral density Z-score≥+3.2) had knee radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Medial/lateral tibial/femoral osteophyte and medial/lateral joint space narrowing (JSN) grades were summed and Δosteophytes, ΔJSN derived. Pain, function and stiffness were quantified using the WOMAC questionnaire. Associations between HBM status and sub-phenotype progression were determined using multivariable linear/poisson regression, adjusting for age, sex, height, baseline sub-phenotype grade, menopause, education and total body fat mass (TBFM). Generalized estimating equations accounted for individual-level clustering.RESULTS: 169 individuals had repeated radiographs, providing 330 knee images; 63% had HBM, 73% were female, mean (SD) age was 58 (12) years. Whilst HBM was not clearly associated with overall Kellgren-Lawrence measured progression (RR = 1.55 [0.56.4.32]), HBM was positively associated with both Δosteophytes and ΔJSN individually (adjusted mean differences between individuals with and without HBM 0.45 [0.01.0.89] and 0.15 [0.01.0.29], respectively). HBM individuals had higher WOMAC knee pain scores (β = 7.42 [1.17.13.66]), largely explained by adjustment for osteophyte score (58% attenuated) rather than JSN (30% attenuated) or TBFM (16% attenuated). The same pattern was observed for symptomatic stiffness and functional limitation.CONCLUSIONS: HBM is associated with osteophyte progression, which appears to contribute to increased reported pain, stiffness and functional loss.

AB - OBJECTIVE: High bone mass (HBM) is associated with an increased prevalence of radiographic knee OA (kOA), characterized by osteophytosis. We aimed to determine if progression of radiographic kOA, and its sub-phenotypes, is increased in HBM and whether observed changes are clinically relevant.DESIGN: A cohort with and without HBM (L1 and/or total hip bone mineral density Z-score≥+3.2) had knee radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Medial/lateral tibial/femoral osteophyte and medial/lateral joint space narrowing (JSN) grades were summed and Δosteophytes, ΔJSN derived. Pain, function and stiffness were quantified using the WOMAC questionnaire. Associations between HBM status and sub-phenotype progression were determined using multivariable linear/poisson regression, adjusting for age, sex, height, baseline sub-phenotype grade, menopause, education and total body fat mass (TBFM). Generalized estimating equations accounted for individual-level clustering.RESULTS: 169 individuals had repeated radiographs, providing 330 knee images; 63% had HBM, 73% were female, mean (SD) age was 58 (12) years. Whilst HBM was not clearly associated with overall Kellgren-Lawrence measured progression (RR = 1.55 [0.56.4.32]), HBM was positively associated with both Δosteophytes and ΔJSN individually (adjusted mean differences between individuals with and without HBM 0.45 [0.01.0.89] and 0.15 [0.01.0.29], respectively). HBM individuals had higher WOMAC knee pain scores (β = 7.42 [1.17.13.66]), largely explained by adjustment for osteophyte score (58% attenuated) rather than JSN (30% attenuated) or TBFM (16% attenuated). The same pattern was observed for symptomatic stiffness and functional limitation.CONCLUSIONS: HBM is associated with osteophyte progression, which appears to contribute to increased reported pain, stiffness and functional loss.

KW - osteoarthritis

KW - progression

KW - high bone mass

KW - BMD

KW - WOMAC

KW - health-related quality of life

U2 - 10.1016/j.joca.2020.03.020

DO - 10.1016/j.joca.2020.03.020

M3 - Article (Academic Journal)

C2 - 32417557

SN - 1063-4584

SP - 1180

EP - 1190

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

ER -

Individuals with High Bone Mass have increased progression of radiographic and clinical features of knee osteoarthritis.

Abstract

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