CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(03): 310-316
DOI: 10.1055/s-0040-1701281
Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Association between Knee Osteoarthritis and Metabolic Syndrome in Non-Institutionalized Elderly Patients[*]

Article in several languages: português | English
1   Programa de Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
2   Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
Beatriz Lavras Costallat
3   Departamento de Radiologia, Hospital Vera Cruz, Campinas, Brasil
2   Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
2   Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
› Author Affiliations
Further Information

Publication History

10 October 2018

19 March 2019

Publication Date:
16 March 2020 (online)


Objective This study aimed to analyze the association between knee osteoarthritis (OA) and metabolic syndrome (MS) in non-institutionalized elderly patients.

Methods A cross-sectional, randomized study, drawn from a probabilistic cluster study conducted with 416 elderly people from a Family Health Unit (USF, in the Portuguese acronym) of our municipality. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), and OA according to the Kellgren-Lawrence (KL) scale (≥ 2).

Results For the statistical analysis, we performed an exploratory data analysis, Mann-Whitney or Chi-Squared tests and univariate and multivariate logistic regressions, with significance level of p < 0.05; the concordance between the evaluators was verified through the Kappa coefficient. There was an association between OA and body mass index (BMI) (p = 0.0021) and between OA and waist circumference (WC) (p < 0.001; odds ratio [OR] = 3.524). There was no significant association between OA and the number of metabolic components nor with SM itself.

Conclusion We conclude that knee OA is associated with WC, regardless of weight, and that the increase in its measure reflects a greater chance of MS in non-institutionalized elderly patients.

* Work developed at Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

  • Referências

  • 1 Kluzek S, Newton JL, Arden NK. Is osteoarthritis a metabolic disorder?. Br Med Bull 2015; 115 (01) 111-121
  • 2 Farnaghi S, Crawford R, Xiao Y, Prasadam I. Cholesterol metabolism in pathogenesis of osteoarthritis disease. Int J Rheum Dis 2017; 20 (02) 131-140
  • 3 World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1: Diagnosis and classification of diabetes mellitus (No. WHO/NCD/NCS/99.2). Geneva: World health organization; 1999
  • 4 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285 (19) 2486-2497
  • 5 Einhorn D, Reaven GM, Cobin RH. , et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9 (03) 237-252
  • 6 Balkau B, Charles MA, Drivsholm T. , et al. European Group For The Study Of Insulin Resistance (EGIR). Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab 2002; 28 (05) 364-376
  • 7 Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica. Diretrizes brasileiras de obesidade 2009/2010. 3a ed. Itapevi, SP: AC Farmacêutica; 2009
  • 8 Le Clanche S, Bonnefont-Rousselot D, Sari-Ali E, Rannou F, Borderie D. Inter-relations between osteoarthritis and metabolic syndrome: A common link?. Biochimie 2016; 121: 238-252
  • 9 Courties A, Sellam J, Berenbaum F. Metabolic syndrome-associated osteoarthritis. Curr Opin Rheumatol 2017; 29 (02) 214-222
  • 10 Grundy SM, Cleeman JI, Daniels SR. , et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112 (17) 2735-2752
  • 11 Findlay DM. Vascular pathology and osteoarthritis. Rheumatology (Oxford) 2007; 46 (12) 1763-1768
  • 12 Redon J, Cifkova R, Laurent S. , et al. Scientific Council of the European Society of Hypertension. The metabolic syndrome in hypertension: European society of hypertension position statement. J Hypertens 2008; 26 (10) 1891-1900
  • 13 Carnevale Schianca GP, Fra GP, Steffanini M. , et al. Impaired glucose metabolism in hypertensive patients with/without the metabolic syndrome. Eur J Intern Med 2014; 25 (05) 477-481
  • 14 Sellam J, Berenbaum F. Is osteoarthritis a metabolic disease?. Joint Bone Spine 2013; 80 (06) 568-573
  • 15 Sun AR, Friis T, Sekar S, Crawford R, Xiao Y, Prasadam I. Is synovial macrophage activation the inflammatory link between obesity and osteoarthritis?. Curr Rheumatol Rep 2016; 18 (09) 57
  • 16 Schett G, Kleyer A, Perricone C. , et al. Diabetes is an independent predictor for severe osteoarthritis: results from a longitudinal cohort study. Diabetes Care 2013; 36 (02) 403-409
  • 17 Marques CDL, Duarte ALB. A importância do reconhecimento de comorbidades em pacientes com osteoartrite. Temas Reumatol 2011; 12 (01) 3-6
  • 18 Kellgren JH, Lawrence JS. The Epidemiology of Chronic Rheumatism: Atlas of Standard Radiographs of Arthritis. Oxford: Blackwell Scientific; 1963
  • 19 Dahaghin S, Bierma-Zeinstra SM, Koes BW, Hazes JM, Pols HA. Do metabolic factors add to the effect of overweight on hand osteoarthritis? The Rotterdam Study. Ann Rheum Dis 2007; 66 (07) 916-920
  • 20 Eymard F, Parsons C, Edwards MH. , et al. Diabetes is a risk factor for knee osteoarthritis progression. Osteoarthritis Cartilage 2015; 23 (06) 851-859
  • 21 Jungmann PM, Kraus MS, Alizai H. , et al. Association of metabolic risk factors with cartilage degradation assessed by T2 relaxation time at the knee: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 2013; 65 (12) 1942-1950
  • 22 Atayde SA, Yoshinari NH, Nascimento DP. , et al. Experimental diabetes modulates collagen remodelling of joints in rats. Histol Histopathol 2012; 27 (11) 1471-1479
  • 23 Oliviero F, Lo Nigro A, Bernardi D. , et al. A comparative study of serum and synovial fluid lipoprotein levels in patients with various arthritides. Clin Chim Acta 2012; 413 (1-2): 303-307
  • 24 Gierman LM, van der Ham F, Koudijs A. , et al. Metabolic stress-induced inflammation plays a major role in the development of osteoarthritis in mice. Arthritis Rheum 2012; 64 (04) 1172-1181
  • 25 Yasuda E, Nakamura R, Matsugi R. , et al. Association between the severity of symptomatic knee osteoarthritis and cumulative metabolic factors. Aging Clin Exp Res 2018; 30 (05) 481-488
  • 26 Maddah S, Mahdizadeh J. Association of metabolic syndrome and its components with knee osteoarthritis. Acta Med Iran 2015; 53 (12) 743-748
  • 27 Han CD, Yang IH, Lee WS, Park YJ, Park KK. Correlation between metabolic syndrome and knee osteoarthritis: data from the Korean National Health and Nutrition Examination Survey (KNHANES). BMC Public Health 2013; 13: 603
  • 28 Niu J, Clancy M, Aliabadi P, Vasan R, Felson DT. Metabolic syndrome, its components, and knee osteoarthritis: the Framingham osteoarthritis study. Arthritis Rheumatol 2017; 69 (06) 1194-1203
  • 29 Shin D. Association between metabolic syndrome, radiographic knee osteoarthritis, and intensity of knee pain: results of a national survey. J Clin Endocrinol Metab 2014; 99 (09) 3177-3183
  • 30 Chi WC, Wolff J, Greer R, Dy S. Multimorbidity and decision-making preferences among older adults. Ann Fam Med 2017; 15 (06) 546-551
  • 31 Yarnall AJ, Sayer AA, Clegg A, Rockwood K, Parker S, Hindle JV. New horizons in multimorbidity in older adults. Age Ageing 2017; 46 (06) 882-888