There is a well‐established link between obesity and knee osteoarthritis, and recent research has implicated diabetes as a potential cause of cartilage degeneration. This study uses the National Health and Nutrition Examination Survey (NHANES) database to examine the association between knee pain and various metabolic factors.
A retrospective cross‐sectional study of the NHANES database from 1999 to 2004 was performed. The primary outcome was any knee pain and bilateral knee pain. The main effects of interest were body mass index (BMI) and hemoglobin A1c (HbA1c). We additionally assessed various patient factors, including age, race, poverty, gender, and smoking status. Multivariable logistic regression models and interaction terms were analyzed.
Data on 12,900 patients were included. In the principal adjusted analysis, the modifiable risk factors associated with any knee pain were: overweight (OR 0.91; 95% CI 0.85, 0.97), obesity (OR 1.54; 95% CI 1.42, 1.66), glycemic control (OR 1.20; 95% CI 1.03, 1.38), and current smokers (OR 1.15; 95% CI 1.05, 1.27), all p<0.05. These same factors remain significant for bilateral knee pain. Subgroup analysis showed patients under 65 years old have a 5% increase in the risk of any knee pain as their body mass index increases, but patients 65 years and older have a 10% increase in risk.
This study confirms knee pain associated with increased weight, glycemic control, current smoking, and age. Most of these risk factors can be modified in patients with knee pain and discussed when providing conservative treatment options.
Ref: https://onlinelibrary.wiley.com/doi/10.1002/acr.24423
