30 mei 2018

Association of type 2 diabetes mellitus with self-reported knee pain, and clinical knee osteoarthritis - The Maastricht Study.

J.T.H. Nielen, P.J. Emans, B. van den Bemt, P.C. Dagnelie, M.T. Schram, C.D.A. Stehouwer, N.C. Schaper, K.F.M. Denissen, F. de Vries, A. Boonen

Background:

Osteoarthritis (oa) is a disabling joint disease with a heterogeneous disease expression. Type 2 diabetes mellitus (t2dm) is suggested to be independently associated with knee oa. However, studies evaluating this association show inconsistent results and no data exist on whether the level of experienced pain differs among patients with or without t2dm.

Objective:

To assess the association of t2dm with non-traumatic knee pain and knee oa, and to understand whether patients with and without t2dm express different levels of pain.

Methods:

Participants of the Maastricht Study aged between 40 and 75 years, with complete data on all variables, were included. Logistic regression models were fitted to assess the association of t2dm with knee pain and clinical knee oa. A linear regression model was used to assess the difference in the level of pain between knee oa patients with and without t2dm.

Results:

t2dm was associated with knee pain (or=1.29 [95% ci=1.04-1.60]), and knee oa (or=1.81 [95% ci: 1.42-2.30]), but associations were no longer statistically significant after adjustment for bmi (knee pain: or=0.97 [95% ci=0.76-1.22]; knee oa: (or=1.22 [95% ci=0.94-1.60]). Furthermore, among subjects with knee oa, there was no difference in the severity of knee pain between patients with or without t2dm.

Conclusion:

t2dm does not seem to be independently associated with knee pain and knee oa. In view of the prominent role of bmi in this association and the clinical burden of oa, weight control should be further emphasized in the management of t2dm.