Association between Metabolic Risk Factors and Severity of Knee Osteoarthritis in Type 2 Diabetes Mellitus Patients

Abstract

This chapter aimed to investigate whether individuals suffering from more severe knee osteoarthritis display a worse metabolic profile. Osteoarthritis (OA) is one of the most common disabling diseases and has become a growing health care problem because of its increasing prevalence worldwide. A higher prevalence of OA has been reported among patients with metabolic syndrome, and diabetes mellitus (DM) was reported as an independent predictor for OA. This cross-sectional study was conducted in 2018 and included 57 patients with type-2 diabetes mellitus (T2DM). Both demographic information and results from metabolic tests were gathered. Anteroposterior (AP) and lateral radiographs of both knees were taken after a medical history was taken and a physical examination was performed. The severity of OA was then divided into two groups using the Kellgren-Lawrence (KL) classification method.  A total of 57 patients with T2DM enrolled in the study, of which 32 patients exhibited grade 1 or 2 KL (group A) and 25 with grade 3 or 4 KL (group B). The mean age and mean body mass index (BMI) were higher in group B compared to group A, and the differences were statistically significant (P-value = 0.01). there is a vicious cycle between being overweight/obese and having a more severe form of OA, which means that people with more severe OA engage in less physical activity due to pain and discomfort, leading to weight gain. On the other hand, obesity increases mechanical forces across weight-bearing joints. As with the other metabolic tests, the mean serum hemoglobin A1C (HbA1c) level was not statistically significant (P-value = 0.34). The data revealed that metabolic factors play a minor role in the severity of OA in patients with DM, and these changes are more influenced by increasing BMI and age.