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Osteoarthritis
Original research
Diabetes mellitus is not a risk factor for osteoarthritis
  1. Andrew Khor1,
  2. Cheryl-Ann Ma2,
  3. Cassandra Hong1,2,
  4. Laura Li-Yao Hui1 and
  5. Ying Ying Leung1,2
  1. 1Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
  2. 2Duke-NUS Medical School, Singapore, Singapore
  1. Correspondence to Dr Ying Ying Leung; katyccc{at}hotmail.com

Abstract

Background Association between diabetes mellitus (DM) and risk of osteoarthritis (OA) can be confounded by body mass index (BMI), a strong risk factor for both conditions. We evaluate the association between DM or hyperglycaemia with OA using systematic review and meta-analysis.

Methods We searched PubMed and Web of Science databases in English for studies that gave information on the association between DM and OA. Two meta-analysis models were conducted to address: (1) risk of DM comparing subjects with and without OA and (2) risk of OA comparing subjects with and without DM. As far as available, risk estimates that adjusted for BMI were used.

Results 31 studies with a pooled population size of 295 100 subjects were reviewed. 16 and 15 studies reported positive associations and null/ negative associations between DM and OA. 68.8% of positive studies had adjusted for BMI, compared with 93.3% of null/negative studies. In meta-analysis model 1, there was an increase prevalence of DM in subjects with OA compared with those without (OR 1.56, 95% CI 1.28 to 1.89). In meta-analysis model 2, there was no increased risk of OA (OR 1.14, 95% CI 0.98 to 1.33) in subjects with DM compared with those without, regardless of gender and OA sites. Comparing subjects with DM to those without, an increased risk of OA was noted in cross-sectional studies, but not in case-control and prospective cohort studies.

Conclusions This meta-analysis does not support DM as an independent risk factor for OA. BMI was probably the most important confounding factor.

  • osteoarthritis
  • diabetes mellitus
  • obesity
  • meta-analysis
  • systematic review
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/rmdopen-2019-001030

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    Footnotes

    • Contributors YYL and CM conceptualised and designed the study. AK, CM, CH, LH and YYL acquired the data. AK and YYL performed the data analysis. All authors interpreted the data. AK and YYL drafted the manuscript. All authors critically revised the manuscript and approved the final version of manuscript.

    • Funding YYL was supported by the National Medical Research Council, Singapore (NMRC/CSAINV/0022/2017).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Data are available on reasonable request. Request can be made by email to the correspondent author.