The association between asymptomatic hyperuricemia and knee osteoarthritis: data from the third National Health and Nutrition Examination Survey

S. Wang, M. H. Pillinger, S. Krasnokutsky, K. E. Barbour

Research output: Contribution to journalArticle

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Abstract

Objective: In vitro and clinical studies suggest that urate may contribute to osteoarthritis (OA) risk. We tested the associations between hyperuricemia and knee OA, and examined the role of obesity, using a cross-sectional, nationally representative dataset. Method: National Health and Nutrition Examination Survey (NHANES) III used a multistage, stratified probability cluster design to select USA civilians from 1988 to 1994. Using NHANES III we studied adults >60 years, with or without hyperuricemia (serum urate > 6.8 mg/dL), excluding individuals with gout (i.e., limiting to asymptomatic hyperuricemia (AH)). Radiographic knee OA (RKOA) was defined as Kellgren–Lawrence grade ≥ 2 in any knee, and symptomatic radiographic knee osteoarthritis (RKOA) (sRKOA) was defined as RKOA plus knee pain (most days for 6 weeks) in the same knee. Results: AH prevalence was 17.9% (confidence interval (CI) 15.3–20.5). RKOA prevalence was 37.7% overall (CI 35.0–40.3), and was 44.0% for AH vs 36.3% for normouricemic adults (p = 0.056). symptomatic radiographic knee osteoarthritis (sRKOA) was more prevalent in AH vs normouricemic adults (17.4% vs 10.9%, p = 0.046). In multivariate models adjusting for obesity, model-based associations between AH and knee OA were attenuated (for RKOA, prevalence ratio (PR) = 1.14, 95% CI 0.95, 1.36; for sRKOA, PR = 1.40, 95% CI 0.98, 2.01). In stratified multivariate analyses, AH was associated with sRKOA in adults without obesity (PR = 1.66, 95% CI 1.02, 2.71) but not adults with obesity (PR = 1.21, 95% CI 0.66, 2.23). Conclusions: Among adults aged 60 or older, AH is associated with knee OA risk that is more apparent in adults without obesity.

Original languageEnglish (US)
Pages (from-to)1301-1308
Number of pages8
JournalOsteoarthritis and Cartilage
Volume27
Issue number9
DOIs
StatePublished - Sep 2019

Fingerprint

Hyperuricemia
Knee Osteoarthritis
Nutrition Surveys
Nutrition
Health
Knee
Confidence Intervals
Obesity
Uric Acid
Gout
Osteoarthritis
Multivariate Analysis
Pain

Keywords

  • Cartilage
  • Hyperuricemia
  • NHANES
  • Obesity
  • Osteoarthritis
  • Urate

ASJC Scopus subject areas

  • Rheumatology
  • Biomedical Engineering
  • Orthopedics and Sports Medicine

Cite this

The association between asymptomatic hyperuricemia and knee osteoarthritis : data from the third National Health and Nutrition Examination Survey. / Wang, S.; Pillinger, M. H.; Krasnokutsky, S.; Barbour, K. E.

In: Osteoarthritis and Cartilage, Vol. 27, No. 9, 09.2019, p. 1301-1308.

Research output: Contribution to journalArticle

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abstract = "Objective: In vitro and clinical studies suggest that urate may contribute to osteoarthritis (OA) risk. We tested the associations between hyperuricemia and knee OA, and examined the role of obesity, using a cross-sectional, nationally representative dataset. Method: National Health and Nutrition Examination Survey (NHANES) III used a multistage, stratified probability cluster design to select USA civilians from 1988 to 1994. Using NHANES III we studied adults >60 years, with or without hyperuricemia (serum urate > 6.8 mg/dL), excluding individuals with gout (i.e., limiting to asymptomatic hyperuricemia (AH)). Radiographic knee OA (RKOA) was defined as Kellgren–Lawrence grade ≥ 2 in any knee, and symptomatic radiographic knee osteoarthritis (RKOA) (sRKOA) was defined as RKOA plus knee pain (most days for 6 weeks) in the same knee. Results: AH prevalence was 17.9{\%} (confidence interval (CI) 15.3–20.5). RKOA prevalence was 37.7{\%} overall (CI 35.0–40.3), and was 44.0{\%} for AH vs 36.3{\%} for normouricemic adults (p = 0.056). symptomatic radiographic knee osteoarthritis (sRKOA) was more prevalent in AH vs normouricemic adults (17.4{\%} vs 10.9{\%}, p = 0.046). In multivariate models adjusting for obesity, model-based associations between AH and knee OA were attenuated (for RKOA, prevalence ratio (PR) = 1.14, 95{\%} CI 0.95, 1.36; for sRKOA, PR = 1.40, 95{\%} CI 0.98, 2.01). In stratified multivariate analyses, AH was associated with sRKOA in adults without obesity (PR = 1.66, 95{\%} CI 1.02, 2.71) but not adults with obesity (PR = 1.21, 95{\%} CI 0.66, 2.23). Conclusions: Among adults aged 60 or older, AH is associated with knee OA risk that is more apparent in adults without obesity.",
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AU - Pillinger, M. H.

AU - Krasnokutsky, S.

AU - Barbour, K. E.

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N2 - Objective: In vitro and clinical studies suggest that urate may contribute to osteoarthritis (OA) risk. We tested the associations between hyperuricemia and knee OA, and examined the role of obesity, using a cross-sectional, nationally representative dataset. Method: National Health and Nutrition Examination Survey (NHANES) III used a multistage, stratified probability cluster design to select USA civilians from 1988 to 1994. Using NHANES III we studied adults >60 years, with or without hyperuricemia (serum urate > 6.8 mg/dL), excluding individuals with gout (i.e., limiting to asymptomatic hyperuricemia (AH)). Radiographic knee OA (RKOA) was defined as Kellgren–Lawrence grade ≥ 2 in any knee, and symptomatic radiographic knee osteoarthritis (RKOA) (sRKOA) was defined as RKOA plus knee pain (most days for 6 weeks) in the same knee. Results: AH prevalence was 17.9% (confidence interval (CI) 15.3–20.5). RKOA prevalence was 37.7% overall (CI 35.0–40.3), and was 44.0% for AH vs 36.3% for normouricemic adults (p = 0.056). symptomatic radiographic knee osteoarthritis (sRKOA) was more prevalent in AH vs normouricemic adults (17.4% vs 10.9%, p = 0.046). In multivariate models adjusting for obesity, model-based associations between AH and knee OA were attenuated (for RKOA, prevalence ratio (PR) = 1.14, 95% CI 0.95, 1.36; for sRKOA, PR = 1.40, 95% CI 0.98, 2.01). In stratified multivariate analyses, AH was associated with sRKOA in adults without obesity (PR = 1.66, 95% CI 1.02, 2.71) but not adults with obesity (PR = 1.21, 95% CI 0.66, 2.23). Conclusions: Among adults aged 60 or older, AH is associated with knee OA risk that is more apparent in adults without obesity.

AB - Objective: In vitro and clinical studies suggest that urate may contribute to osteoarthritis (OA) risk. We tested the associations between hyperuricemia and knee OA, and examined the role of obesity, using a cross-sectional, nationally representative dataset. Method: National Health and Nutrition Examination Survey (NHANES) III used a multistage, stratified probability cluster design to select USA civilians from 1988 to 1994. Using NHANES III we studied adults >60 years, with or without hyperuricemia (serum urate > 6.8 mg/dL), excluding individuals with gout (i.e., limiting to asymptomatic hyperuricemia (AH)). Radiographic knee OA (RKOA) was defined as Kellgren–Lawrence grade ≥ 2 in any knee, and symptomatic radiographic knee osteoarthritis (RKOA) (sRKOA) was defined as RKOA plus knee pain (most days for 6 weeks) in the same knee. Results: AH prevalence was 17.9% (confidence interval (CI) 15.3–20.5). RKOA prevalence was 37.7% overall (CI 35.0–40.3), and was 44.0% for AH vs 36.3% for normouricemic adults (p = 0.056). symptomatic radiographic knee osteoarthritis (sRKOA) was more prevalent in AH vs normouricemic adults (17.4% vs 10.9%, p = 0.046). In multivariate models adjusting for obesity, model-based associations between AH and knee OA were attenuated (for RKOA, prevalence ratio (PR) = 1.14, 95% CI 0.95, 1.36; for sRKOA, PR = 1.40, 95% CI 0.98, 2.01). In stratified multivariate analyses, AH was associated with sRKOA in adults without obesity (PR = 1.66, 95% CI 1.02, 2.71) but not adults with obesity (PR = 1.21, 95% CI 0.66, 2.23). Conclusions: Among adults aged 60 or older, AH is associated with knee OA risk that is more apparent in adults without obesity.

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