Bone shape mediates the relationship between sex and incident knee osteoarthritis
Abstract Background Knee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-09-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-018-2251-z |
| _version_ | 1819035089395253248 |
|---|---|
| author | Barton L. Wise Jingbo Niu Yuqing Zhang Felix Liu Joyce Pang John A. Lynch Nancy E. Lane |
| author_facet | Barton L. Wise Jingbo Niu Yuqing Zhang Felix Liu Joyce Pang John A. Lynch Nancy E. Lane |
| author_sort | Barton L. Wise |
| collection | DOAJ |
| description | Abstract Background Knee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and women is mediated by bone shape. Methods We randomly sampled 304 knees from the OAI with incident ROA (i.e., development of Kellgren/Lawrence grade ≥ 2 by month 48) and 304 knees without incident ROA. We characterized distal femur and proximal tibia shape on baseline radiographs using Statistical Shape Modeling. If a specific bone shape was associated with the risk of incident ROA, marginal structural models were generated to assess the mediation effect of that bone shape on the relation of sex and risk of incident knee ROA adjusting for baseline covariates. Results Case and control participants were similar by age, sex and race, but case knees were from higher body mass index (BMI) participants (29.4 vs. 27.0; p < 0.001). Women had 49% increased odds of incident knee ROA compared with men (adjusted odds ratio (OR) = 1.49, 95% Confidence Interval (C.I.): 1.04, 2.12). There was an inconsistent mediation effect for tibial mode 2 between sex and incident knee ROA, with an indirect effect OR of 0.96 (95% C.I.: 0.91–1.00) and a direct effect OR of 1.56 (95% C.I.: 1.08–2.27), suggesting a protective effect for this mode. Similar findings were also observed for the mediation effect of tibia mode 10 and femur mode 4. These shape modes primarily involved differences in the angular relation of the heads to the shafts of the femur and tibia. Conclusions Distal femur and proximal tibia bone shapes partially and inconsistently mediated the relationship between sex and incident knee OA. Women had a higher risk of incident ROA, and specific bone shapes modestly protected them from even higher risk of ROA. The clinical significance of these findings warrant further investigation. |
| first_indexed | 2024-12-21T07:44:05Z |
| format | Article |
| id | doaj.art-93d1533bb6e84bbaa5cfedba6d7fd262 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-21T07:44:05Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-93d1533bb6e84bbaa5cfedba6d7fd2622022-12-21T19:11:14ZengBMCBMC Musculoskeletal Disorders1471-24742018-09-011911910.1186/s12891-018-2251-zBone shape mediates the relationship between sex and incident knee osteoarthritisBarton L. Wise0Jingbo Niu1Yuqing Zhang2Felix Liu3Joyce Pang4John A. Lynch5Nancy E. Lane6Department of Internal Medicine, University of California, Davis School of MedicineBoston University School of MedicineBoston University School of MedicineDepartment of Epidemiology and Biostatistics, University of California, San FranciscoUniversity of New Mexico School of MedicineDepartment of Epidemiology and Biostatistics, University of California, San FranciscoDepartment of Internal Medicine, University of California, Davis School of MedicineAbstract Background Knee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and women is mediated by bone shape. Methods We randomly sampled 304 knees from the OAI with incident ROA (i.e., development of Kellgren/Lawrence grade ≥ 2 by month 48) and 304 knees without incident ROA. We characterized distal femur and proximal tibia shape on baseline radiographs using Statistical Shape Modeling. If a specific bone shape was associated with the risk of incident ROA, marginal structural models were generated to assess the mediation effect of that bone shape on the relation of sex and risk of incident knee ROA adjusting for baseline covariates. Results Case and control participants were similar by age, sex and race, but case knees were from higher body mass index (BMI) participants (29.4 vs. 27.0; p < 0.001). Women had 49% increased odds of incident knee ROA compared with men (adjusted odds ratio (OR) = 1.49, 95% Confidence Interval (C.I.): 1.04, 2.12). There was an inconsistent mediation effect for tibial mode 2 between sex and incident knee ROA, with an indirect effect OR of 0.96 (95% C.I.: 0.91–1.00) and a direct effect OR of 1.56 (95% C.I.: 1.08–2.27), suggesting a protective effect for this mode. Similar findings were also observed for the mediation effect of tibia mode 10 and femur mode 4. These shape modes primarily involved differences in the angular relation of the heads to the shafts of the femur and tibia. Conclusions Distal femur and proximal tibia bone shapes partially and inconsistently mediated the relationship between sex and incident knee OA. Women had a higher risk of incident ROA, and specific bone shapes modestly protected them from even higher risk of ROA. The clinical significance of these findings warrant further investigation.http://link.springer.com/article/10.1186/s12891-018-2251-zKneeOsteoarthritisBone shapeSexStatistical shape modelingRadiography |
| spellingShingle | Barton L. Wise Jingbo Niu Yuqing Zhang Felix Liu Joyce Pang John A. Lynch Nancy E. Lane Bone shape mediates the relationship between sex and incident knee osteoarthritis BMC Musculoskeletal Disorders Knee Osteoarthritis Bone shape Sex Statistical shape modeling Radiography |
| title | Bone shape mediates the relationship between sex and incident knee osteoarthritis |
| title_full | Bone shape mediates the relationship between sex and incident knee osteoarthritis |
| title_fullStr | Bone shape mediates the relationship between sex and incident knee osteoarthritis |
| title_full_unstemmed | Bone shape mediates the relationship between sex and incident knee osteoarthritis |
| title_short | Bone shape mediates the relationship between sex and incident knee osteoarthritis |
| title_sort | bone shape mediates the relationship between sex and incident knee osteoarthritis |
| topic | Knee Osteoarthritis Bone shape Sex Statistical shape modeling Radiography |
| url | http://link.springer.com/article/10.1186/s12891-018-2251-z |
| work_keys_str_mv | AT bartonlwise boneshapemediatestherelationshipbetweensexandincidentkneeosteoarthritis AT jingboniu boneshapemediatestherelationshipbetweensexandincidentkneeosteoarthritis AT yuqingzhang boneshapemediatestherelationshipbetweensexandincidentkneeosteoarthritis AT felixliu boneshapemediatestherelationshipbetweensexandincidentkneeosteoarthritis AT joycepang boneshapemediatestherelationshipbetweensexandincidentkneeosteoarthritis AT johnalynch boneshapemediatestherelationshipbetweensexandincidentkneeosteoarthritis AT nancyelane boneshapemediatestherelationshipbetweensexandincidentkneeosteoarthritis |