| Summary: | <p><strong>Purpose:</strong> To describe the associations of glucose homeostasis measures and metabolic syndrome (MetS) measures with knee cartilage defects and cartilage volume in young adults.</p>
<p><strong>Methods:</strong> Australian young adults from the Childhood Determinants of Adult Health Study were selected to undergo knee magnetic resonance imaging (MRI) scans during 2008-2010 (aged 31-41 years). Fasting blood sample, waist circumference and blood pressure measures were collected during 2004-2006 (aged 26-36 years). Glucose, insulin, triglyceride and high-density lipoprotein (HDL) were measured using serum samples. Homeostatic model assessment 2-insulin resistance (HOMA2-IR), HOMA2-beta cell function (HOMA2-β), HOMA2-insulin sensitivity (HOMA-S) were calculated using HOMA2 calculator (version 2.2.3 available from http://www.dtu.ox.ac.uk/homacalculator) according to fasting glucose and fasting insulin. MetS was defined when at least three of the following five components were present: waist circumference (male ≥102 cm, female ≥88 cm), fasting glucose (≥5.6 mmol/L), serum triglycerides (≥1.7 mmol/L), HDL (male <1.03 mmol/L, female <1.3 mmol/L), and blood pressure (≥130/85 mmHg). Cartilage defects and cartilage volume were measured from MRI scans. Data were analysed using log binomial or linear regressions and adjusted for age, gender and body mass index.</p>
<p><strong>Results:</strong> Among 328 participants (47.3% were females), 40 (12.7%) had hyperglycaemia and 21 (6.7%) had MetS. Glucose homeostasis measures (except fasting glucose) were associated with tibiofemoral cartilage defects (Fasting insulin: relative risk (RR) 1.05/mU/L, 95% confidence interval (CI) 1.01 to 1.09; HOMA2-IR: 1.46, 1.10 to 1.95; HOMA2-β: 2.54, 1.27 to 5.11; HOMA2-S: 0.44, 0.23 to 0.81), but not patellar cartilage defects. MetS measures were not associated with cartilage defects, except associations between hypertriglyceridemia and patellar cartilage defects (RR 1.72, 95% CI 1.09 to 2.72) and between low HDL and tibiofemoral cartilage defects (RR 2.11, 95% CI 1.22 to 3.66). All the significant associations persisted after further adjustment for total physical activity. There were no associations between glucose homeostasis measures or MetS measures and knee cartilage volume.</p>
<p><strong>Conclusions:</strong> Insulin resistance was associated with higher risk of tibiofemoral cartilage defects, but not patellar cartilage defects amongst young adults. MetS was not associated with cartilage defects; neither glucose homeostasis measures nor MetS were associated with cartilage volume. These suggest that glucose homeostasis, but not MetS, may play a role in cartilage damage in young adults and may lead to knee osteoarthritis in later life.</p>
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