Relationship of Bone Mineral Density and Knee Osteoarthritis (Kellgren-Lawrence Grade): Fifth Korea National Health and Nutrition Examination Survey

• Published in: Clinics in orthopedic surgery Vol. 13; no. 1; pp. 60 - 66
• Main Authors: Choi, Eun-Seok, Shin, Hyun Dae, Sim, Jae Ang, Choi, Won-Jun, Shin, Dae-Do, Baik, Jong-Min
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Orthopaedic Association 01.03.2021; 대한정형외과학회
• Subjects: Absorptiometry, Photon; Aged; Bone Density; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Nutrition Surveys; Original; Osteoarthritis, Knee - diagnostic imaging; Osteoarthritis, Knee - epidemiology; Osteoporosis - diagnostic imaging; Osteoporosis - epidemiology; Republic of Korea - epidemiology; 정형외과학; Republic of Korea; Osteoporosis; Korea National Health and Nutrition Examination Survey; Osteoarthritis; Kellgren-Lawrence grade
• ISSN: 2005-291X; 2005-4408; 2005-4408
• DOI: 10.4055/cios20111

Osteoarthritis (OA) and osteoporosis (OP) are the 2 most common bone disorders associated with aging. We can simply assume that older patients have a higher incidence of OA and OP with more severity. Although several papers have conducted studies on the relationship between OA and OP, none of them has demonstrated a conclusive link. In this study, we used radiological knee OA and bone mineral density (BMD; T-score of the total hip and lumbar spine) to analyze the incidence of OA and OP in a large population. We aimed to determine the relationship between OA and OP and investigate the associated risk factors. This cross-sectional study used data extracted from the 2010-2012 Korea National Health and Nutrition Examination Survey. We evaluated a total of 4,250 participants aged ≥ 50 years who underwent knee radiography and dual-energy X-ray absorptiometry and their laboratory results. The relationship between radiological knee OA and BMD was assessed. The generalized linear model was used to evaluate the relationship between BMD and Kellgren-Lawrence (KL) grade. The higher KL grade was associated with older age, higher body mass index (BMI), female sex, and lower hemoglobin level ( < 0.001). No significant association was found between OA and the following variables: white blood cell, platelet, total cholesterol, vitamin D, alkaline phosphatase, parathyroid hormone, hypertension, diabetes, asthma, dyslipidemia, smoking status, alcohol consumption, and regular exercise ( > 0.05). After adjusting for confounding factors (age, BMI, diabetes, hypertension, smoking, and alcohol consumption), the average T-scores of total hip and lumbar spine were the highest in the mild OA group with KL grade 2 (-0.22 ± 1.08 and -0.89 ± 1.46, respectively, < 0.001). The average T-scores of the total hip and lumbar spine significantly decreased as OA progressed from moderate (KL grade 3; -0.49 ± 1.05 and -1.33 ± 1.38, respectively, < 0.001) to severe (KL grade 4; -0.73 ± 1.13 and -1.74 ± 1.75, respectively, < 0.001). T-scores of the moderate-to-severe OA group were significantly lower than those of the non-OA group (KL grades 0 and 1, < 0.001). Compared with the non-OA group, BMD (T-scores of the total hip and lumbar spine) was higher in the mild OA group and lower in the moderate-to-severe OA group.