title: Association of atherosclerosis with presence and progression of osteoarthritis: the Rotterdam Study.
abstract: OBJECTIVE
  This study examined whether vascular alterations are associated with the presence and progression of osteoarthritis of the knee, the hip and the different hand joints in a large prospective cohort study.
  
  
  METHODS
  In this population-based study involving participants aged 55 years and older (Rotterdam Study I), men (n=2372) and women (n=3278) were analysed separately. x-Rays of the knee, hip and hand were scored using the Kellgren and Lawrence score for osteoarthritis at baseline, after 6.6 years and 10 years. Measures of atherosclerosis (carotid intima media thickness (IMT) and carotid plaque) and data on covariates (age, body mass index, hypertension, cholesterol ratio, diabetes mellitus and smoking) were collected at baseline. Multivariate logistic regression models with generalised estimated equations were used to calculate OR and corresponding 95% CI. Secondary multiple comparison adjustment resulted in a significance level of p<0.0021.
  
  
  RESULTS
  In women, IMT showed an independent association with the prevalence of knee osteoarthritis (adjusted OR (aOR) 1.7, 1.1 to 2.7), and carotid plaque with distal interphalangeal (DIP) osteoarthritis (aOR 1.4, 1.2 to 1.7) and with metacarpophalangeal osteoarthritis (aOR 1.5, 1.1 to 2.2). An independent association for IMT with progression of metacarpophalangeal osteoarthritis was found in women (aOR 2.9, 1.18 to 6.93). Additional adjustment for multiple testing yielded a significant association between carotid plaque and DIP osteoarthritis in women (p<0.001).
  
  
  CONCLUSIONS
  This study showed independent associations of atherosclerosis with osteoarthritis of the knee and hand joints in women. The evidence was most solid for a relation with DIP osteoarthritis. More research is needed to confirm the associations and examine the differential association with various joints.
authors.affiliation: Erasmus University Medical Centre, General Practice, Rotterdam 3015 CA, The Netherlands. t.hoeven@erasmusmc.nl
authors.forename: Theun Antonius
authors.initials: TA
authors.lastname: Hoeven
authors.forename: Maryam
authors.initials: M
authors.lastname: Kavousi
authors.forename: Stefan
authors.initials: S
authors.lastname: Clockaerts
authors.forename: Hanneke J M
authors.initials: HJ
authors.lastname: Kerkhof
authors.forename: Joyce B
authors.initials: JB
authors.lastname: van Meurs
authors.forename: Oscar
authors.initials: O
authors.lastname: Franco
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Patrick
authors.initials: P
authors.lastname: Bindels
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Witteman
authors.forename: Sita
authors.initials: S
authors.lastname: Bierma-Zeinstra
mesh_terms: D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000453:epidemiology*; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors
chemical_list: D002784:Cholesterol