title: Markers of atherosclerosis in relation to presence and progression of knee osteoarthritis: a population-based cohort study.
abstract: OBJECTIVE
  To investigate the association between markers of atherosclerosis and the presence and progression of knee OA in a population-based cohort study.
  
  
  METHODS
  The study was performed within the framework of the prospective Rotterdam Study. Markers of atherosclerosis included coronary artery calcification (CAC) and plasma levels of CD40L, vascular cell adhesion molecule 1 (VCAM-1) and VEGF. CAC data were available for 1669 participants, and CD40L, VCAM-1 and VEGF data for 975. Radiographs of the knee were scored with the Kellgren and Lawrence score for OA at baseline and follow-up [average follow-up time 4.5 years (s.d. 0.5)]. We used multivariate logistic regression models with generalized estimated equations to calculate odds ratios (95% CIs) for the association of atherosclerosis markers with prevalence and progression of knee OA.
  
  
  RESULTS
  The mean age was 73.1 (s.d. 7.5) years. Within the study population, 18% had radiographic knee OA (11% of men and 23% of women). CAC and VEGF were not associated with prevalent knee OA. Only among women, CD40L [adjusted odds ratio 1.3 (1.1, 1.6)] and VCAM-1 [adjusted odds ratio 1.3 (1.1, 1.6)] were associated with prevalent knee OA. No associations with progression were found in women. In men, too few progressors were available to assess associations.
  
  
  CONCLUSIONS
  In this population-based study, CAC and VEGF were not associated with the presence or progression of knee OA. Only among women, plasma levels of CD40L and VCAM-1 were higher in individuals with knee OA compared with those without knee OA. This might suggest an association between atherosclerosis and knee OA through low-grade systemic inflammation in women.
authors.affiliation: Department of General Practice Department of Epidemiology t.hoeven@erasmusmc.nl.
authors.forename: Theun A
authors.initials: TA
authors.lastname: Hoeven
authors.affiliation: Department of Epidemiology.
authors.forename: Maryam
authors.initials: M
authors.lastname: Kavousi
authors.affiliation: Department of Epidemiology Department of Neurology Department of Radiology.
authors.forename: Muhammed A
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Internal Medicine.
authors.forename: Joyce B
authors.initials: JB
authors.lastname: van Meurs
authors.affiliation: Department of General Practice.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Bindels
authors.affiliation: Department of Epidemiology.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of General Practice Department of Orthopaedics, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Sita M
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D023201:CD40 Ligand / Q000097:blood*; D015331:Cohort Studies; D015897:Comorbidity; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D020370:Osteoarthritis, Knee / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012044:Regression Analysis; D012737:Sex Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D019010:Vascular Cell Adhesion Molecule-1; D023201:CD40 Ligand
keywords: atherosclerosis; knee; longitudinal; markers; osteoarthritis