title: Body mass index and hand osteoarthritis susceptibility: an updated meta-analysis.
abstract: OBJECTIVE
  Numerous epidemiologic studies have evaluated the association between overweight and hand osteoarthritis; However, the existing results are inconsistent.
  
  
  METHODS
  Systematic searches were performed and reference lists from the retrieved trials were searched. This meta-analysis and meta-regression was executed to identify all English-language articles that quantitatively assess the strength of associations between body mass index and hand osteoarthritis risk. Study-specific incremental estimates were standardized to determine the risk associated with a 5 kg/m2increase in body mass index. We conducted the study according to the guidelines for the meta-analysis of observational studies in epidemiology.
  
  
  RESULTS
  Of the 21 studies included, 13 were cross-sectional studies, three were case control studies and five were cohort studies. The pooled summary estimates were 1.10 (95%CI: 0.98-1.24) with no significant difference (P = 0.09). Subgroup analysis shows that body mass index was positively associated with hand osteoarthritis in cross-sectional studies (1.05 [95%CI: 1.02-1.08] P < 0.01), while with no significant difference was found in case-control studies (1.28 [95%CI: 0.87-1.88]) and in cohort studies (1.06 [95%CI: 0.71-1.58]) (P = 0.21 and P = 0.77, respectively). A weak but significant effect on radiographic hand osteoarthritis risk was found. The summary estimates were 1.06 (95%CI: 1.02-1.10) in studies defined by radiography and 1.25 (95%CI: 1.06-1.49) by radiography and clinically (P < 0 .01 and P = 0.01, respectively).
  
  
  CONCLUSIONS
  It appears that increased body mass index contributes to a positively moderate effect on susceptibility to hand osteoarthritis, as defined radiographically and/or radiographically and clinically. The effects vary by study design and osteoarthritis definition.
authors.affiliation: Department of Epidemiology, Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Liying
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Endodontics, Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Xie
authors.affiliation: Department of Epidemiology, Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Yidan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Hygienic Microbiology, Public Health College, Harbin Medical University, Harbin, China.
authors.forename: Yingchen
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Yihua
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Epidemiology, Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Tian
authors.affiliation: Department of Epidemiology, Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Minjie
authors.initials: M
authors.lastname: Chu
authors.affiliation: Department of Statistics, Public Health College Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D016017:Odds Ratio; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
keywords: body mass index; meta-analysis; osteoarthritis