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Association of Hand or Knee Osteoarthritis With Diabetes Mellitus in a Population of Hispanics From Puerto Rico

Nieves-Plaza, Mariely MS*†; Castro-Santana, Lesliane E. MD; Font, Yvonne M. MD; Mayor, Angel M. MD, MS*‡; Vilá, Luis M. MD

JCR: Journal of Clinical Rheumatology: January 2013 - Volume 19 - Issue 1 - p 1–6
doi: 10.1097/RHU.0b013e31827cd578
Original Articles

Background Although a higher prevalence of osteoarthritis (OA) has been reported among diabetes mellitus (DM) patients, inconsistencies and limitations of observational studies have precluded a conclusive association.

Objective The objective of this study was to evaluate the association of hand or knee OA with DM in a population of Hispanics from Puerto Rico.

Methods A cross-sectional study was performed in 202 subjects (100 adult DM patients as per the National Diabetes Data Group Classification and 102 nondiabetic subjects). Osteoarthritis of hand and knee was ascertained using the American College of Rheumatology classification criteria. Sociodemographic characteristics, health-related behaviors, comorbidities, pharmacotherapy, and DM clinical manifestations were determined. Multivariable logistic regression was used to evaluate the association of DM with hand or knee OA and to evaluate factors associated with hand or knee OA among DM patients.

Results The mean (SD) age for DM patients was 51.6 (13.1) years; 64.0% were females. The mean (SD) DM duration was 11.0 (10.4) years. The prevalence of OA in patients with DM and nondiabetic subjects was 49.0% and 26.5%, respectively (P < 0.01). In the multivariable analysis, patients with DM had 2.18 the odds of having OA when compared with nondiabetic subjects (95% confidence interval [CI], 1.12–4.24). In a subanalysis among DM patients, female patients were more likely to have hand or knee OA (odds ratio [95% CI], 5.06 [1.66–15.66]), whereas patients who did not use insulin alone for DM therapy were more likely to have OA (odds ratio [95% CI], 4.44 [1.22–16.12]).

Conclusions In this population of Hispanics from Puerto Rico, DM patients were more likely to have OA of hands or knees than were nondiabetic subjects. This association was retained in multivariable models accounting for established risk factors for OA. Among DM patients, females were at greater risk for OA, whereas the use of insulin was negatively associated.

From the *Puerto Rico Clinical & Translational Research Consortium (PRCTRC), University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico; †School of Medicine, University of Pittsburgh, Pittsburgh, PA; and ‡Department of Medicine (Division of Rheumatology), University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.

This study was supported by the National Center for Research Resources (U54 RR 026139-01A1), the National Institute on Minority Health and Health Disparities (8U54MD007587), and the National Center for Advancing Translational Sciences (TL1TR000145) from the National Institutes of Health and by unrestricted educational grant from Abbott Laboratories, Inc.

The authors declare no conflict of interest.

Correspondence: Luis M. Vilá, MD, Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, PO Box 365067, San Juan, Puerto Rico 00936-5067. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.