Markers of atherosclerosis in relation to presence and progression of knee osteoarthritis: a population-based cohort study

Abstract

OBJECTIVES: 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. CONCLUSION: 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.