Journal List > J Korean Rheum Assoc > v.14(4) > 1003584

Cho, Kim, Kim, and Seo: The Prevalence and Risk Factors of Knee and Hand Osteoarthritis in Korea

Abstract

Objective:

To estimate the prevalence of radiographic and symptomatic knee osteoarthritis (OA) and hand OA among community dwellers in a Korean rural area and to elucidate its risk factors.

Methods:

This cross-sectional population based study was conducted on residents over 40 years of age in Ansung, Gyeonggi Province. Subjects completed an interview based on a standardized questionnaire and clinical evaluation including knee and hand radiographs. We defined a subject with the Kellgren and Lawrence grade >2 as having radiographic OA (ROA). Symptomatic OA (SOA) was defined by the presence of both radiographic OA and self-reported pain.

Results:

We obtained both symptom information and radiographs from 3,876 subjects. The prevalence of radiographic and symptomatic knee OA was 14.9% and 5.4%, respectively. The prevalence of radiographic and symptomatic hand OA was 13.4% and 8.0%, respectively. The prevalence of knee and hand OA (ROA & SOA) was higher among women than men. Multiple logistic regression analysis showed a significant association of age and female sex with both knee and hand OA (ROA & SOA), of body mass index (BMI) with knee OA (ROA & SOA) and hand ROA.

Conclusion:

Both symptomatic and radiographic knee OA and hand OA is common in the general adult population of Korea, with preponderance for women. Age and female sex are common risk factors for knee and hand OA. Weight control is necessary for prevention of knee OA. Other factors might also contribute to the development of OA, but further study is needed to elucidate the role of these factors.

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Table 1.
Demographic characteristics of the subjects
Men (n=1,701) Women (n=2,175) Total (n=3,876) p-value
Age (mean±SD, years) 59.1±8.6 59.3±8.8 59.2±8.7 NS
BMI (mean±SD, kg/m2) 23.9±3.1 25.0±3.4 24.5±3.3 <0.001
Smoking (%) 715 (42.1) 58 (2.7) 773 (20) <0.001
Exercise (%)
No 1,139 (67) 1,484 (68.3) 2,623 (67.7) NS
≥1 times/week 560 (33) 690 (31.7) 1,250 (32.3)
Education (%)
≤6 years 644 (38.0) 1,511 (69.7) 2,155 (55.8)
6~12 years 846 (49.9) 607 (28.0) 1,453 (37.6) < 0.001
≥12 years 205 (12.1) 50 (2.3) 255 (6.6)
Diabetes mellitus (%) 330 (19.9) 397 (18.6) 727 (19.2) NS
Hypertension (%) 285 (16.8) 488 (22.4) 773 (19.9) < 0.001
Occupation (%)
Factory workers, laborers & farmers 1,393 (82.0) 1,357 (62.5) 2,750 (71.1) < 0.001
Others 305 (18.0) 814 (37.5) 1,119 (28.9)

BMI: body mass index, NS: no significance

Table 2.
Prevalence of knee osteoarthritis (OA) in the total target population by age groups
Men Women Total
Age (years) n ROA (%) SOA (%) n ROA (%) SOA (%) n ROA (%) SOA (%)
(95% CI) (95% CI) (95% CI) (95% CI) (95% CI) (95% CI)
40-49 305 6 (2.0) 3 (1.0) 417 6 (1.5) 1 (0.2) 722 12 (1.7) 4 (0.6)
(0.41-3.53) (-0.12-2.09) (0.30-2.58) (-0.23-0.71) (0.73-2.59) (0.01-1.10)
50-59 555 26 (4.7) 2 (0.4) 619 32 (5.2) 12 (1.9) 1,174 58 (4.9) 14 (1.2)
(2.93-6.44) (-0.14-0.86) (3.43-6.91) (0.85-3.02) (3.70-6.18) (0.57-1.81)
60-69 587 88 (15.0) 14 (2.4) 818 190 (23.2)∗ 95 (11.6)∗ 1,405 278 (19.8) 109 (7.8)
(12.1-17.88) (1.15-3.62) (20.33-26.12) (9.42-13.81) (17.70-21.87) (6.36-9.16)
≥70 245 66 (26.9) 9 (3.7) 317 162 (51.1)∗ 73 (23.0)∗ 562 228 (40.6) 82 (14.6)
(21.38-32.49) (1.32-6.03) (45.60 - 56.61) (18.39-27.66) (36.51-44.63) (11.67-17.51)
All 1,692 186 (11.0) 28 (1.7) 2,171 390 (18.0)∗ 181 (8.3)∗ 3,863 576 (14.9) 209 (5.4)
(9.50-12.48) (1.05-2.26) (16.35-19.58) (7.17-9.50) (13.79-16.03) (4.70-6.12)

CI: confidence interval, ROA: radiographic OA, SOA: symptomatic OA ∗p< 0.001 compared to men by chi-square test

Table 3.
Prevalence of hand osteoarthritis (OA) in the total target population by age groups
Men Women Total
Age (years) n ROA (%) SOA (%) n ROA (%) SOA (%) n ROA (%) SOA (%)
(95% CI) (95% CI) (95% CI) (95% CI) (95% CI) (95% CI)
40-49 306 1 (0.3) 0 (0) 417 11 (2.7) 5 (1.2) 723 12 (1.7) 5 (0.7)
(-0.31-0.97) (-) (1.10-4.18) (0.15-2.24) (0.73-2.59) (0.09-1.30)
50-59 555 15 (2.7) 6 (1.1) 621 62 (10.0)∗ 5 (5.6)∗ 1,176 77 (6.5) 41 (3.5)
(1.35-4.05) (0.22-1.94) (7.63-12.34) (3.82-7.45) (5.13-7.96) (2.44-4.53)
60-69 589 40 (6.8) 18 (3.1) 819 213 (26.0)∗ 138 (16.8)∗ 1,408 253 (18.0) 156 (11.1)
(4.76-8l82) (1.67-4.45) (23.0 - 29.01) (14.29-19.41) (15.96-19.97) (9.44-12.72)
≥70 245 30 (12.2) 14 (5.7) 318 147 (46.2)∗ 93 (29.2)∗ 563 177 (31.4) 107 (19.0)
(8.14-16.35) (2.81-8.62) (40.75-51.71) (24.25-34.25) (27.60-35.27) (15.76-22.25)
All 1,695 86 (5.3) 38 (2.2) 2,175 433 (19.9)∗ 271 (12.5)∗ 3,870 519 (13.4) 309 (8.0)
(4.03-6.12) (1.54-2.95) (18.23-21.59) (11.07-13.85) (12.34-14.48) (7.13-8.84)

CI: confidence interval, ROA: radiographic OA, SOA: symptomatic OA ∗p< 0.001 compared to men by chi-square test

Table 4.
Multiple logistic regression analysis for the existence for radiographic knee and hand OA
Variables Knee OA Hand OA
OR (95% CI) p-value OR (95% CI) p-value
Age
40-49 1.0 - 1.0 -
50-59 3.89 (2.08-7.29) 0.000 3.08 (1.60-5.93) 0.001
60-69 13.45 (7.37-24.54) 0.000 13.57 (7.33-25.10) 0.000
>70 34.08 (18.30-63.47) 0.000 40.09 (21.40-75.09) 0.000
Gender
Men 1.0 - 1.0
Women 4.20 (3.15-5.59) 0.000 1.72 (1.36-2.17) 0.000
BMI (kg/m2)
<25 1.0 - 1.0 -
25-30 2.39 (1.90-3.0) 0.000 1.24 (1.0-1.54) 0.053
>30 6.47 (4.45-9.41) 0.000 1.56 (1.03-2.35) 0.035
Smoking
No 1.0 - 1.0 -
Yes 0.93 (0.63-1.37) NS 0.82 (0.60-1.12) NS
Exercise
No 1.0 - 1.0 -
≥ 1 times/week 0.86 (0.67-1.09) NS 0.69 (0.55 - 0.87) 0.002
Diabetes mellitus
No 1.0 - 1.0 -
Yes 0.94 (0.73-1.22) NS 1.31 (1.04-1.66) 0.022
Occupation
Others 1.0 - 1.0 -
Factory workers, laborers & farmers 0.88 (0.69-1.12) NS 0.70 (0.55-0.89) 0.004

NS: no significance

Table 5.
Multiple logistic regression analysis for the existence of symptomatic knee and hand OA
Variables Knee OA Hand OA
OR (95% CI) p-value OR (95% CI) p-value
Age
40-49 1.0 - 1.0 -
50-59 5.0 (1.95-12.86) 0.001 2.86 (0.82-10.03) NS
60-69 20.07 (8.07-49.92) 0.000 19.19 (6.02-61.13) 0.000
>70 50.76 (19.97-129.02) 0.000 56.10 (17.34-181.54) 0.000
Gender
Men 1.0 - 1.0 -
Women 5.44 (3.67-8.06) 0.000 5.61 (3.54-8.90) 0.000
BMI (kg/m2)
<25 1.0 - 1.0 -
25-30 2.80 (2.09-3.75) 0.000 1.06 (0.76-1.49) NS
≥30 8.69 (5.55-13.59) 0.000 1.05 (0.55-1.97) NS
Smoking
No 1.0 - 1.0 -
Yes 0.75 (0.42-1.32) NS 0.70 (0.37-1.32) NS
Exercise
No 1.0 - 1.0 -
≥ 1 times/week 0.82 (0.60-1.10) NS 0.75 (0.52-1.09) NS
Diabetes mellitus
No 1.0 - 1.0 -
Yes 1.12 (0.83-1.53) NS 1.27 (0.88-1.83) NS
Occupation
Others 1.0 - 1.0 -
Factory workers, laborers & farmers 0.89 (0.66-1.20) NS 0.65 (0.45 - 0.94) 0.022

NS: no significance

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