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Kim, Song, Lee, Sheen, Park, Lee, Lee, Kim, Kim, Park, and Hong: The Study of Risk Factors for Symptomatic Knee Osteoarthritis in Korea
Original Article

J Korean Rheum Assoc 2008;15(2):123-130.

Published online: 20 March 2008

DOI: https://doi.org/10.4078/jkra.2008.15.1.123

The Study of Risk Factors for Symptomatic Knee Osteoarthritis in Korea

Jinhyun Kim, Yeong Wook Song, Jung-Chan Lee, Donghyuk Sheen∗, Nam-Gyu Park, Yun Jong Lee, Eun Bong Lee, Hyun Ah Kim∗∗, Yun-Keun Kim, Byung-Joo Park, Sung-Chul Hong†

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

∗Eulji University College of Medicine, Daejeon, Korea

∗∗Hallym University Sacred Heart Hospital, Anyang, Korea

∗∗∗Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea

†Jeju National University College of Medicine, Jeju, Korea

Received 29 February 2008       Accepted 2 May 2008

Copyright © 2008 The Korean Rheumatism Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

To investigate the risk factors for symptomatic knee osteoarthritis (OA) in Koreans

Methods

A total of 1,194 persons consisting of 588 men and 606 women (mean age±SD, 48.9±14.0 years) were enrolled in rural and urban areas or in a hospital of Korea between september 2000 and august 2001. All participants were interviewed about symptoms of knee OA and possible risk factors including age, sex, occupation, body mass index (BMI), smoking, age of menarche, menopause and hormone replacement therapy and examined. Knee radiograph was obtained in all participants with knee symptoms. Symptomatic knee OA was defined according to clinical criteria or clinical and radiographic criteria for classification of osteoarthritis of the knee by Altman.

Results

Of 1,194 participants, symptomatic knee OA was found in 189 persons (15.8%) and multivariate analysis showed that female (OR=5.66, 95% CI 3.42∼9.38), aging (OR=1.10, 95% CI 1.08∼1.12), living in rural area (OR=3.83, 95% CI 2.27∼6.45) and BMI over 25 kg/m2 (OR=2.26, 95% CI 1.42∼3.59) were risk factors. Age (older than 70 years, OR=1.08, 95% CI1.04∼1.12) and living in rural area (OR=5.39, 05% CI 1.94∼14.96) were associated with symptomatic knee OA in men and age (older than 40 years, OR=1.11, 95% CI 1.07∼1.16), living in rural area (OR=2.46, 95% CI 1.17∼5.17), and BMI over 25 kg/m2 (OR=3.45, 95% CI 1.63∼7.29) in women.

Conclusion

The risk factors for symptomatic knee OA were aging, female, living in rural area and high BMI in Koreans.

Keywords: Risk factor, Knee Osteoarthritis, Koreans

References

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Table 1.
Characteristics of total participants and participants with symptomatic knee osteoarthritis
Variables Total participants   Participants with symptomatic knee osteoarthritis
Variables Male Female Total Male Female Total
  (n=588, 49.2%) (n=606, 50.8%) (n=1,194) (n=46, 24.3%) (n=143, 75.7% (n=189)
Age (years, means±SD) 49.0±13.2 48.7±14.6 48.9±14.0 59.2±10.9 61.9±9.2 61.3±9.7
Living in urban 192 (36.7%) 331 (63.3%) 523 6 (12.5%) 42 (87.5%) 48
rural 385 (64.0%) 217 (36.0%) 602 39 (33.6%) 77 (66.4%) 116∗∗
BMI (kg/m2) ＜25.0 412 (49.5%) 420 (50.5%) 832 29 (27.1%) 78 (72.9%) 107∗∗
≥25.0 169 (53.3%) 148 (46.7%) 317 15 (21.1%) 56 (78.9%) 71
Occupation HPW 204 (53.1%) 180 (46.9%) 384 24 (27.6%) 63 (72.4%) 87∗∗
Non-HPW 291 (54.6%) 242 (45.4%) 533 17 (34.7%) 32 (65.3%) 49
Smoking ≥20 packs No 153 (24.8%) 465 (10.5%) 618 9 (6.9%) 122 (93.1%)∗ 131
  Yes 393 (91.6%) 36 (8.4%) 429 33 (73.3%)∗ 12 (26.7%) 45

∗ p＜0.001 by chi-square test,

∗∗ Not statistically significant by chi-square test BMI: body mass index, HPW: heavy physical workload

Table 2.
Univariate analysis of variables as risk factors for symptomatic knee osteoarthritis
Variables   n pOR 95% CI
Total        
Age (years) ∼39 305 1.00  
  40∼49 292 24.76 3.32∼184.81
  50∼59 240 75.96 10.40∼554.58
  60∼69 176 169.40 23.23∼123.19
  70∼ 93 250.22 33.70∼1857.65
Sex Male 588 1.00  
  Female 606 3.64 2.55∼5.19
Living in urban   523 1.00  
rural   602 2.36 1.65∼3.38
BMI (kg/m2) ＜25.0 832 1.00  
  ≥25.0 317 1.96 1.40∼2.73
Occupation no HPW 533 1.00  
  HPW 384 2.89 1.98∼4.23
Male        
Age (years) ∼39 124    
  40∼49 155 1.00  
  50∼59 138 2.07 0.84∼5.10
  60∼69 88 2.35 0.89∼6.20
  70∼ 32 8.34 2.97∼23.41
Living in urban   192 1.00  
rural   385 4.52 1.80∼11.37
BMI (kg/m2) ＜25.0 412 1.00  
  ≥25.0 169 1.57 0.79∼3.10
Occupation no HPW 291 1.00  
  HPW 204 0.85 0.39∼1.84
Smoking ＜20 packs 153 1.00  
  ≥20 packs 393 1.22 0.55∼2.66
Female        
Age (years) ∼39 181 1.00  
  40∼49 137 20.38 2.66∼156.22
  50∼59 102 89.53 12.08∼663.53
  60∼69 88 271.14 36.47∼2,015.95
  70∼ 61 197.58 26.11∼1,494.85
Living in urban   331 1.00  
rural   217 3.07 1.88∼4.99
BMI (kg/m2) ＜25 420 1.00  
  ≥25.0 148 2.73 1.66∼4.50
Age of menarche ＜16 235 1.00  
  ≥16 171 1.58 0.90∼2.77
Menopausal status No 397 1.00  
  Yes 209 1.78 1.11∼2.86
History of HRT No 167 1.00  
  Yes 29 1.17 0.48∼2.83

Analyzed by logistic regression pOR: prevalence odds ratio (age-adjusted), CI: confidence interval, BMI: body mass index, HPW: heavy physical workload, HRT: hormone replacement therapy

Table 3.
Multivariate analysis as risk factors for symptomatic knee osteoarthritis
Variables pOR 95% CI
Total    
Older age 1.10 1.08∼1.12
Female sex 5.66 3.42∼9.38
Living in rural area 3.83 2.27∼6.45
BMI (kg/m2) 2.26 1.42∼3.59
Male    
Older age ≥70 years 1.08 1.04∼1.12
Living in rural area 5.39 1.94∼14.96
BMI (kg/m2) ≥25.0 1.63 0.77∼3.45
Occupation with HPW 0.69 0.31∼1.57
Female    
Older age ≥40 1.11 1.07∼1.16
Living in rural area 2.46 1.17∼5.17
BMI (kg/m2) ≥25.0 3.45 1.63∼7.29
Age of menarche 1.67 0.75∼3.71
Menopausal status 1.07 0.46∼2.51

Analyzed by logistic regression pOR: prevalence odds ratio, CI: confidence interval, BMI: body mass index, HPW: heavy physical workload

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