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UBC Theses and Dissertations

The epidemiology of osteoarthritis and its association with cardiovascular disease and diabetes Rahman, Md Mushfiqur


Background: Osteoarthritis (OA) is a highly prevalent chronic condition and the most common form of rheumatic disease. The relationship between OA and cardiovascular disease (CVD) and diabetes has not been observed prospectively and the data on descriptive epidemiology of administratively defined OA are limited. Objectives: 1) to determine whether OA increases the risk of CVD (myocardial infarction, ischemic heart disease, congestive heart failure, and stroke) and diabetes; 2) to examine the association between OA and prevalent CVD; 4) to estimate the prevalence, incidence, and trends of OA; and 5) to validate the administrative diagnosis of OA. Methods: Using a random sample (n = 640,000) from the British Columbia administrative database during the period 1991-2009, the crude and age-standardized incidence rates and the prevalence of OA were calculated. Administrative OA Definition 1 required at least one physician diagnosis or hospital admission, and Definition 2 required, at least two physician diagnoses in two years or one hospital admission. The relative risks (RR) of CVD and diabetes in persons with OA, compared to age-sex matched non-OA individuals, were estimated using Cox proportional hazards models. Based on the Canadian Community Health Survey (CCHS) data, odds ratio (OR) between OA and heart disease was obtained. The validity of the two administrative definitions was determined using four clinical reference standards. Results: The overall prevalence of OA on March 2009, was 19.7%, and the incidence rate in the year 2008/09 was 14.6/1000 person-years under Definition 1. The adjusted RRs (95% CI) for CVD were 1.26 (1.13-1.42), 1.17 (1.07-1.26), 1.08 (0.97-1.19), and 1.15 (1.04-1.27), among younger women, older women, younger men, and older men, respectively. For diabetes, adjusted RRs (95% CI) were 1.27 (1.18-1.38), 1.23 (1.12-1.34), 1.19 (1.09-1.29), and 0.94 (0.82-1.09) for younger women, older women, younger men, and older men, respectively. In the CCHS sample, ORs (95% CI) for heart disease were 1.35 (1.21-1.50) among men and 1.51 (1.39-1.64) among women. Conclusions: These novel findings update current knowledge of OA epidemiology and highlight the risks of CVD and diabetes among persons with OA. These data are useful in formulating public health policies around OA treatment and prevention.

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