M. Sowers et al., The associations of bone mineral density and bone turnover markers with osteoarthritis of the hand and knee in pre- and perimenopausal women, ARTH RHEUM, 42(3), 1999, pp. 483-489
Objective. To determine whether Caucasian women ages 28-48 years with newly
defined osteoarthritis (OA) would have greater bone mineral density (BMD)
and less bone turnover over time than would women without OA,
Methods. Data were derived from the longitudinal Michigan Bone Health Study
. Period prevalence and 3-year incidence of OA were based on radiographs of
the dominant hand and both knees, scored with the Kellgren/Lawrence (K/L)
scale. OA scores were related to BMD, which was measured by dual-energy x-r
ay absorptiometry, and to serum osteocalcin levels, which were measured by
radioimmunoassay.
Results. The period prevalence of OA (WL grade greater than or equal to 2 i
n the knees or the dominant hand) was 15.3% (92 of 601), with 8.7% for the
knees and 6.7% for the hand. The 3-year incidence of knee OA was 1.9% (9 of
482) and of hand OA was 3.3% (16 of 482), Women with incident knee OA had
greater average BMD (z-scores 0.3-0.8 higher for the 3 BMD sites) than wome
n without knee OA (P < 0.04 at the femoral neck). Women with incident knee
OA had less change in their average BMD z-scores over the 3-year study peri
od. Average BMD z-scores for women with prevalent knee OA were greater (0.4
-0.7 higher) than for women without knee OA (P < 0.002 at all sites). There
was no difference in average BMD z-scores or their change in women with an
d without hand OA. Average serum osteocalcin levels were lower in incident
cases of hand OA (>60%; P = 0.02) or knee OA (20%; P not significant). The
average change in absolute serum osteocalcin levels was not as great in wom
en with incident hand OA or knee OA as in women without OA (P < 0.02 and P
< 0.05, respectively).
Conclusion. Women with radiographically defined knee OA have greater BMD th
an do women without knee OA and are less likely to lose that higher level o
f BMD. There was less bone turnover among women with hand OA and/or knee OA
. These findings suggest that bone-forming cells might show a differential
response in OA of the hand and knee, and may suggest a different pathogenes
is of hand OA and knee OA.