Bone shape mediates the relationship between sex and incident knee osteoarthritis

Barton L Wise, Jingbo Niu, Yuqing Zhang, Felix Liu, Joyce Pang, John A. Lynch, Nancy E Lane

Research output: Contribution to journalArticle

Abstract

Background: Knee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and women is mediated by bone shape. Methods: We randomly sampled 304 knees from the OAI with incident ROA (i.e., development of Kellgren/Lawrence grade ≥ 2 by month 48) and 304 knees without incident ROA. We characterized distal femur and proximal tibia shape on baseline radiographs using Statistical Shape Modeling. If a specific bone shape was associated with the risk of incident ROA, marginal structural models were generated to assess the mediation effect of that bone shape on the relation of sex and risk of incident knee ROA adjusting for baseline covariates. Results: Case and control participants were similar by age, sex and race, but case knees were from higher body mass index (BMI) participants (29.4 vs. 27.0; p < 0.001). Women had 49% increased odds of incident knee ROA compared with men (adjusted odds ratio (OR) = 1.49, 95% Confidence Interval (C.I.): 1.04, 2.12). There was an inconsistent mediation effect for tibial mode 2 between sex and incident knee ROA, with an indirect effect OR of 0.96 (95% C.I.: 0.91-1.00) and a direct effect OR of 1.56 (95% C.I.: 1.08-2.27), suggesting a protective effect for this mode. Similar findings were also observed for the mediation effect of tibia mode 10 and femur mode 4. These shape modes primarily involved differences in the angular relation of the heads to the shafts of the femur and tibia. Conclusions: Distal femur and proximal tibia bone shapes partially and inconsistently mediated the relationship between sex and incident knee OA. Women had a higher risk of incident ROA, and specific bone shapes modestly protected them from even higher risk of ROA. The clinical significance of these findings warrant further investigation.

Original languageEnglish (US)
Article number331
JournalBMC Musculoskeletal Disorders
Volume19
Issue number1
DOIs
StatePublished - Sep 12 2018

Fingerprint

Knee Osteoarthritis
Knee
Bone and Bones
Tibia
Femur
Odds Ratio
Confidence Intervals
Structural Models
Incidence
Body Mass Index
Head

Keywords

  • Bone shape
  • Knee
  • Osteoarthritis
  • Radiography
  • Sex
  • Statistical shape modeling

ASJC Scopus subject areas

  • Rheumatology
  • Orthopedics and Sports Medicine

Cite this

Bone shape mediates the relationship between sex and incident knee osteoarthritis. / Wise, Barton L; Niu, Jingbo; Zhang, Yuqing; Liu, Felix; Pang, Joyce; Lynch, John A.; Lane, Nancy E.

In: BMC Musculoskeletal Disorders, Vol. 19, No. 1, 331, 12.09.2018.

Research output: Contribution to journalArticle

Wise, Barton L ; Niu, Jingbo ; Zhang, Yuqing ; Liu, Felix ; Pang, Joyce ; Lynch, John A. ; Lane, Nancy E. / Bone shape mediates the relationship between sex and incident knee osteoarthritis. In: BMC Musculoskeletal Disorders. 2018 ; Vol. 19, No. 1.
@article{6695d059a85c4624a59c887603c33406,
title = "Bone shape mediates the relationship between sex and incident knee osteoarthritis",
abstract = "Background: Knee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and women is mediated by bone shape. Methods: We randomly sampled 304 knees from the OAI with incident ROA (i.e., development of Kellgren/Lawrence grade ≥ 2 by month 48) and 304 knees without incident ROA. We characterized distal femur and proximal tibia shape on baseline radiographs using Statistical Shape Modeling. If a specific bone shape was associated with the risk of incident ROA, marginal structural models were generated to assess the mediation effect of that bone shape on the relation of sex and risk of incident knee ROA adjusting for baseline covariates. Results: Case and control participants were similar by age, sex and race, but case knees were from higher body mass index (BMI) participants (29.4 vs. 27.0; p < 0.001). Women had 49{\%} increased odds of incident knee ROA compared with men (adjusted odds ratio (OR) = 1.49, 95{\%} Confidence Interval (C.I.): 1.04, 2.12). There was an inconsistent mediation effect for tibial mode 2 between sex and incident knee ROA, with an indirect effect OR of 0.96 (95{\%} C.I.: 0.91-1.00) and a direct effect OR of 1.56 (95{\%} C.I.: 1.08-2.27), suggesting a protective effect for this mode. Similar findings were also observed for the mediation effect of tibia mode 10 and femur mode 4. These shape modes primarily involved differences in the angular relation of the heads to the shafts of the femur and tibia. Conclusions: Distal femur and proximal tibia bone shapes partially and inconsistently mediated the relationship between sex and incident knee OA. Women had a higher risk of incident ROA, and specific bone shapes modestly protected them from even higher risk of ROA. The clinical significance of these findings warrant further investigation.",
keywords = "Bone shape, Knee, Osteoarthritis, Radiography, Sex, Statistical shape modeling",
author = "Wise, {Barton L} and Jingbo Niu and Yuqing Zhang and Felix Liu and Joyce Pang and Lynch, {John A.} and Lane, {Nancy E}",
year = "2018",
month = "9",
day = "12",
doi = "10.1186/s12891-018-2251-z",
language = "English (US)",
volume = "19",
journal = "BMC Musculoskeletal Disorders",
issn = "1471-2474",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Bone shape mediates the relationship between sex and incident knee osteoarthritis

AU - Wise, Barton L

AU - Niu, Jingbo

AU - Zhang, Yuqing

AU - Liu, Felix

AU - Pang, Joyce

AU - Lynch, John A.

AU - Lane, Nancy E

PY - 2018/9/12

Y1 - 2018/9/12

N2 - Background: Knee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and women is mediated by bone shape. Methods: We randomly sampled 304 knees from the OAI with incident ROA (i.e., development of Kellgren/Lawrence grade ≥ 2 by month 48) and 304 knees without incident ROA. We characterized distal femur and proximal tibia shape on baseline radiographs using Statistical Shape Modeling. If a specific bone shape was associated with the risk of incident ROA, marginal structural models were generated to assess the mediation effect of that bone shape on the relation of sex and risk of incident knee ROA adjusting for baseline covariates. Results: Case and control participants were similar by age, sex and race, but case knees were from higher body mass index (BMI) participants (29.4 vs. 27.0; p < 0.001). Women had 49% increased odds of incident knee ROA compared with men (adjusted odds ratio (OR) = 1.49, 95% Confidence Interval (C.I.): 1.04, 2.12). There was an inconsistent mediation effect for tibial mode 2 between sex and incident knee ROA, with an indirect effect OR of 0.96 (95% C.I.: 0.91-1.00) and a direct effect OR of 1.56 (95% C.I.: 1.08-2.27), suggesting a protective effect for this mode. Similar findings were also observed for the mediation effect of tibia mode 10 and femur mode 4. These shape modes primarily involved differences in the angular relation of the heads to the shafts of the femur and tibia. Conclusions: Distal femur and proximal tibia bone shapes partially and inconsistently mediated the relationship between sex and incident knee OA. Women had a higher risk of incident ROA, and specific bone shapes modestly protected them from even higher risk of ROA. The clinical significance of these findings warrant further investigation.

AB - Background: Knee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and women is mediated by bone shape. Methods: We randomly sampled 304 knees from the OAI with incident ROA (i.e., development of Kellgren/Lawrence grade ≥ 2 by month 48) and 304 knees without incident ROA. We characterized distal femur and proximal tibia shape on baseline radiographs using Statistical Shape Modeling. If a specific bone shape was associated with the risk of incident ROA, marginal structural models were generated to assess the mediation effect of that bone shape on the relation of sex and risk of incident knee ROA adjusting for baseline covariates. Results: Case and control participants were similar by age, sex and race, but case knees were from higher body mass index (BMI) participants (29.4 vs. 27.0; p < 0.001). Women had 49% increased odds of incident knee ROA compared with men (adjusted odds ratio (OR) = 1.49, 95% Confidence Interval (C.I.): 1.04, 2.12). There was an inconsistent mediation effect for tibial mode 2 between sex and incident knee ROA, with an indirect effect OR of 0.96 (95% C.I.: 0.91-1.00) and a direct effect OR of 1.56 (95% C.I.: 1.08-2.27), suggesting a protective effect for this mode. Similar findings were also observed for the mediation effect of tibia mode 10 and femur mode 4. These shape modes primarily involved differences in the angular relation of the heads to the shafts of the femur and tibia. Conclusions: Distal femur and proximal tibia bone shapes partially and inconsistently mediated the relationship between sex and incident knee OA. Women had a higher risk of incident ROA, and specific bone shapes modestly protected them from even higher risk of ROA. The clinical significance of these findings warrant further investigation.

KW - Bone shape

KW - Knee

KW - Osteoarthritis

KW - Radiography

KW - Sex

KW - Statistical shape modeling

UR - http://www.scopus.com/inward/record.url?scp=85053284326&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053284326&partnerID=8YFLogxK

U2 - 10.1186/s12891-018-2251-z

DO - 10.1186/s12891-018-2251-z

M3 - Article

C2 - 30208910

AN - SCOPUS:85053284326

VL - 19

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

SN - 1471-2474

IS - 1

M1 - 331

ER -