Diabetes as a cause of osteoarthritis

Diabetes causes an increased risk of osteoarthritis. This is the result of the research team headed by Prof. Dr. med. Georg Schett from the University of Erlangen evaluating the data of the so-called Bruneck study. Accordingly, diabetics need an artificial knee or hip joint much more frequently than healthy persons, the endocrinologists report in the specialist journal „Diabetes Care“.

20/11/2012

The researchers used the Bruneck study as a cohort study to determine the possible links between diabetes and osteoarthritis. The cohort study included an age- and gender-stratified random sample of 927 men and women between the ages of 40 and 80 years. Since 1990, the health data of all older inhabitants of the village of Bruneck in South Tyrol has been recorded. For over twenty years, the development of the state of health of the subjects can be traced back.

Diabetics get a joint replacement more often
According to the scientists, the Bruneck study offers „ very reliable data for the study of disease risks“, as the local hospital is the only point of contact for clinical care in the region and the migration of the population in the remote Alpine community is very low. When evaluating the data, the endocrinologists around Professor Georg Schett found that people with type 2 diabetes received an artificial hip or knee joint four times more frequently than the other inhabitants of Bruneck. When the data were adjusted for age, obesity and other osteoarthritis risk factors, the likelihood of hip or knee replacement surgery was still twice as high for diabetic patients than for other villagers.

Elevated blood sugar level damages the joints
Study leader Prof. Dr. med. According to the current results, Schett assumes that the permanently elevated blood sugar level in diabetes is to be considered an independent risk factor for osteoarthritis. High blood sugar thus promotes joint wear. As scientists report, it has long been known that blood sugar can enter the articular cartilage. With elevated blood sugar levels, this may cause damage to cartilage cells and promote the formation of inflammatory proteins, such as tumor necrosis factor alpha, Schett and colleagues report. The joint-damaging effect of tumor necrosis factor is also known from rheumatoid arthritis (rheumatoid arthritis). In any case, type 2 diabetes promotes the development of severe osteoarthritis - regardless of age and body mass index (BMI; relation between body weight and height). „Our results strengthen the concept of a strong metabolic component in the pathogenesis of osteoarthritis“, the researchers write.

Link between diabetes and osteoarthritis long undetected
According to the president of the German Diabetes Society (DDG), Professor med. Stephan Matthaei, the study once again highlights the need for early and consistent treatment for type 2 diabetes. Because „There is much to suggest that osteoarthritis is another late complication of type 2 diabetes“ and therefore could „An optimal diabetes management presumably also prevent arthrosis“, Matthaei explained. For the distribution of osteoarthritis, the DDG reports that just under 400,000 people annually receive an artificial hip knee joint in Germany. A direct connection with diabetes has not been established for a long time, „Because both diseases are common in old age and obesity is a major risk factor“ in both osteoarthritis and diabetes, reports Prof. Schett. (Fp)

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Image: Michael Horn