Osteoarthritis prevalent and onset accelerated in women with PCOS
medwireNews: Women with polycystic ovary syndrome (PCOS) have a higher prevalence and accelerated onset of osteoarthritis (OA) in both weight and non-weight bearing joints than the general population, according to an analysis of data from two Danish-based registries.
Among 18,923 women who were diagnosed with PCOS and/or hirsutism between 1995 and 2012 and 56,166 age-matched controls, the prevalence of knee, hip, and hand OA in 2015 was significantly higher in those with PCOS than in those without, at 5.2% versus 3.0%.
This increased prevalence of OA in patients with PCOS compared with controls was evident in each of the three joints, at rates of 3.7% versus 2.0% for knee OA, 1.1% versus 0.9% for hip OA, and 0.4% versus 0.2% for hand OA.
The women with PCOS also had a higher incidence of OA during the observation period of up to 20 years, at 4.3% compared with 2.6% for controls.
The incidence of knee, hip, and hand OA per 1000 person–years was significantly higher among the PCOS versus control group, at 2.8 versus 1.5 (hazard ratio [HR]=1.9), 0.8 versus 0.6 (HR=1.3), and 0.3 versus 0.1 (HR=1.8), respectively.
The findings suggest that “a PCOS diagnosis was associated with accelerated development of OA when compared with age-matched controls from the same population,” say Stefan Kluzek (University of Nottingham, UK) and colleagues in Arthritis Research & Therapy.
They note that the association between PCOS and increased incidence of OA was “particularly strong” for knee OA and for this joint it was significant for women of all ages, even those younger than 45 years.
Kluzek et al believe that “excessive loading associated with higher body weight alone is unlikely to explain the accelerated development of OA in women with PCOS,” because the increased incidence among this group compared with controls remained even after women with obesity were excluded from the analysis, at least in the case of knee and hand OA.
Also, “we observed an increased incidence of OA in both weight-bearing and non-weight-bearing joints,” the researchers point out.
They say that “[t]he most biologically plausible mechanism for the impact of PCOS on increased OA risk is the higher BMI due to excess adipose tissue in the PCOS population when compared with controls,” and that “[f]urther studies are needed to understand the relative effect of metabolic and hormonal changes linked with PCOS and their role in promoting development of OA.”
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