Objective: To investigate whether subjects with diabetes show accelerated knee joint structural degeneration over 4 years compared to diabetes-free controls.
Materials and methods: Two hundred forty-four participants with diabetes were selected from the Osteoarthritis Initiative cohort and matched with 244 diabetes-free controls. 3.0-T MRI scans of the right knee were obtained at baseline and 4-year follow-up. Evaluation of structural knee abnormalities was performed using the Whole-Organ Resonance Imaging Scoring system (WORMS). Linear regression analysis was conducted to compare structural temporal changes in each compartment, as well as the mean across all compartments by diabetes status.
Results: Study groups were similar in age (63.0 vs. 63.3 years, p = 0.73), body mass index (31.5 vs. 31.0 kg/m2, p = 0.21), sex (female 52.0 vs. 52.9%, p = 0.85) and radiographic Kellgren/Lawrence score distribution (p = 0.99). Structural degeneration was significantly worse in the knees of diabetics with an increase in the overall WORMS sum score (delta WORMS [95% CI]: 4.87 [4.17, 5.57], vs. 3.23 [2.60, 3.85] p = 0.001). Moreover, diabetics showed a greater increase in cartilage lesions in the global knee (p < 0.001), but also separately in the patella, lateral tibia, and both femoral compartments (lowest p value; p = 0.001). Furthermore, diabetics showed also a greater increase in meniscus lesion score, in both the medial (p = 0.01) and lateral meniscus (p = 0.01).
Conclusions: Diabetics exhibited a significantly greater increase in cartilage and meniscus lesions when compared to diabetes-free controls over 4 years. Overall, our findings suggest that diabetics exhibit a stronger deterioration of knee structure and are therefore potentially at higher risk for developing knee OA.
Keywords: Biomarkers; Diabetes mellitus; Knee osteoarthritis; Magnetic resonance imaging; Risk factors.