Association Of Metabolic Syndrome With Pain Intensity In Patients Of Osteoarthritis Knee

Osteoarthritis (OA) of the knee is a common chronic joint disease characterized by pain and significant restrictive disability due to gradual deterioration and inflammation of the articular cartilages. Overall prevalence of knee osteoarthritis in India is 28.7% with common risk factors being female gender, obesity, age and sedentary work.1 The pathophysiologic mechanisms of OA are under debate, but there is general agreement that biomechanics and increased dynamic loading of the joint are involved.2 However genetic, metabolic, and neuroendocrine factors have also been implicated in increased incidence of OA knee.3

It has been recently suggested that there is a chronic low grade systemic inflammation in OA knee which has led some authors to consider osteoarthritis to be part of a greater inflammatory metabolic syndrome.4 Metabolic Syndrome (MetS) comprises a number of conditions, including central obesity, atherogenic dyslipidemia, impaired fasting glucose and hypertension (HTN). It is prevalent in 33.5% Indians (24.9% males and 42.3% females).5 Obesity, besides causing higher mechanical load on knee joint, is also thought to be related to excessive proinflammatory cytokine production which could play a pathophysiologic role in OA .6 The atherogenic effects related to hypertension can also change the microvasculature of sub-chondral bone, thus leading to development of OA changes.7

However, despite the high prevalence of both MetS and OA knee in Indian population, there are limited studies regarding the association between these two and effect of MetS on the pain intensity of patients with OA knee. Therefore we have planned to conduct this study to determine the association between OA knee, MetS (and its various parameters) and Pain intensity (Visual Analogue Score) in a population based study of a sample of Indian Population (Rural and Urban) visiting a tertiary care hospital in Bhopal.