ASSOCIATION BETWEEN METABOLIC SYNDROME AND KNEE PAIN IN MIDDLE-AGED ADULTS OVER 10-13 YEARS

A. Singh, B. Fraser, A. Venn, L. Blizzard, G. Jones, C. Ding, B. AntonyUniversity of Tasmania, Menzies Institute for Medical Research, Hobart, Australia  Background Metabolic syndrome (MetS) is characterized by an increased waist circumference, dyslipidaemia (elevated triglycerides and reduced high-density lipoprotein (HDL)), hypertension and hyperglycaemia. MetS has been suggested as having a role in osteoarthritis (OA) pathogenesis. Few studies have described the association of MetS with joint pain in older adults with OA; however, none has described the association between MetS and knee pain in a middle-aged adult population. Objectives We aimed to describe the association of MetS and trajectories of MetS over 10-13 years with knee symptoms in general population-based middle-aged adults. Methods Fasting blood biochemistry, waist circumference and blood pressure measures collected during the Childhood Determinants of Adult Health (CDAH)-1 study (year:2004-6; n = 2447) and at 10-13 year follow-up at CDAH-3 (n = 1549) were used to define MetS using the International Diabetes Federation (IDF) definition. Knee symptoms were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale at the CDAH-3 follow-up (mid-adulthood). Univariable and multivariable (adjusted for age, sex, and body mass index (BMI)) zero-inflated Poisson (ZIP) regression models were used for analysis. Image/graph: Results Overall, the prevalence of MetS increased from 8% (mean age:31.48±2.60; female:52.06%) to 13% (mean age: 44±2.90; female: 53.78%) over 10-13 years. Four MetS trajectories were identified—‘No MetS’ (85.01%); ‘Improved MetS’ (2.14%), ‘Incident MetS’ (8.81%), and ‘Persistent MetS, (4.04%). The presence of MetS at any point, compared to no MetS, was significantly associated with worse knee symptoms at follow-up. Notably, ‘Incident MetS’ was most strongly associated with knee symptoms [RoM: 1.56;95%CI: 1.48,1.65] and pain [RoM:1.52;95%CI:1.37,1.70] at follow-up (Table 1). Table 1. Association between trajectories of metabolic syndrome and knee symptoms Variable (Type) Association of MetS with knee symptoms at CDAH-3 Unadjusted RoM (95% CI)p-value Adjusted RoM (95% CI)p-value Four trajectories of MetS status from CDAH-1 to CDAH3 (Predictor) WOMAC total (outcome) No MetS (Predictor) 1 (Ref) 1 (Ref) Improved MetS (Predictor) 1.44 (1.24, 1.66)p<0.001 1.22 (1.05, 1.41)P=0.009 Incident MetS (Predictor) 1.80 (1.71, 1.90)p<0.001 1.56 (1.48, 1.65)p<0.001 Persistent MetS (Predictor) 1.45 (1.35, 1.56)p<0.001 1.15 (1.06, 1.25)P=0.001 Ptrend p<0.001 p<0.001 WOMAC pain (outcome) No MetS (Predictor) 1 (Ref) 1 (Ref) Improved MetS (Predictor) 1.12 (0.83, 1.52)p=0.444 0.96 (0.71, 1.31)P=0.804 Incident MetS (Predictor) 1.69 (1.53, 1.87)p<0.001 1.52 (1.37, 1.70)p<0.001 Persistent MetS (Predictor) 1.23 (1.06, 1.42)P=0.005 1.02 (0.87 1.20)p<0.804 Ptrend p<0.001 p<0.001 WOMAC Stiffness (outcome) No MetS (Predictor) 1 (Ref) 1 (Ref) Improved MetS (Predictor) 1.38 (0.95, 2.01)p=0.090 1.20 (0.81, 1.77)P=0.363 Incident MetS (Predictor) 1.27 (1.10, 1.46)p=0.001 1.16 (0.99, 1.35)p=0.066 Persistent MetS (Predictor) 1.26 (1.03, 1.53)P=0.022 1.06 (0.84, 1.33)P=0.621 Ptrend p<0.001 P=0.166 WOMAC Function (outcome) No MetS (Predictor) 1 (Ref) 1 (Ref) Improved MetS (Predictor) 1.23 (1.02, 1.47)p=0.028 1.05 (0.88, 1.27)P=0.571 Incident MetS (Predictor) 1.76 (1.65, 1.87)p<0.001 1.56 (1.45, 1.67)p<0.001 Persistent MetS (Predictor) 1.45 (1.32, 1.59)p<0.001 1.16 (1.05, 1.29)P=0.005 Ptrend p<0.001 p<0.001 BMI: body mass index, CDAH: Childhood Determinants of Adult Health, CI: confidence interval, n: number of patients at the respective time point, MetS: metabolic syndrome, RoM: ratio of means; WOMAC: Western Ontario MacMaster osteoarthritis score Model adjusted for age, sex, and BMI Bold denotes statistical significance, p<0.05 Conclusion In a middle-aged population-based sample, there was an independent positive association between MetS and knee symptoms. The MetS developed in mid-adulthood was most strongly associated with knee symptoms compared to those who had MetS in young adulthood or at both time points. Acknowledgements AS is supported by the International Graduate Research Scholarship, University of Tasmania. Disclosure of Interests None Declared. Keywords: Pain, Osteoarthritis, Epidemiology DOI: 10.1136/annrheumdis-2023-eular.258Citation: , volume 82, supplement 1, year 2023, page 442Session: Touring the landscape of epidemiology (Poster Tours)