NEW data shed light on the nuanced differences in osteoarthritis (OA) among diverse populations, particularly concerning sex and race. A research team led by Sherwin Novin, University of North Carolina at Chapel Hill, USA, conducted a population-based cohort study using data from the Johnson County Health Study, with the aim of comparing differences in knee and multi-joint OA (MJOA) features based on sex, race, and ethnicity.
Overall data from 544 participants were analysed (mean age: 55.3 years; standard deviation: 9.5; 33.1% male; 68.2% White; 22.8% Black; 9.0% Hispanic). Radiographic features and self-report scores determined OA phenotypes, while demographic associations were revealed using logistic regression models adjusted for age, BMI, and education.
Results suggest that males face a significantly higher risk of MJOA in their lower extremities compared to females. This risk was evident in both radiographic features and self-reported symptoms. Specifically, males demonstrated a 2.27-fold higher risk for MJOA in three or more joints, including the hip, knee, ankle, or foot, as seen in radiographic assessments. Symptomatically, males exhibited a 2.33-fold higher risk for MJOA. On the other hand, females were found to be significantly more likely than males to have radiographic knee OA, with a 1.56-fold higher risk. This was particularly notable in features such as lateral joint space narrowing, medial tibial osteophytes, and sclerosis.
Race and ethnicity analyses revealed that Black individuals had a higher risk of radiographic knee OA compared to White individuals, with a 1.63-fold higher risk. Additionally, Black participants demonstrated more advanced grades of most radiographic features related to knee OA. Hispanic participants exhibited lower odds of advanced knee OA radiographic features compared to their White counterparts, particularly in Kellgren–Lawrence grade severity. However, the researchers noted that the study’s most significant limitation was the low sample size, especially among Hispanic participants, and therefore meaningful comparison could not be drawn between multi-joint OA differences in Black, White, and Hispanic participants. Finally, the study did not identify statistically significant differences in pain, aching, and stiffness symptoms based on race and ethnicity.
Overall, the preliminary data indicate potential associations between sex, race, and OA outcomes, highlighting the need for further exploration in a larger and more diverse cohort to contribute valuable insights to the OA literature.