Talk: Incidence of Severe Knee and Hip Osteoarthritis in Relation to Dietary Intake of Antioxidants Beta–Carotene, Vitamin C, Vitamin E and Selenium: a Population-Based Prospective Cohort Study (2009 ACR/ARHP Annual Scientific Meeting)

Sunday, October 18, 2009: 4:45 PM

108 B (Pennsylvania Convention Center)

Gunnar Engström¹, Maria Gerhardsson de Verdier², Peter M. Nilsson³, Elisabet Wirfält³, Carl Mellström², Jan Rollof² and Stefan Lohmander³, ¹Lund University, Sweden, ²AstraZeneca R&D, Lund, Sweden, ³Lund University, Lund, Sweden

Presentation Number: 630

Purpose: The relationship between dietary factors, in particular antioxidants, and osteoarthritis (OA) remains unclear. This prospective population-based study explored the relationships between intake of antioxidants and incidence of severe hip and knee osteoarthritis.
Method: The Malmö Diet and Cancer cohort (n=28098, age 45-73 years, 61% women) was established between 1991 and 1996. A modified diet history method was used to assess dietary habits. Incidence of severe knee and hip OA, defined as new cases of arthroplasty due to hip or knee OA, was monitored until 2005, in relation to energy-adjusted intakes of Vitamin C, Vitamin E, β–carotene and selenium.

Results: A total of 465 incident cases of knee OA and 554 of hip OA occurred during the follow-up. After adjustments for risk factors, high dietary intake of Vitamin C and selenium was significantly associated with incidence of hip OA [hazards ratio: 1.45 (95%CI:1.09-1.9) and 1.32 (95%CI: 1.01-1.7), respectively, for the highest versus lowest quintile of the antioxidant]. When consumption of antioxidant supplements was taken into account, high selenium intake was significantly associated with incidence of both hip and knee OA. There was no evidence of any protective effect for any of the antioxidants.
Table 3. Intake of four antioxidants in relation to knee or hip OA during follow-up.

Knee OA

Hip OA

yes
no
P
yes
No
P
N
465
27196

544
27055

Beta-carotene
4.1+3.6 (3.2)
3.8+3.4 (2.8)
0.03
4.0+3.1
(3.2)
3.8+3.4
(2.8)
0.11
Beta-carotene*
4.2+3.6 (3.2)
3.9+3.9 (2.8)
0.05
4.1+3.4
(3.2)
3.9+3.9
(2.8)
0.10
Vitamin E
10.4+4.2 (9.6)
10.6+4.3 (9.8)
0.26
10.5+4.0
(9.5)
10.6+4.3
(9.8)
0.94
Vitamin E*
17.1+27 (10.9)
16.1+28 (11.1)
0.14
15.4+16
(11)
16.1+28
(11)
0.90
Vitamin C
114+62 (103)
110+62 (98)
0.01
116+59
(105)
110+62
(98)
0.01
Vitamin C*
174+243 (124)
175+267 (116)
0.24
166+194
(120)
176+268
(116)
0.39
Selenium
40.3+14 (38)
39.3+14 (37)
0.007
41.7+16
(39)
39.2+14
(37)
<0.001
Selenium*
49.1+27 (41)
46.9+26 (40)
0.02
51.8+29
(43)
46.8+26
(40)
<0.001
*including supplements
Values are crude mean±SD (median). Log transformed values used for calculation of p-values, adjusted for age, sex, method, log energy, season

Conclusion: In this population-based study, there was no evidence of a protective effect of antioxidants against severe knee or hip OA leading to arthroplasty. The association between high intake of Vitamin C and selenium and incidence of severe OA needs to be confirmed by other prospective studies with data on diet and intake of supplements.

Keywords: antioxidants, osteoarthritis and vitamins

Disclosure: G. Engström, AstraZeneca, 3 ; M. Gerhardsson de Verdier, AstraZeneca, 3 ; P. M. Nilsson, None; E. Wirfält, None; C. Mellström, AstraZeneca, 3 ; J. Rollof, AstraZeneca, 3 ; S. Lohmander, AstraZeneca, 2 .

630 - Incidence of Severe Knee and Hip Osteoarthritis in Relation to Dietary Intake of Antioxidants Beta–Carotene, Vitamin C, Vitamin E and Selenium: a Population-Based Prospective Cohort Study