Factors Associated with Knee Pain with Different Grades of Knee Osteoarthritis among Korean Adults Aged 50 Years or More

Eun Young Choi; Min Jeong Kim

doi:10.15384/kjhp.2016.16.3.145

Korean J Health Promot > Volume 16(3); 2016 > Article

Choi and Kim: Factors Associated with Knee Pain with Different Grades of Knee Osteoarthritis among Korean Adults Aged 50 Years or More

Original Article

Korean Journal of Health Promotion 2016;16(3):145-152.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.3.145

Factors Associated with Knee Pain with Different Grades of Knee Osteoarthritis among Korean Adults Aged 50 Years or More

Department of Family Medicine, Dankook Univeristy Hospital, Dankook University College of Medicine, Cheonan, Korea

Eun Young Choi, Min Jeong Kim

Corresponding author: Eun Young Choi, MD, PhD Department of Family Medicine, Dankook Univeristy Hospital, Dankook University College of Medicine, 201 Manghyang‐ro, Dongnam‐gu, Cheonan 31116, Korea
Tel: +82‐41‐550‐3998, Fax: +82‐41‐550‐3998 E‐mail: choiey0410@gmail.com

Received July 27, 2015 Accepted November 11, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

요약

Background

Discordance between knee pain and radiologic osteoarthritis is well‐known. This study was to investigate factors associated with knee pain with different grades of knee osteoarthritis among Korean adults aged 50 years or more.

Methods

Total 5,978 Korean aged 50 years or more who underwent the radiographs of the knees were analyzed from Korean National Nutrition and Health Examination Survey conducted in 2010‐11. Radiographs of the knees were scored for osteoarthritis using the Kellgren‐Lawrence scale. Multivariate logistic regression analysis adjusting for sociodemographic factors, lifestyle factors, comorbidity and health status was used for analysis.

Results

The prevalence of knee pain was higher in female compared to that of male (P<0.001), and increased as increasing severity of radiologic knee osteoarthritis. Female was associated with increased risk of knee pain in all of Kellgren‐Lawrence degrees. In most of Kellgren‐Lawrence degrees, depression was associated with increased risk of knee pain, and those with high school diploma or higher were associated with decreased risk of knee pain. A few factors (age, body mass index, and no alcohol drinking) were also associated with increased risk of knee pain for particular grades of radiographic knee osteoarthritis.

Conclusions

Knee pain increased as increasing severity of radiologic knee osteoarthritis. Although there were differences of risk factors associated with knee pain with different grades of knee osteoarthritis, female, depression were associated with increased of knee pain, and those with high school diploma or higher were associated with decreased risk of knee pain in most of Kellgren‐Lawrence degrees.

Figure 1.

Frequency of knee pain according to K‐L grade.

Table 1.

Chacracteristics of participants according to the presence of knee pain^a

	Knee pain (‐)	Knee pain (+)	P^b
N	4,636	1,342
Female	47.1 (0.7)	75.4 (1.3)	<0.001
Age, y	61.1 (0.2)	66.7 (0.4)	<0.001
Married	83.0 (0.7)	65.5 (1.9)	<0.001
BMI, kg/m²	23.9 (0.1)	24.6 (0.1)	<0.001
Education			<0.001
Middle school	60.4 (1.2)	86.0 (1.1)
High school	26.7 (0.9)	10.6 (1.0)
University	12.9 (0.9)	3.4 (0.6)
Alcohol use	51.5 (0.9)	32.9 (1.8)	<0.001
Current smoking	21.8 (0.8)	12.6 (1.1)	<0.001
Regular exercise	49.0 (1.0)	43.2 (1.8)	0.002
Manual Occupation	37.7 (1.4)	34.6 (2.1)	0.083
Diabetes	16.5 (0.7)	17.8 (1.5)	0.427
Hypertension	48.4 (1.0)	59.3 (1.8)	<0.001
Depression	13.3 (0.6)	24.0 (1.4)	<0.001
Osteoarthritis	27.0 (0.9)	63.2 (1.6)	<0.001
K‐L grade			<0.001
0	48.5 (1.1)	20.3 (1.5)
1	24.5 (0.8)	16.5 (1.2)
2	13.4 (0.7)	12.4 (1.1)
3 or 4	13.5 (0.7)	50.8 (1.7)

Abbreviations: BMI, body mass index; K‐L grade, Kellgren‐ Lawrence grade.

^aData are presented as mean (standard error) or percentage (standard error).

^bCalculated by chi‐square test or t‐test.

Table 2.

Factors associated with knee pain^a

	OR	P
Sex		<0.001
Male	1.00
Female	1.98 (1.58‐2.48)
Age, y	1.03 (1.02‐1.04)	<0.001
Marital status		0.810
Unmarried	1.00
Married	1.02 (0.82‐1.26)
BMI, kg/m²	1.03 (0.99‐1.06)	0.195
Education^b		<0.001
Middle school	1.00
High school	0.51 (0.40‐0.65)
University	0.42 (0.28‐0.63)
Alcohol use		0.438
No	1.00
Yes	0.93 (0.76‐1.13)
Smoking		0.917
No	1.00
Yes	1.02 (0.77‐1.36)
Regular exercise		0.273
No	1.00
Yes	0.97 (0.74‐1.26)
Occupation		0.215
Office worker	1.00
Manual worker	1.13 (0.92‐1.37)
Diabetes		0.707
No	1.00
Yes	0.94 (0.74‐1.21)
Hypertension		0.876
No	1.00
Yes	1.05 (0.85‐1.29)
Depression		<0.001
No	1.00
Yes	1.88 (1.51‐2.34)
K‐L grade^b		<0.001
0	1.00
1	1.34 (1.01‐1.77)
2	1.77 (1.34‐2.34)
3 or 4	4.79 (3.76‐6.12)

Abbreviations: BMI, body mass index; K‐L grade, Kellgren‐ Lawrence grade.

^aCalculated by multiple logistic regression analysis mutually adjusted for all variables shown.

^bP_trend<0.001.

Table 3.

Factors associated with knee pain according to K‐L grade^a

		K‐L grade
	Grade 0	Grade 1	Grade 2	Grade 3‐4
Sex
Male	1.00	1.00	1.00	1.00
Female	1.73 (1.16‐2.59)	2.24 (1.35‐3.70)	1.73 (1.01‐2.96)	2.15 (1.35‐3.42)
Age, y	1.05 (1.02‐1.07)	1.01 (0.98‐1.04)	1.01 (0.99‐1.04)	1.03 (1.01‐1.05)
Marital status
Unmarried	1.00	1.00	1.00	1.00
Married	1.00 (0.67‐1.51)	1.19 (0.68‐2.07)	0.73 (0.42‐1.25)	1.11 (0.81‐1.51)
BMI, kg/m²	1.05 (0.98‐1.12)	0.98 (0.91‐1.07)	0.93 (0.85‐1.02)	1.06 (1.01‐1.11)
Education
Middle school	1.00	1.00	1.00	1.00
High school	0.55 (0.36‐0.86)	0.60 (0.35‐1.03)	0.58 (0.32‐1.05)	0.36 (0.21‐0.61)
University	0.62 (0.34‐1.12)	0.35 (0.15‐0.82)	0.43 (0.14‐1.33)	0.26 (0.11‐0.61)
Alcohol use
No	1.00	1.00	1.00	1.00
Yes	0.96 (0.68‐1.35)	0.78 (0.49‐1.22)	0.50 (0.33‐0.76)	1.28 (0.88‐1.87)
Smoking
No	1.00	1.00	1.00	1.00
Yes	0.86 (0.50‐1.48)	1.12 (0.63‐2.01)	1.08 (0.58‐2.00)	1.15 (0.64‐2.10)
Regular exercise
No	1.00	1.00	1.00	1.00
Yes	0.83 (0.58‐1.18)	1.00 (0.68‐1.48)	0.63 (0.39‐1.01)	0.97 (0.74‐1.26)
Occupation
Office worker	1.00	1.00	1.00	1.00
Manual worker	1.19 (0.79‐1.78)	0.95 (0.61‐1.48)	1.37 (0.88‐2.15)	1.17 (0.86‐1.57)
Diabetes
No	1.00	1.00	1.00	1.00
Yes	0.92 (0.54‐1.57)	0.72 (0.42‐1.22)	0.93 (0.54‐1.62)	1.10 (0.76‐1.59)
Hypertension
No	1.00	1.00	1.00	1.00
Yes	0.86 (0.59‐1.25)	1.11 (0.71‐1.74)	1.12 (0.74‐1.71)	1.20 (0.89‐1.62)
Depression
No	1.00	1.00	1.00	1.00
Yes	2.16 (1.45‐3.20)	1.44 (0.90‐2.29)	3.18 (1.91‐5.32)	1.62 (1.12‐2.33)

Abbreviations: K‐L grade, Kellgren‐Lawrence grade; BMI, body mass index.

^aCalculated by multiple logistic regression analysis mutually adjusted for all variables shown.

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