ORCID Profile
0000-0003-2982-4591
Current Organisation
UNSW Sydney
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Publisher: Springer Science and Business Media LLC
Date: 27-10-2023
Publisher: Wiley
Date: 30-01-2023
DOI: 10.1002/ART.42307
Abstract: To define the association between change in body mass index (BMI) and the incidence and progression of the structural defects of knee osteoarthritis as assessed by radiography. Radiographic analyses of knees at baseline and at 4–5 years of follow‐up were obtained from the following 3 independent cohort studies: the Osteoarthritis Initiative (OAI) study, the Multicenter Osteoarthritis Study (MOST), and the Cohort Hip and Cohort Knee (CHECK) study. Logistic regression analyses using generalized estimating equations, with clustering of both knees within in iduals, were used to investigate the association between change in BMI from baseline to 4–5 years of follow‐up and the incidence and progression of knee osteoarthritis. A total of 9,683 knees (from 5,774 participants) in an “incidence cohort” and 6,075 knees (from 3,988 participants) in a “progression cohort” were investigated. Change in BMI was positively associated with both the incidence and progression of the structural defects of knee osteoarthritis. The adjusted odds ratio (OR) for osteoarthritis incidence was 1.05 (95% confidence interval [95% CI] 1.02–1.09), and the adjusted OR for osteoarthritis progression was 1.05 (95% CI 1.01–1.09). Change in BMI was also positively associated with degeneration (i.e., narrowing) of the joint space and with degeneration of the femoral and tibial surfaces (as indicated by osteophytes) on the medial but not on the lateral side of the knee. A decrease in BMI was independently associated with lower odds of incidence and progression of the structural defects of knee osteoarthritis and could be a component in preventing the onset or worsening of knee osteoarthritis.
Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism
Date: 30-05-2023
DOI: 10.1136/ANNRHEUMDIS-2023-EULAR.1395
Abstract: As smoking causes inflammation, and inflammation is implicated in the development of osteoarthritis, it is conceivable that smoking would have negative effects on knee osteoarthritis (KOA). However, results from prior studies are controversial and unclear, with some studies even finding that smoking protects against KOA. To describe the association between smoking and KOA (symptoms and structural defects) in people with or at risk of KOA in a multi-cohort study using in idual participant data (IPD) meta-analyses, which are considered the ‘gold standard’ for the synthesis of quantitative evidence. We performed IPD meta-analyses using data from three independent cohorts: the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST) from the USA and the Cohort for Hip and Cohort for Knee (CHECK) from the Netherlands. We assessed the association between smoking status at baseline (never smokers current smokers and former smokers) and the outcomes of symptoms and structural defects in KOA, either cross-sectionally at baseline or longitudinally over 4 to 5 years of follow-up. For symptoms, we assessed pain, disability, and stiffness using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). For structural defects, we assessed overall structural defects and three in idual structural features (i.e., joint space narrowing osteophytes on the femoral surface and osteophytes on the tibial surface), on both the lateral and medial sides of the knee, from radiographs. Overall structural defects were assessed using Kellgren-Lawrence (KL) grades. A knee with a KL grade ≥ 2 is considered to have ‘radiographic KOA’. The three in idual structural features were assessed using Osteoarthritis Research Society International (OARSI) grades. We investigated 14,470 knees from 7,304 participants for the outcomes of symptoms, and 12,337 knees from 6,455 participants for the outcomes of structural defects. In our cross-sectional analyses, compared to never smokers, current smokers had baseline scores for pain, disability, and stiffness that were greater by 1.01 (95% confidence interval [CI] 0.60 to 1.41) units, 3.62 (95% CI 2.04 to 5.20) units, and 0.42 (95% CI: 0.29 to 0.54) units, respectively. In contrast, former smokers had baseline scores for pain, disability, and stiffness that were no different from those of never smokers (with differences in scores being 0.11 95% CI: -0.08 to 0.29 units -0.09 95% CI: -1.14 to 0.97 units and 0.06 95% CI: -0.08 to 0.20 units, respectively). In terms of structural defects, our cross-sectional analyses showed that neither current smokers nor former smokers were any worse than never smokers with respect to grades for overall structural defects or in idual structural features. However, compared to never smokers, current smokers had greater odds of having radiographic KOA (odds ratio [OR] 1.25 95% CI: 1.02 to 1.52), while former smokers were no different from never smokers for this outcome (OR 0.91 95% CI: 0.83 to 1.01). In our longitudinal analyses, compared to never smokers, only one outcome showed a difference between groups. Specifically, current smokers had greater odds of degeneration of the in idual structural feature of joint space narrowing on the medial side of the knee over 4 to 5 years of follow-up (OR 1.27 95% CI: 1.01 to 1.60), while former smokers were no different from never smokers for this outcome (OR 1.02 95% CI: 0.84 to 1.24). Current smoking may have negative effects on, and quitting smoking could be important in preventing or slowing, both the symptoms and structural defects of KOA in people with or at risk of KOA. We acknowledge the contributions of the study participants, investigators, research staff involved, and the provision of data sets and/or research tools from 3 cohort studies: the OAI, the MOST study, and the CHECK study. Zubeyir Salis: None declared, Amanda Sainsbury-Salis Speakers bureau: presentation fees and travel reimbursements from Eli Lilly and Co, the Pharmacy Guild of Australia, Novo Nordisk, the Dietitians Association of Australia, Shoalhaven Family Medical Centres, the Pharmaceutical Society of Australia, and Metagenics., Consultant of: Served on the Nestlé Health Science Optifast VLCD advisory board from 2016 to 2018.
Publisher: Springer Science and Business Media LLC
Date: 11-01-2022
DOI: 10.1038/S41366-021-01046-3
Abstract: To describe the association between body weight change and the risk of knee replacement and hip replacement. Time-to-event survival analysis from a population-based cohort of participants who had or were at risk of clinically significant knee osteoarthritis at baseline. Data from the Osteoarthritis Initiative (OAI), which collected data from four clinical centres in the United States. A total of 8069 knees from 4081 participants, and 8076 hips from 4064 participants (59.3% female) aged 45-79 years, with mean ± SD body mass index (BMI) of 28.7 ± 4.8 kg/m Body weight change from baseline as a percentage of baseline at repeated follow-up visits over 8 years. Incidence of primary knee or hip replacement during 8-year follow-up. Body weight change had a small, positive, linear association with the risk of knee replacement (adjusted hazard ratio [HR] 1.02 95% confidence interval [CI] 1.00-1.04). Body weight change was also positively and linearly associated with the risk of hip replacement in hips that were persistently painful at baseline (adjusted HR 1.03 95% CI 1.01-1.05), but not in hips that were not persistently painful at baseline. There were no significant interactions between body weight change and baseline BMI in the association with knee or hip replacement. In people with or at risk of clinically significant knee osteoarthritis, every 1% weight loss was associated with a 2% reduced risk of knee replacement and - in those people who also had one or more persistently painful hips - a 3% reduced risk of hip replacement, regardless of baseline BMI. Public health strategies that incorporate weight loss interventions have the potential to reduce the burden of knee and hip replacement surgery.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1093/AJCN/NQAC024
Publisher: Wiley
Date: 05-01-2023
DOI: 10.1002/ACR.25021
Abstract: To define the association between change in body mass index (BMI) and the risk of knee and hip replacement. We used data from 3 independent cohort studies: the Osteoarthritis Initiative (OAI), the Multicenter Osteoarthritis Study (MOST), and the Cohort Hip and Cohort Knee (CHECK) study, which collected data from adults (45–79 years of age) with or at risk of clinically significant knee osteoarthritis. We conducted Cox proportional hazards regression analysis with clustering of both knees and hips per person to determine the association between change in BMI (our exposure of interest) and the incidence of primary knee and hip replacement over 7–10 years’ follow‐up. Change in BMI (in kg/m 2 ) was calculated between baseline and the last follow‐up visit before knee or hip replacement, or for knees and hips that were not replaced, the last follow‐up visit. A total of 16,362 knees from 8,181 participants, and 16,406 hips from 8,203 participants, were eligible for inclusion in our knee and hip analyses, respectively. Change in BMI was positively associated with the risk of knee replacement (adjusted hazard ratio [HR adj ] 1.03 [95% confidence interval (95% CI) 1.00–1.06]) but not hip replacement (HR adj 1.00 [95% CI 0.95–1.04]). The association between change in BMI and knee replacement was independent of participants’ BMI category at baseline (i.e., normal, overweight, or obese). Public health strategies incorporating weight loss interventions could reduce the burden of knee but not hip replacement surgery.
Publisher: Springer Science and Business Media LLC
Date: 29-12-2022
Publisher: Wiley
Date: 14-02-2023
DOI: 10.1002/ACR.25057
Abstract: To define the association between change in body mass index (BMI) and the incidence and progression of structural defects of hip osteoarthritis as assessed by radiography. We used data from 2 independent cohort studies: the Osteoarthritis Initiative (OAI) and the Cohort Hip and Cohort Knee (CHECK) study. Our exposure was change in BMI from baseline to 4–5 years’ follow‐up. Our outcomes were the incidence and progression of structural defects of hip osteoarthritis as assessed using a modified Croft grade in OAI and the Kellgren/Lawrence grade in the CHECK study. To study incidence, we created incidence cohorts of hips without definite overall structural defects at baseline (i.e., grade ) and then investigated the odds of hips having definite overall structural defects at follow‐up (i.e., grade ≥2). To study progression, we created progression cohorts of hips with definite overall structural defects at baseline (i.e., grade ≥2) and then investigated the odds of having a grade increase of ≥1 from baseline to follow‐up. There was a total of 5,896 and 1,377 hips in the incidence cohorts, and 303 and 129 hips in the progression cohorts for the OAI and CHECK study, respectively. Change in BMI (decrease or increase) was not associated with any change in odds of the incidence or progression of definite structural defects of hip osteoarthritis in either the OAI or CHECK cohorts. Weight loss may not be an effective strategy for preventing, slowing, or delaying the structural defects of hip osteoarthritis over 4–5 years.
Publisher: Springer Science and Business Media LLC
Date: 26-04-2023
DOI: 10.1186/S12874-023-01926-4
Abstract: Rheumatology researchers often categorize continuous predictor variables. We aimed to show how this practice may alter results from observational studies in rheumatology. We conducted and compared the results of two analyses of the association between our predictor variable (percentage change in body mass index [BMI] from baseline to four years) and two outcome variable domains of structure and pain in knee and hip osteoarthritis. These two outcome variable domains covered 26 different outcomes for knee and hip combined. In the first analysis (categorical analysis), percentage change in BMI was categorized as ≥ 5% decrease in BMI, 5% change in BMI, and ≥ 5% increase in BMI, while in the second analysis (continuous analysis), it was left as a continuous variable. In both analyses (categorical and continuous), we used generalized estimating equations with a logistic link function to investigate the association between the percentage change in BMI and the outcomes. For eight of the 26 investigated outcomes (31%), the results from the categorical analyses were different from the results from the continuous analyses. These differences were of three types: 1) for six of these eight outcomes, while the continuous analyses revealed associations in both directions (i.e., a decrease in BMI had one effect, while an increase in BMI had the opposite effect), the categorical analyses showed associations only in one direction of BMI change, not both 2) for another one of these eight outcomes, the categorical analyses suggested an association with change in BMI, while this association was not shown in the continuous analyses (this is potentially a false positive association) 3) for the last of the eight outcomes, the continuous analyses suggested an association of change in BMI, while this association was not shown in the categorical analyses (this is potentially a false negative association). Categorization of continuous predictor variables alters the results of analyses and could lead to different conclusions therefore, researchers in rheumatology should avoid it.
Publisher: BMJ
Date: 23-05-2022
DOI: 10.1136/ANNRHEUMDIS-2022-EULAR.811
Abstract: Overweight and obesity are associated with greater incidence and progression of the structural defects of knee osteoarthritis, but it is unknown if weight loss is of benefit. To describe the association between change in body mass index (BMI) and the incidence and progression of structural defects in knee osteoarthritis. Scores from radiographic analyses of knees at baseline and at 4 to 5 years’ follow up were obtained from three independent data sets (the OAI and MOST data sets from the United States from America, and the CHECK data set from the Netherlands). The exposure of interest was change in BMI from baseline to 4 to 5 years’ follow up. To investigate the incidence of structural defects of knee osteoarthritis, we selected a total of 9732 knees (from 5802 participants) that had a Kellgren-Lawrence (KL) grade of knee osteoarthritis at baseline of ‘none’ (0) or ‘doubtful’ (1) (the ‘incidence cohort’), and determined the odds of having a KL grade at follow-up of ‘minimal’ (2), ‘moderate’ (3), or ‘severe’ (4). To investigate progression, we selected a total of 6084 knees (from 3996 participants) that had a KL grade at baseline of ‘minimal’ (2), ‘moderate’ (3), or ‘severe’ (4) (the ‘progression cohort’), and determined the odds of increasing by 1 or more KL grades by follow up. The degradation of three in idual structural features of knee osteoarthritis (i.e., joint space narrowing, osteophytes on the femoral surface, and osteophytes on the tibial surface), on both the medial and lateral sides of the knee, were also investigated in both the incidence and progression cohorts. Here, degradation was defined as an increase by 1 or more Osteoarthritis Research Society International (OARSI) grades. Change in BMI was positively associated with both the incidence and progression of knee osteoarthritis, as defined by KL grade. Specifically, for each one-unit change in BMI, the adjusted odds ratio for incidence was 1.05 (95% confidence interval [CI] 1.02 to 1.09), and for progression, the same adjusted odds ratio and 95% CI was also observed. Change in BMI was also positively associated with degradation (i.e., narrowing) of joint space on the medial but not the lateral side of the knee, with an adjusted odds ratio of 1.08 (95% CI 1.04 to 1.12) in the ‘incidence cohort’ and 1.08 (95% CI 1.03 to 1.12) in the ‘progression cohort’. Degradation of the tibial and femoral surfaces (i.e., osteophytes) was also seen on the medial but not the lateral side of the knee, but only in one of the two cohorts investigated (the ‘incidence cohort’), with an adjusted odds ratio of 1.07 (95% CI 1.03 to 1.12) for osteophytes on the femoral surface, and 1.05 (95% CI 1.01 to 1.09) for osteophytes on the tibial surface. Each one-unit reduction in BMI is associated with a 5 to 8% decrease in the odds of the incidence and progression of the structural defects of knee osteoarthritis, with lower odds of structural degradation specific to the medial – not lateral – side of the knee. We acknowledge the provision of datasets and/or research tools from three studies: the Osteoarthritis Initiative (OAI) Study the Multicenter Osteoarthritis Study (MOST) and the Cohort Hip and Cohort Knee (CHECK) Study. OAI is a collaborative informatics system created by the National Institute of Mental Health and the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS) to provide a worldwide resource to quicken the pace of biomarker identification, scientific investigation and OA drug development. The OAI data repository is housed within the National Institute of Mental Health (NIMH) Data Archive (NDA). For the MOST data set, we wish to acknowledge the contributions of the study participants, investigators and research staff involved. MOST is comprised of four (4) cooperative grants: U01 AG18820 David T. Felson (Boston University) U01 AG18832 James Torner (University of Iowa) U01 AG18947 Cora E. Lewis (University of Alabama at Birmingham) U01 AG19069 Michael C. Nevitt (University of California, San Francisco), funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by MOST investigators. This manuscript was prepared using MOST data and does not claim, infer, or imply endorsement by MOST, by the MOST investigators and their respective institutions or by the University of California of the Data Recipients’ use of the Data, of the entity or personnel conducting the research, or of any results of the research. The CHECK study is funded by the Dutch Arthritis Foundation. Involved are: Erasmus Medical Center Rotterdam Kennemer Gasthuis Haarlem Leiden University Medical Center Maastricht University Medical Center Martini Hospital Groningen /Allied Health Care Center for Rheumatology and Rehabilitation Groningen Medical Spectrum Twente Enschede /Ziekenhuisgroep Twente Almelo Reade Center for Rehabilitation and Rheumatology St.Maartens-kliniek Nijmegen University Medical Center Utrecht and Wilhelmina Hospital Assen. Zubeyir Salis: None declared, Helen Keen: None declared, Blanca Gallego: None declared, Tuan van Nguyen: None declared, Amanda Sainsbury Speakers bureau: ZS and AS own 50% each of the shares in Zuman International, which receives royalties for books AS has written and payments for presentations, and provides paid training for higher degree students. AS additionally reports receiving presentation fees and travel reimbursements from Eli Lilly and Co, the Pharmacy Guild of Australia, Novo Nordisk, the Dietitians Association of Australia, Shoalhaven Family Medical Centres, the Pharmaceutical Society of Australia, and Metagenics, and serving on the Nestlé Health Science Optifast VLCD advisory board from 2016 to 2018., Consultant of: ZS and AS own 50% each of the shares in Zuman International, which receives royalties for books AS has written and payments for presentations, and provides paid training for higher degree students. AS additionally reports receiving presentation fees and travel reimbursements from Eli Lilly and Co, the Pharmacy Guild of Australia, Novo Nordisk, the Dietitians Association of Australia, Shoalhaven Family Medical Centres, the Pharmaceutical Society of Australia, and Metagenics, and serving on the Nestlé Health Science Optifast VLCD advisory board from 2016 to 2018.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.SLEH.2017.07.006
Abstract: Sleep is important for the physical, social and mental well-being of both children and adults. Over the years, there has been a general presumption that sleep will inevitably decline with the increase in technology and a busy 24-hour modern lifestyle. This narrative review discusses the empirical evidence for secular trends in sleep duration and the implications of these trends.
Publisher: Wiley
Date: 19-04-2023
DOI: 10.1111/JGS.18371
Abstract: Most guidelines recommending weight loss for hip osteoarthritis are based on research on knee osteoarthritis. Prior studies found no association between weight loss and hip osteoarthritis, but no previous studies have targeted older adults. Therefore, we aimed to determine whether there is any clear benefit of weight loss for radiographic hip osteoarthritis in older adults because weight loss is associated with health risks in older adults. We used data from white female participants aged ≥65 years from the Study of Osteoporotic Fractures. Our exposure of interest was weight change from baseline to follow‐up at 8 years. Our outcomes were the development of radiographic hip osteoarthritis (RHOA) and the progression of RHOA over 8 years. Generalized estimating equations (clustering of 2 hips per participant) were used to investigate the association between exposure and outcomes adjusted for major covariates. There was a total of 11,018 hips from 5509 participants. There was no associated benefit of weight loss for either of our outcomes. The odds ratios (95% confidence intervals) for the development and progression of RHOA were 0.99 (0.92–1.07) and 0.97 (0.86–1.09) for each 5% weight loss, respectively. The results were consistent in sensitivity analyses where participants were limited to those who reported trying to lose weight and who also had a body mass index in the overweight or obese range. Our findings suggest no associated benefit of weight loss in older female adults in the structure of the hip joint as assessed by radiography.
No related grants have been discovered for ZUBEYIR SALIS.