Fatty acids and osteoarthritis: the MOST study

Authors: FELSON, DAVID - Boston University Medical School; MISRA, DEVYANI - Harvard Medical School; LAVALLEY, MICHAEL - Boston University School Of Public Health; CLANCY, MARY - Boston University Medical School; CHEN, X. - Boston University Medical School; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; TORNER, JAMES - University Of Iowa; LEWIS, C. - University Of Alabama At Birmingham; NEVITT, MICHAEL - University Of California San Francisco (UCSF)

Submitted to: Osteoarthritis and Cartilage
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/8/2021
Publication Date: 7/1/2021
Citation: Felson, D.T., Misra, D., Lavalley, M., Clancy, M., Chen, X., Lichtenstein, A.H., Matthan, N., Torner, J., Lewis, C.E., Nevitt, M.C. 2021. Fatty acids and osteoarthritis: the MOST study. Osteoarthritis and Cartilage. https://doi.org/10.1016/j.joca.2021.03.006.
DOI: https://doi.org/10.1016/j.joca.2021.03.006

Interpretive Summary: Some data have suggested circulating saturated and n-6 fatty acids (FAs) increase, whereas n-3 FAs reduce, inflammation and the development of osteoarthritis (OA). We used samples from the Multicenter Osteoarthritis study, composed of a group of individuals at risk of developing knee OA, to assess the potential relationship between plasma FA and OA. No significant nor suggestive associations of FA levels were noted with OA nor with any OA outcome in knee or hand. These data suggest despite previously described effects on systemic inflammation, blood levels of FAs were not associated with risk of later knee OA or other OA outcomes.

Technical Abstract: Objective: Inflammation worsens joint destruction in osteoarthritis (OA) and aggravates pain. Saturated and n-6 fatty acids (FAs) increase, whereas n-3 FAs reduce inflammation. We examined whether FA levels affected the development of OA. Design: We studied participants from the Multicenter Osteoarthritis study (MOST) at risk of developing knee OA. After baseline, repeated knee x-rays and MRIs were obtained and knee symptoms queried through 60 month follow-up. Using baseline fasting samples, serum FAs were analyzed with standard assays. After excluding participants with baseline OA, we defined two sets of cases: those developing radiographic OA and those developing symptomatic OA (knee pain and radiographic OA). Controls did not develop these outcomes. Additionally, we examined worsening of MRI cartilage loss and synovitis and of knee pain using WOMAC and evaluated the number of hand joints affected by nodules. In regression models, we tested the association of each OA outcome with levels of saturated, n-3 and n-6 FAs adjusting for age, sex, BMI, education, race, baseline pain and depressive symptoms. Results: We studied 260 cases with incident symptomatic and 259 with incident radiographic OA. Mean age was 61 years (61% women). We found no significant nor suggestive associations of FA levels with incident OA (e.g., for incident symptomatic OA, OR per s.d. increase in n-3 FA 1.00 (0.85, 1.18) nor with any OA outcome in knee or hand. Conclusion: Despite previously described effects on systemic inflammation, blood levels of FAs were not associated with risk of later knee OA or other OA outcomes.