Essential fatty acids and osteoarthritis

Authors: FELSON, DAVID - Boston University; MISRA, DEVYANI - Harvard Medical School; LAVALLEY, MICHALE - Boston University; CLANCY, MARGARET - Boston University; RABASA, GABRIELA - Boston University; 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, CORA - University Of Alabama At Birmingham; NEVITT, MICHAEL - University Of California San Francisco (UCSF)

Submitted to: Arthritis Care and Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/11/2024
Publication Date: 1/15/2024
Citation: Felson, D.T., Misra, D., LaValley, M., Clancy, M., Rabasa, G., Lichtenstein, A.H., Matthan, N., Torner, J., Lewis, C.E., Nevitt, M.C. 2024. Essential fatty acids and osteoarthritis. Arthritis Care and Research. https://doi.org/10.1002/acr.25302.
DOI: https://doi.org/10.1002/acr.25302

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. Baseline fasting samples were used to measure serum FAs. After baseline, repeated knee x-rays and MRIs were obtained and knee symptoms queried through 60 month follow-up. No significant nor suggestive associations of FA levels 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. n-6 Fatty Acids (FAs) increase, whereas n-3 FAs reduce inflammation. We examined whether specific essential 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 months. 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 incident radiographic OA and those developing incident symptomatic OA (knee pain and radiographic OA). Controls did not develop these outcomes. Additionally, we examined worsening of MRI cartilage damage and synovitis and worsening knee pain and evaluated the number of hand joints affected by nodules. In regression models, we tested the association of each OA outcome with levels of specific n-3 and n-6 FAs adjusting for age, sex, BMI, education, physical activity, race, baseline pain, smoking, statin use and depressive symptoms. Results: We studied 363 cases with incident symptomatic and 295 with incident radiographic knee OA. Mean age was 62 years (59% women). We found no signficant nor suggestive associations of n-3 or n-6 FA levels with incident OA (e.g. for incident symptomatic OA, OR per s.d. increase in n-3 FA 1.05 (0.94, 1.18)) nor with any OA outcome in knee or hand. Conclusion: Serum levels of essential FAs were not associated with risk of incident knee OA or other OA outcomes.