Although osteoarthritis (OA) is the most common chronic joint condition and is an important public health concern among the elderly, there is a paucity of epidemiological data on risk factors for OA. This research will 1) examine whether risk factors for OA and disc degeneration (DD) vary by joint site, by single versus multiple joint involvement, and by symptomatic versus asymptomatic status across joint sites; and, 2) examine the importance of specific mechanical and metabolic risk factors for joint-specific OA and DD. Data for adults aged 50 and older from three national surveys will be analyzed: Health Examination Survey I, 1960-1962 (HES I)(n=3783); National Health and Nutrition Examination Survey I, 1971-1974 (NHANES I)(n=3373); National health and Nutrition Examination Survey II, 1976-1980 (NHANES II)(n=5108). OA status will be based on x-rays of hands and feet (HES I), knees and hips (NHANES I) and DD on cervical and lumbar spine x-rays (NHANES II). The risk factors to be analyzed for all joint sites are: age, sex, race, occupation, height, weight, skinfolds, muscularity, anthropometric girth measurements, serum cholesterol, blood pressure, diabetes, and reproductive history. Additional risk factors available for some but not all joints will also be analyzed: injury, physical activity/exercise, waist/hip ratio, triglyceride, HDL, uric acid, bone density, glucose tolerance, and leg length. Nineteen major hypotheses will be tested by multiple binomial and polychotomous logistic regression. This study offers several advantages over previous cross-sectional studies: 1) large heterogeneous samples allowing for multivariate analysis of risk factors for a variety of joints; 2) generalizability of results to the U.S. adult population; 3) respondent, clinical, and radiographic data all in the same study; and, 4) radiographic data on multiple joints that were read independent of respondent characteristics, and graded according to standard diagnostic criteria.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
Project #
Application #
Study Section
Epidemiology and Disease Control Subcommittee 3 (EDC)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Francisco
Schools of Medicine
San Francisco
United States
Zip Code
Ettinger, W H; Davis, M A; Neuhaus, J M et al. (1994) Long-term physical functioning in persons with knee osteoarthritis from NHANES. I: Effects of comorbid medical conditions. J Clin Epidemiol 47:809-15
Davis, M A; Ettinger, W H; Neuhaus, J M et al. (1992) Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. J Rheumatol 19:1943-9
Davis, M A; Ettinger, W H; Neuhaus, J M et al. (1991) Knee osteoarthritis and physical functioning: evidence from the NHANES I Epidemiologic Followup Study. J Rheumatol 18:591-8
Davis, M A; Ettinger, W H; Neuhaus, J M (1990) Obesity and osteoarthritis of the knee: evidence from the National Health and Nutrition Examination Survey (NHANES I). Semin Arthritis Rheum 20:34-41
Davis, M A; Neuhaus, J M; Ettinger, W H et al. (1990) Body fat distribution and osteoarthritis. Am J Epidemiol 132:701-7
Davis, M A; Ettinger, W H; Neuhaus, J M et al. (1989) The association of knee injury and obesity with unilateral and bilateral osteoarthritis of the knee. Am J Epidemiol 130:278-88
Davis, M A; Ettinger, W H; Neuhaus, J M (1988) The role of metabolic factors and blood pressure in the association of obesity with osteoarthritis of the knee. J Rheumatol 15:1827-32