The mediating effect of body mass index on the relationship between smoking and hip or knee replacement due to primary osteoarthritis. A population-based cohort study (the HUNT Study)

PloS One
M B JohnsenK Storheim

Abstract

To investigate the total effect of smoking on total hip or knee replacement (THR/TKR) due to primary osteoarthritis (OA) and to quantify the indirect effect of smoking through body mass index (BMI). Participants from the Nord-Trøndelag Health Study (the HUNT Study) were linked to the Norwegian Arthroplasty Register to detect the first THR or TKR due to primary OA. A mediation analysis was used to decompose the total effect of smoking into a direct and indirect effect. BMI was considered a mediator in the analysis. All effects were estimated as hazard ratios (HRs) with 95% confidence intervals (CIs). The indirect effect of smoking mediated through BMI was expressed as a percentage (proportion*100). In total 55 188 participants were followed up during 17.2 years (median). We identified 1322 THRs and 754 TKRs. For men, the total effect of current vs. never smoking revealed a decreased risk of THR (HR 0.59, 95% CI 0.46-0.76) and TKR (HR 0.47, 95% CI 0.32-0.66). For women, current smoking increased the risk of THR (HR 1.34, 95% CI 1.11-1.60). For men, 6% and 7% of the risk reduction for THR and TKR, respectively, was mediated by BMI. We found a negative association between smoking and THR or TKR for men. On the contrary, smoking was...Continue Reading

References

Feb 1, 1989·Arthritis and Rheumatism·D T FelsonR F Meenan
Jan 22, 2003·Scandinavian Journal of Medicine & Science in Sports·S Sipilä, J Poutamo
Jun 28, 2005·Osteoarthritis and Cartilage·Velandai K SrikanthGraeme Jones
Mar 15, 2006·Acta Orthopaedica·Birgitte EspehaugOla Kindseth
Dec 13, 2006·Annals of the Rheumatic Diseases·S AminD T Felson
Feb 13, 2007·Osteoarthritis and Cartilage·T L RacunicaF M Cicuttini
Feb 15, 2007·Nature Clinical Practice. Rheumatology·Sita M A Bierma-Zeinstra, Bart W Koes
Oct 30, 2008·Annals of the Rheumatic Diseases·B LiuUNKNOWN Million Women Study Collaborators
Jun 6, 2009·American Journal of Epidemiology·Bryan LauStephen J Gange
Oct 24, 2009·American Journal of Epidemiology·Danella M Hafeman
Jun 7, 2011·Epidemiology·Tyler J VanderWeele
Aug 11, 2012·International Journal of Epidemiology·S KrokstadJ Holmen
Jun 13, 2013·The Journal of Orthopaedic and Sports Physical Therapy·Sarah A RichmondCarolyn A Emery
Sep 7, 2013·BMC Musculoskeletal Disorders·George MnatzaganianJanet E Hiller
Dec 3, 2014·Osteoarthritis and Cartilage·D T Felson, Y Zhang

❮ Previous
Next ❯

Citations

Apr 3, 2019·BMC Musculoskeletal Disorders·Marianne Bakke JohnsenJonas Bloch Thorlund
May 6, 2019·Cells, Tissues, Organs·Xingen ZhangGuiqian Chen

❮ Previous
Next ❯

Software Mentioned

R
Stata

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.