ALS and PDC of Guam: forty-year follow-up.

BACKGROUND: It was noticed in the mid-1950s that the incidence of ALS and parkinsonism--dementia complex (PDC) were much higher on Guam than anywhere else in the world. In 1958, a registry of patients and controls was established to ascertain the familial and genetic aspects of these diseases. Patients and individually matched controls and their relatives were registered from 1958 to 1963. The registry was updated and analyzed in 1998 through 1999. OBJECTIVE: To ascertain whether first-degree relatives of patients had a higher risk for developing ALS or PDC than relatives of controls. METHODS: During the period of 1958 to 1963, 126 new patients and 126 individually matched controls and their respective first-degree relatives and spouses were evaluated neurologically and registered. Forty years later, the number of new cases among the patient and control relatives were compared to an expected number of new cases based on the age- and sex-specific incidence of ALS and PDC in the population at large. RESULTS: From 1958 to 1999, there were 102 new ALS or PDC cases among relatives of patients and 33 among relatives of controls. These values were compared with the derived expected values. There were more observed than expected new cases among patients' relatives, and less observed cases than expected among the controls' relatives. CONCLUSIONS: Relatives of patients with ALS or PDC have significantly higher risks for developing the disease than the Guamanian population, whereas relatives of controls have significantly lower risks.

TAU as a susceptibility gene for amyotropic lateral sclerosis-parkinsonism dementia complex of Guam.

BACKGROUND: A Guam variant of amyotrophic lateral sclerosis (ALS-G) and parkinsonism dementia complex (PDC-G) are found in the Chamorro people of Guam. Both disorders have overlapping neuropathologic findings, with neurofibrillary tangles in spinal cord and brain. The cause of ALS-G-PDC-G is unknown, although inheritance and environment appear important. Because neurofibrillary tangles containing tau protein are present in ALS-G-PDC-G, and because mutations in the tau gene (TAU) cause autosomal dominant frontotemporal dementia, TAU was examined as a candidate gene for ALS-G-PDC-G. METHODS: TAU was evaluated by DNA sequence analysis in subjects with ALS-G-PDC-G, by linkage analysis of TAU polymorphisms in an extended pedigree from the village of Umatac, and by evaluation of linkage disequilibrium with polymorphic markers flanking and within TAU. RESULTS: Linkage disequilibrium between ALS-G-PDC-G and the TAU polymorphism CA3662 was observed. For this 2-allele system, PDC and ALS cases were significantly less likely than Guamanian controls to have the 1 allele (4.9% and 2% vs 11.5%, respectively; Fisher exact P =.007). DNA sequence analysis of TAU coding regions did not demonstrate a mutation responsible for ALS-G-PDC-G. Analysis of TAU genotypes in an extended pedigree of subjects from Umatac showed obligate recombinants between TAU and ALS-G-PDC-G. Linkage analysis of the Umatac pedigree indicates that TAU is not the major gene for ALS-G-PDC-G. CONCLUSIONS: The genetic association between ALS-G-PDC-G implicates TAU in the genetic susceptibility to ALS-G-PDC-G. TAU may be a modifying gene increasing risk for ALS-G-PDC-G in the presence of another, as yet, unidentified gene.

Palmar and plantar pads and flexion creases of genetic polydactyly mice (Pdn).

Attempts to gain a better understanding of the relationship between the epidermal ridge patterns (dermatoglyphics) and flexion creases on the volar aspects of human hands and feet and specific medical disorders led to a search for a suitable animal model, allowing studies of the fetal development of the pertinent structures. A common experimental animal, the rat (Rattus norvegicus), was found to be an excellent candidate, owing to the strong resemblance of the volar pads and flexion creases on its palmar and plantar surfaces to those of human subjects. A hereditary preaxial polydactyly mouse (Pdn) provides an opportunity to study the effects of this malformation on the surrounding morphological structures and, specifically, on the volar pads, i.e., the sites over which the dermatoglyphic patterns develop. The hands and feet of the wild-type (+/+) mice show no anomalies, and their major pad and flexion crease configurations correspond to those of normal rats. The heterozygous (Pdn/+) mice, in spite of having a thumb/big toe with a duplicated distal phalanx on their hands/feet, did not display any alterations in palmar/plantar pads. The homozygous (Pdn/Pdn) mice have a protrusion in the thenar area and one to three supernumerary digits on the preaxial portion of both the hands and feet. The effect of these anomalies was found to be limited to the pad and flexion crease configurations in the preaxial areas; the postaxial sites were not affected. The original number of pads on the thenar/first interdigital areas of Pdn/Pdn mice was apparently identical to that of the +/+ and Pdn/+mice. The preaxial protrusion, however, affected the number, size, and location of the pads observed in the newborn mice, resulting in varying pad configurations, such as fused and scattered pads or a pad cluster formed by gathering the neighboring pads. These pad modifications were induced by the preaxial plantar/palmar protrusion only and were not affected by the presence of supernumerary preaxial digits. In view of the similarities in the morphology and fetal development of human and mouse distal limbs, the present study is relevant to human subjects, particularly to the understanding of the significance of dermatoglyphic variations in individuals with specific medical disorders. Future studies of naturally occurring or experimentally induced limb malformations in mice or rats should provide valuable insights into the development of human hands and feet and into factors contributing to their congenital anomalies.

Familial aggregation of osteoarthritis: data from the Baltimore Longitudinal Study on Aging.

OBJECTIVE: To evaluate the familial aggregation of osteoarthritis (OA) in a cohort of healthy volunteers drawn from a community setting. METHODS: Hand radiographs obtained between 1978 and 1991 and bilateral standing knee radiographs obtained between 1984 and 1991 were read for changes of OA, using Kellgren-Lawrence (K-L) scales. The hand sites were distal interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, and first carpometacarpal (CMC1) joints. For each joint group, the presence of OA in at least 1 joint in a joint group, the number of affected digits in each joint group, and the sum of the K-L grade across all joints were analyzed. Polyarticular OA was recorded if there were OA findings in 2 of 3 hand joint groups plus 1 or both knees. Data from 167 families with hand radiographs, 157 families with knee radiographs, and 148 families with both hand and knee radiographs were analyzed for sib-sib correlations. RESULTS: After adjustment for age, sex, and body mass index, clinically relevant sib-sib common correlations were found for OA of the DIP, PIP, and CMC1 joints, for OA at 2 or 3 hand sites, and for polyarticular OA (r = 0.33-0.81) when OA was defined according to the number of affected joints or as the sum of the K-L grade across all joints. CONCLUSION: These results from a cohort of volunteers drawn from a community setting and ascertained without regard to OA status demonstrate familial aggregation of OA and contribute to the evidence for heritability of OA.

Serum levels of insulin-like growth factor-I are related to age and not to body composition in healthy women and men.

BACKGROUND: Aging is accompanied by decreased bone and lean body mass, increased fat mass, and reduced growth hormone (GH) axis function, reflected in diminished levels of insulin-like growth factor-I (IGF-I). Similar changes in body composition occur in nonelderly, GH-deficient adults and are reversible with GH administration, suggesting that diminished GH/IGF-I axis activity may contribute to such age-related changes. To determine the precise pattern of IGF-I decline with age, and to test the hypothesis that this decline is related to concomitant changes in body composition and bone metabolism independent of age, we conducted a cross-sectional survey in 351 healthy participants in the Baltimore Longitudinal Study of Aging. METHODS: We evaluated relationships among IGF-I, age, and total and regional adiposity, as assessed by body mass index (BMI) and waist-to-hip ratio (WHR); lean body mass, as estimated from urinary creatinine excretion (Crex/ht); bone mineral density (BMD), as assessed by single and dual photon absorptiometry scanning; and circulating levels of parathyroid hormone (PTH), 1,25-(OH)2 D3, 25-OHD, and osteocalcin. RESULTS: Serum IGF-I levels declined with age (p < .0001) in both men (r = -.51) and women (r = -.67). In men, the decline was linear, whereas IGF-I levels decreased faster in women < 45 years of age than in older women (p < .01) or in men (p < .001). IGF-I was inversely related to BMI (p < .005), WHR (p < .001), and PTH (p < .01) in women. IGF-I was positively related to BMD of the hip and radius in both genders (p < .0003) and to Crex/ht (p < .0005) and osteocalcin (p < .0001) in men. With increasing age, Crex/ht and BMD decreased (p < .0001) and WHR, PTH, and osteocalcin increased (p < .005) in both genders, whereas BMI increased only in women (p < .005). After adjustment for age, IGF-I was not significantly related to BMI, WHR, Crex/ht, or BMD in either gender. IGF-I was positively related to 1,25-(OH)2 D3 (p < .01) independently of age in women. CONCLUSIONS: Advancing age, rather than declining serum levels of IGF-I, appears to be a major determinant of life-time changes in body composition and BMD in women and men.

An association between an aggrecan polymorphic allele and bilateral hand osteoarthritis in elderly white men: data from the Baltimore Longitudinal Study of Aging (BLSA).

OBJECTIVE: The aggrecan proteoglycan is a major component of articular cartilage and supports the biomechanical function of this tissue. A variable number tandem repeat (VNTR) polymorphism has been discovered recently in a region of the human aggrecan gene that codes for the chondroitin sulfate attachment sites. We examined whether alleles of this polymorphism displayed a non-random association with bilateral hand or knee osteoarthritis (OA) in men from the Baltimore Longitudinal Study of Aging (BLSA). DESIGN: DNA was obtained from 93 Caucasian men, aged 60 and above, who had bilateral hand and standing knee radiographs read for changes of OA. The DNA was analyzed by polymerase chain reaction (PCR) and/or Southern blotting for the presence of the VNTR alleles. RESULTS: Bilateral hand OA and knee OA were present in 46 and 30% of the men respectively. The following distribution of alleles was observed: allele 33 (0.5%), 29 (2.2%), 28 (31.7%), 27 (43.0%), 26 (16.7%), 25 (3.2%), 22 (2.2%) and 19 (0.5%). This distribution was similar to that detected in a random population of individuals from a separate study. In multiple logistic regression analysis, adjusting for age and body mass index, the presence of allele 27 was associated with bilateral hand OA with an odds ratio (OR) = 3.23 (95% confidence intervals (CI): 1.24-8.41). No other alleles showed an association with bilateral hand OA and the association between allele 27 and bilateral knee OA was not statistically significant (OR = 1.14; 95% CI: 0.45-2.88). CONCLUSIONS: These data demonstrate the first association between a human aggrecan gene polymorphic allele and hand OA. This finding supports the concept that genetic factors may play a role in the development and/or progression of some forms of age-onset OA.

Axial and hip bone mineral density and radiographic changes of osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging.

OBJECTIVE: To examine the relationship between axial and hip bone mineral density (BMD) and radiographic changes of knee osteoarthritis (OA). METHODS: BMD of the lumbar spine and/or right hip was measured, using dual photon absorptiometry, in 402 men and 247 women in the Baltimore Longitudinal Study of Aging who had bilateral standing knee radiographs taken between 1984 and 1991. Radiographs were read for features of OA using Kellgren-Lawrence and reliable individual feature scales. The relationship between BMD and radiographic changes of OA was examined using multiple linear regression adjusting for age, body mass index, and smoking. Additional analyses with adjustment for menopausal status and estrogen replacement therapy were performed in a subset of women. RESULTS: Adjusted mean lumbar spine BMD was higher in subjects with knee osteophytes in both sexes: 1.23 +/- 0.02 vs 1.18 +/- 0.01 g/cm2 (p = 0.02) in men, and 1.12 +/- 0.02 vs 1.08 +/- 0.01 g/cm2 (p = 0.07) in women. There were no differences in levels of adjusted hip BMD by presence of any radiographic features of OA in either men or women. CONCLUSION: These results show that both men and women with radiographic changes of knee OA, specifically osteophytosis, have higher levels of adjusted spine but not hip BMD.

Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset.

OBJECTIVE: To examine the association between hand and knee osteoarthritis (OA) in a community based population. METHODS: Radiographs of 695 participants aged > or = 40 years in the Baltimore Longitudinal Study of Aging were read for changes of OA, using Kellgren-Lawrence grade > or = 2 as the case definition. RESULTS: Logistic regression analyses, adjusting for age, gender and body mass index, revealed a significant association between OA in the knee and the following joint groups: distal and proximal interphalangeal (DIP, PIP) and Hand2 (OA in two or more hand joint groups) for grade 2-4 and grade 3-4 disease, and the first carpometacarpal (CMC1) joint for grade 3-4 disease. CONCLUSION: There is an association between OA in hand sites and the knee. The strength of the associations increases with increasing disease severity. For the PIP site, there is a trend toward increasing strength of association for increasing numbers of affected joints and bilateral disease.

Radial and ulnar cortical thickness of the second metacarpal.

Differential bone mass at various skeletal sites, which may be due to mechanical stress exerted by the muscles attached to the bone, has been demonstrated for athletes who exert one limb more than the other. The question arises as to whether this bilateral asymmetry extends to the two sides of the same bone with different muscular attachments. The objectives of this study were to ascertain whether the radial and ulnar sides of the second metacarpal have similar cortical thickness and determine if bone mass decreases equally with age on the radial and ulnar sides. Hand-wrist radiographs were obtained from 201 male and 191 female Caucasian participants of the Baltimore Longitudinal Study of Aging. Differences between radial and ulnar cortical thickness within age groups were tested with Student's t-test and between age groups using analysis of variance. RAdial cortical thickness of the second metacarpal was found to be 11-12% greater in men and 10-12% greater in women than ulnar cortical thickness in both the left and right hands. Age-related changes in radial cortical thickness were evident in both sexes. In men, radial cortex decreased linearly from age 40 to 89. For women, there was a sharp decline in radial thickness from age 50 to age 60. Ulnar cortical thickness declined from age 50 to 60 for women only. Muscle attachment along the radial length of the second metacarpal may influence the accumulation of bone mass on the radial side at younger ages while muscle disuse may precipitate the loss of bone preferentially from the radial side.

Association of radiographic features of osteoarthritis of the knee with knee pain: data from the Baltimore Longitudinal Study of Aging.

OBJECTIVE: To examine the association between self-reported knee pain and radiographic features of osteoarthritis (OA) of the knee. METHODS: A sample of participants in the Baltimore Longitudinal Study of Aging (452 Caucasian males and 223 Caucasian females) completed questionnaires and underwent a standing radiograph of both knees at the same biennial visit between 1984 and 1989. Radiographs were interpreted using both the Kellgren-Lawrence and individual features scales. Odds ratios were calculated for the association of radiographic features with knee pain after adjustment for age, sex, and body mass index. RESULTS: Overall, 156 (23%) persons reported ever having knee pain, and 104 (15%) reported current knee pain (within the previous year). Both ever knee pain and current knee pain were significantly associated with the presence of definite knee OA (Kellgren-Lawrence grade > or = 2) and with the presence of all individual features. There was a direct relationship between all measures of severity of radiographic OA and knee pain. CONCLUSION: These data demonstrate that radiographic features of knee OA are significantly associated with knee pain. The data also support the continued use of the Kellgren-Lawrence grading scale for defining knee OA in population studies.

The association of body weight, body fatness and body fat distribution with osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging.

OBJECTIVE: To examine the association of body weight, body fatness, and body fat distribution with osteoarthritis (OA) of the knee. METHODS: Bilateral standing knee radiographs, taken between 1985 and 1991, of 465 Caucasian men and 275 Caucasian women subjects aged 40 and above in the Baltimore Longitudinal Study of Aging were read by one investigator for grade of OA using Kellgren-Lawrence scales. Measures of obesity, assessed at same visit as the last radiograph during this interval, included body mass index, percent body fat, and body fat distribution. RESULTS: Both men and women with definite knee OA had higher age adjusted mean levels of body mass index, while women only had higher age adjusted mean levels of percent body fat. Both women and men in the highest tertile of body mass index had significantly increased odds of both definite and bilateral knee OA; women in the middle and highest tertile of percent body fat had significantly increased odds of both definite and bilateral knee OA, and men in the highest tertile of waist-hip ratio had significantly increased odds of bilateral knee OA. After adjusting for body mass index, however, the association of percent body fat and waist-hip ratio with knee OA in women and men, respectively, was no longer significant. CONCLUSION: These data further extend observations that body weight is associated with both definite and bilateral knee OA in both sexes, and support a stronger contribution of mechanical as opposed to systemic factors to explain this association.

Upper extremity bone mass and osteoarthritis of the knees: data from the Baltimore Longitudinal Study of Aging.

To examine the association of upper extremity bone mass with osteoarthritis (OA) of the knee, bilateral standing knee radiographs, taken between 1985 and 1991, in 430 Caucasian male and 266 Caucasian female subjects aged 40 years and above in the Baltimore Longitudinal Study of Aging, were read by one investigator for grade of OA using Kellgren-Lawrence scales. Several measures of upper extremity bone mass, size, and density, including combined cortical thickness (CCT), total width and percentage of cortical area of the second metacarpal, and bone mineral content (BMC), width, and density of the distal third of the left radius measured with single photon absorptiometry, were assessed at the same visit. In univariate analyses, men and women with definite knee OA were significantly older, men had significantly greater radial width, and women had significantly lower bone mass as measured by both CCT and BMC. After adjustment for age and body weight, however, men with knee OA had significantly higher BMC and radial width while neither of these measures of upper extremity bone mass and size was significantly associated with the presence of definite knee OA in women. Neither measure of upper extremity bone density was significantly associated with definite knee OA in either sex. These data suggest that, although men (but not women) with definite knee OA have significantly higher levels of adjusted radial bone mass and size, subjects with knee OA do not have significantly higher levels of adjusted bone mineral density at either upper extremity site.

Bilateral asymmetry in bone weight at various skeletal sites of the rat.

BACKGROUND: Morphological and functional asymmetry in the limbs has generally been regarded as a human characteristic that is of genetic or of both genetic and environmental origin. The aim of this study was to determine the presence of lateral dominance in bone weight of the forelimb of the rat. METHODS: Wistar rats (77) were used, 45 controls and 32 experimental animals, implanted with a steel weight subcutaneously under the right forelimb. Bones examined for bilateral asymmetry in bone weight were the mandibula, the bones of fore- and hindlimbs, calcaneus, and talus of the tarsus. The weight of each dry bone was measured to the nearest milligram. RESULTS: Significant bilateral asymmetry in the forelimb was evident in male and female rats, with the left side having more bone mass than the right. Bilateral differences were more pronounced in the females than the male rats. Greater asymmetry was evident in the experimental group compared to the control rats. CONCLUSIONS: These findings demonstrate that asymmetry is present not only in humans, but also in lower animals such as rats. Greater asymmetry in the experimental rat group is indicative of the influence of environmental factors or physical stress on asymmetry. We conclude that genetics might control the development of asymmetry, but physical stress may alter the functional expression of the asymmetry.

The relationship of age and gender to prevalence and pattern of radiographic changes of osteoarthritis of the knee: data from Caucasian participants in the Baltimore Longitudinal Study of Aging.

The aim of this study was to estimate the prevalence and pattern of radiographic changes of osteoarthritis (OA) of the knee by age and gender in Caucasian participants in the Baltimore Longitudinal Study of Aging. Bilateral standing weight-bearing radiographs of the knee in 547 male and 351 female subjects (aged 20 and above) were read for changes of knee OA using Kellgren-Lawrence and individual features scales. Prevalence of definite (Kellgren-Lawrence grade > or = 2 changes) knee OA increased with advancing age in both sexes. Approximately 50 percent in both sexes showed bilateral involvement. Men aged 59 and below were more likely to have unilateral impairment than men aged 60 and above; no such differences were found in females. These data demonstrate that age and gender influence both the prevalence and pattern of radiographic changes of knee OA.

Serum levels of insulin-like growth factor in subjects with osteoarthritis of the knee. Data from the Baltimore Longitudinal Study of Aging.

OBJECTIVE: To examine the relationship between serum levels of insulin-like growth factor 1 (IGF-1) and osteoarthritis (OA) of the knee. METHODS: Serum IGF-1 levels were compared in 162 male and 101 female subjects age > or = 20 stratified by presence of radiographic changes of OA of the knee. RESULTS: Mean serum IGF-1 levels were significantly lower in subjects with knee OA; however, after adjustment for age-related changes in IGF-1 levels, these differences were no longer significant. CONCLUSION: These data fail to support the hypothesis that serum IGF-1 levels are reduced in subjects with OA of the knee independent of the known age-related changes in these levels.

Appendicular bone mass and osteoarthritis of the hands in women: data from the Baltimore Longitudinal Study of Aging.

OBJECTIVE: The association of appendicular bone mass with hand osteoarthritis (OA) was studied in 238 Caucasian female participants aged 40 and above in the Baltimore Longitudinal Study of Aging. METHODS: Bilateral hand radiographs taken between 1978 and 1991 were read for grade of OA using Kellgren-Lawrence scales. Two measures of appendicular bone mass, percent cortical area of the second metacarpal and bone mineral density of the distal radius measured with single photon absorptiometry, were assessed at the same visit. RESULTS: Bivariate analyses showed that increasing grade of hand OA was associated with increasing age and decreasing bone mass as measured by both techniques. After adjustment for age and body mass index, however, neither of these measures of appendicular bone mass remained significantly associated with grade of hand OA. CONCLUSION: Our data fail to support the hypothesis that increased appendicular bone mass is associated with hand OA in women.

Palmar and plantar pads and flexion creases of the rat (Rattus norvegicus).

The recent detection of dermal ridge configurations on the volar pads of the rat (Rattus norvegicus) has created opportunities for experimental studies of dermatoglyphics. In the present work, the palmar and plantar surfaces of the rat were studied to establish the feasibility of comparative rat and human dermatoglyphic investigations. The studied features included the volar pads and flexion creases. The number and location of the palmar and plantar pads in the rat were found to be similar to those of humans. The exception was a previously unrecognized small pad on the palms and soles of the rat, located on the radial and tibial side, respectively, of the proximal component of the first interdigital pad. This pad has no parallel in human embryos. Rats were found to have flexion creases in the non-pad areas between the neighboring pads, similar in location and appearance to those of humans. Unlike humans, however, rats also have boundary creases, separating the pad and non-pad areas. The marked similarities in the morphology of the volar areas between rats and humans make the rat ideally suitable for experimental studies of dermatoglyphics and flexion creases. Results of such studies should be applicable to human developmental dermatoglyphics, including those pertaining to medical disorders.

Hand dominance and bilateral asymmetry in the structure of the second metacarpal.

Bilateral asymmetry in the structure of the second metacarpal was examined in relation to functional hand dominance in a large, clinically nonselected, healthy population sample from the Baltimore Longitudinal Study of Aging. Bilateral bone measurements were made from anteroposterior hand radiographs of a total of 992 individuals, 609 males and 383 females, with an age range of 19-94 years. Hand dominance was determined on the basis of personal impression. Total width and medullary width at the midshaft of the second metacarpal were measured to 0.05 mm using a Helios caliper. These two measurements were used to derive cortical thickness, cortical bone area, periosteal (total) area, medullary area, percent cortical area, and the second moment of area in the mediolateral plane. In both right and left-handed individuals, statistically significant side differences were found in the calculated bone areas and the second moment of area, with the dominant hand being larger. Cortical thickness did not show significant side-related differences for either handedness. These results show that functional handedness leads to periosteal and endosteal expansion of the second metacarpal cortex on the dominant side, increasing bone strength without increasing cortical thickness. This is the first time this pattern of asymmetry has been reported in left-handers as well as right-handers. Our results argue for the primacy of environmental (mechanical) effects in determining bilateral asymmetry of limb bone structural properties.

Reproductive correlates of bone mass in elderly women. Study of Osteoporotic Fractures Research Group.

Results from previous studies of reproductive factors and bone density have been conflicting; some demonstrate a beneficial effect, but others show a detrimental effect on bone density. The present study investigates the association of parity, lactation, and menstruation with radial bone density in 2230 white women, 65 years of age and older. Bone density was assessed by single-photon absorptiometry. Linear multiple regression was utilized to determine if reproductive factors were associated with radial bone density. The number of births, duration of menstrual bleeding, age at menarche, and years menstruating were significant independent predictors of postmenopausal bone density of the radius. A 1.4% increase in distal radius bone density was observed with each additional birth. Women who began menstruation at age 9 had 6.3% higher bone density than women who began at age 16. Women who menstruated for 3 days during each menstrual cycle had 2.8% less distal radius bone density than women who bled for 7 days. Each decade of menstruation was associated with a 2% greater distal radius bone density. No difference in bone density was demonstrated for women who breast-fed and women who did not. Length of the menstrual cycle, amount of menstrual flow, and irregularity of the menstrual cycle were not significantly associated with radial bone mineral density. In conclusion, pregnancy and menstruation are associated with postmenopausal bone density of the radius.

Obesity and osteoarthritis of the hands in women.

The association of obesity and body fat distribution with hand osteoarthritis was studied in 317 Caucasian female subjects aged 40 years and above in the Baltimore Longitudinal Study of Aging. Bilateral hand radiographs taken between 1978 and 1991 were read by one investigator for grade of osteoarthritis using Kellgren-Lawrence scales. Possible risk factors, assessed at same visit as the first radiograph during this interval, included age and measures of obesity, per cent body fat, and fat distribution. Results of bivariate analyses showed that increasing grade of hand osteoarthritis was associated with increasing age, greater mean levels of waist-hip ratio and per cent body fat; there was no association with body mass index. After adjustment for age, however, none of these independent variables remained significantly associated with grade of hand osteoarthritis. These data fail to support hypotheses that measures of obesity are associated with hand osteoarthritis in women independent of their known age-related changes.