Arthritis & rheumatology (Hoboken, N.J.) · 2026
Per- and Polyfluoroalkyl Substances and Knee Osteoarthritis: Data From the Osteoarthritis Initiative.
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Driban Jeffrey B, Rokoff Lisa B, Lu Bing, McAlindon Timothy E, Eaton Charles B, Roberts Mary B, Mathes Diana, Lestician Colleen, Xu Zhijin Carrie, Fan Zhihua Tina, O'Leary Shawn P, Haugen Ida K, Sellam Jérémie, Courties Alice, Fleisch Abby F
Аннотация
OBJECTIVE: To examine whether concentrations of specific per- and polyfluoroalkyl substances (PFAS) and a mixture of PFAS relate to incident knee osteoarthritis (KOA) and knee pain progression.
METHODS: Among a case-cohort sample from the OA Initiative (n = 1,878), we examined associations of serum concentrations of eight PFAS with odds of developing over the subsequent 48 months (1) symptomatic KOA and (2) a clinically meaningful change in the Western Ontario and McMaster Universities OA Index knee pain score. We used weighted logistic regression to assess single PFAS (continuous and quartiles) and quantile g-computation to assess the PFAS mixture in relation to our outcomes, accounting for sociodemographics.
RESULTS: Fifty-eight percent of participants were female with a mean age of 62 years and body mass index of 28.6 kg/m2. Participants with higher perfluorooctanoic acid (continuous) had greater odds of incident symptomatic KOA (odds ratio [OR] per interquartile range [IQR] 1.12, 95% confidence interval [CI] 1.04-1.21). Participants in the highest quartiles of perfluorononanoic acid (PFNA) had greater odds of incident symptomatic KOA [OR for the third quartile 1.63, 95% CI 1.29-2.07; fourth quartile 1.55, 95% CI 1.19-2.01). Perfluorooctanoic acid may have a nonlinear relationship with the greatest chance of incident symptomatic KOA with serum concentrations between 5.19 and 6.88 ng/mL (OR 1.55, 95% CI 1.21-1.97). Participants with greater perfluorooctanoic acid and PFNA (continuous) had greater odds of knee pain progression (OR per IQR: perfluorooctanoic acid 1.10, 95% CI 1.03-1.18; PFNA 1.06, 95% CI 1.01-1.11). Mixture models showed perfluorooctanoic acid and PFNA were among the PFAS with the strongest positive weights for both outcomes.
CONCLUSION: In a large cohort at risk for KOA, higher perfluorooctanoic acid and PFNA serum concentrations may be associated with a greater likelihood of symptomatic KOA incidence and knee pain progression.
METHODS: Among a case-cohort sample from the OA Initiative (n = 1,878), we examined associations of serum concentrations of eight PFAS with odds of developing over the subsequent 48 months (1) symptomatic KOA and (2) a clinically meaningful change in the Western Ontario and McMaster Universities OA Index knee pain score. We used weighted logistic regression to assess single PFAS (continuous and quartiles) and quantile g-computation to assess the PFAS mixture in relation to our outcomes, accounting for sociodemographics.
RESULTS: Fifty-eight percent of participants were female with a mean age of 62 years and body mass index of 28.6 kg/m2. Participants with higher perfluorooctanoic acid (continuous) had greater odds of incident symptomatic KOA (odds ratio [OR] per interquartile range [IQR] 1.12, 95% confidence interval [CI] 1.04-1.21). Participants in the highest quartiles of perfluorononanoic acid (PFNA) had greater odds of incident symptomatic KOA [OR for the third quartile 1.63, 95% CI 1.29-2.07; fourth quartile 1.55, 95% CI 1.19-2.01). Perfluorooctanoic acid may have a nonlinear relationship with the greatest chance of incident symptomatic KOA with serum concentrations between 5.19 and 6.88 ng/mL (OR 1.55, 95% CI 1.21-1.97). Participants with greater perfluorooctanoic acid and PFNA (continuous) had greater odds of knee pain progression (OR per IQR: perfluorooctanoic acid 1.10, 95% CI 1.03-1.18; PFNA 1.06, 95% CI 1.01-1.11). Mixture models showed perfluorooctanoic acid and PFNA were among the PFAS with the strongest positive weights for both outcomes.
CONCLUSION: In a large cohort at risk for KOA, higher perfluorooctanoic acid and PFNA serum concentrations may be associated with a greater likelihood of symptomatic KOA incidence and knee pain progression.