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Title: Diabetes mellitus and the risk of total knee replacement among Chinese in Singapore, the Singapore Chinese Health Study
Authors: Leung, Y.-Y 
Allen, J.C 
Ang, L.-W
Yuan, J.-M
Koh, W.-P 
Keywords: aged
body mass
diabetes mellitus
diabetic complication
ethnic group
follow up
health survey
knee osteoarthritis
knee replacement
middle aged
proportional hazards model
prospective study
risk factor
statistics and numerical data
Arthroplasty, Replacement, Knee
Body Mass Index
Diabetes Complications
Diabetes Mellitus
Ethnic Groups
Follow-Up Studies
Middle Aged
Osteoarthritis, Knee
Proportional Hazards Models
Prospective Studies
Public Health Surveillance
Risk Factors
Issue Date: 2017
Citation: Leung, Y.-Y, Allen, J.C, Ang, L.-W, Yuan, J.-M, Koh, W.-P (2017). Diabetes mellitus and the risk of total knee replacement among Chinese in Singapore, the Singapore Chinese Health Study. Scientific Reports 7 : 40671. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Association between diabetes mellitus (diabetes) and risk of knee osteoarthritis (KOA) is confounded by high body mass index (BMI), a strong risk factor for both conditions. We evaluated the association between diabetes and incidence of total knee replacement (TKR) due to severe KOA in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese men and women, aged 45-74 years at recruitment in 1993-1998, and re-interviewed in 1999-2004. Height, weight, lifestyle factors and history of diabetes were obtained through in-person interviews at recruitment and re-interview. Incident cases of TKR were identified via record linkage with nationwide hospital discharge database. Subjects with/without prevalent diabetes had comparable BMI (24.0 kg/m 2 versus 23.0 kg/m 2). After an average of 14-years, 1,973 subjects had TKR attributable to KOA. Compared to subjects without diabetes, hazard ratio (HR) of TKR for subjects with diabetes was 0.63 [95% confidence interval (CI), 0.52-0.75] after controlling for BMI and other risk factors. An inverse association was also observed between incident diabetes at re-interview and subsequent risk of TKR (HR = 0.74; 95% CI = 0.58-0.94). The inverse diabetes-TKR risk association was similar by gender and across three categories of BMI. Our study does not support diabetes as a risk factor of KOA. © The Author(s) 2017.
Source Title: Scientific Reports
ISSN: 20452322
DOI: 10.1038/srep40671
Rights: Attribution 4.0 International
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