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Cigarette smoking and risk of total knee replacement for severe osteoarthritis among Chinese in Singapore--the Singapore Chinese health study.
Osteoarthritis Cartilage. 2014 Jun; 22(6):764-70.OC

Abstract

PURPOSE

Data on the effects of cigarette smoking with osteoarthritis (OA) are inconsistent and no study has examined the effect of smoking cessation. We examined smoking status, duration, dosage and cessation in association with risk of total knee replacement (TKR) for severe knee OA among elderly Chinese in Singapore.

METHODS

We used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63,257 Chinese men and women aged 45-74 years during enrollment between 1993 and 1998. Detailed information on smoking, current diet and lifestyle factors were obtained through in person interviews. As of 31 December 2011, 1,973 incident TKR cases for severe knee OA had been identified via linkage with nationwide hospital discharge database. We used Cox regression methods to examine smoking in relation to TKR risk with adjustment for age, gender, education, body mass index (BMI), comorbidities and physical activity level.

RESULTS

Compared to never smokers, current smokers had a 51% decrease in risk of TKR [Hazards ratio (HR) = 0.49; 95% confidence interval (CI) = 0.40-0.60]. Among current smokers, there was a very strong dose-dependent association between increasing duration and dosage of smoking with decreasing risk of TKR (P for trend <0.0001). Among former smokers, there was a dose-dependent response between decrease in duration of smoking cessation and reduction in TKR risk (P for trend = 0.034).

CONCLUSION

Our findings strongly implicate smoking as a protective factor for TKR indicated for severe knee OA. This concurs with experimental data that nicotine promotes proliferation and collagen synthesis in chondrocytes.

Authors+Show Affiliations

Duke-NUS Graduate Medical School Singapore, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore. Electronic address: katyccc@hotmail.com.Epidemiology & Disease Control Division, Ministry of Health, Singapore.Duke-NUS Graduate Medical School Singapore, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.Duke-NUS Graduate Medical School Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24680935

Citation

Leung, Y Y., et al. "Cigarette Smoking and Risk of Total Knee Replacement for Severe Osteoarthritis Among Chinese in Singapore--the Singapore Chinese Health Study." Osteoarthritis and Cartilage, vol. 22, no. 6, 2014, pp. 764-70.
Leung YY, Ang LW, Thumboo J, et al. Cigarette smoking and risk of total knee replacement for severe osteoarthritis among Chinese in Singapore--the Singapore Chinese health study. Osteoarthritis Cartilage. 2014;22(6):764-70.
Leung, Y. Y., Ang, L. W., Thumboo, J., Wang, R., Yuan, J. M., & Koh, W. P. (2014). Cigarette smoking and risk of total knee replacement for severe osteoarthritis among Chinese in Singapore--the Singapore Chinese health study. Osteoarthritis and Cartilage, 22(6), 764-70. https://doi.org/10.1016/j.joca.2014.03.013
Leung YY, et al. Cigarette Smoking and Risk of Total Knee Replacement for Severe Osteoarthritis Among Chinese in Singapore--the Singapore Chinese Health Study. Osteoarthritis Cartilage. 2014;22(6):764-70. PubMed PMID: 24680935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cigarette smoking and risk of total knee replacement for severe osteoarthritis among Chinese in Singapore--the Singapore Chinese health study. AU - Leung,Y Y, AU - Ang,L W, AU - Thumboo,J, AU - Wang,R, AU - Yuan,J M, AU - Koh,W P, Y1 - 2014/03/28/ PY - 2013/11/25/received PY - 2014/02/26/revised PY - 2014/03/19/accepted PY - 2014/4/1/entrez PY - 2014/4/1/pubmed PY - 2015/1/27/medline KW - Chinese KW - Cohort study KW - Knee osteoarthritis KW - Smoking SP - 764 EP - 70 JF - Osteoarthritis and cartilage JO - Osteoarthritis Cartilage VL - 22 IS - 6 N2 - PURPOSE: Data on the effects of cigarette smoking with osteoarthritis (OA) are inconsistent and no study has examined the effect of smoking cessation. We examined smoking status, duration, dosage and cessation in association with risk of total knee replacement (TKR) for severe knee OA among elderly Chinese in Singapore. METHODS: We used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63,257 Chinese men and women aged 45-74 years during enrollment between 1993 and 1998. Detailed information on smoking, current diet and lifestyle factors were obtained through in person interviews. As of 31 December 2011, 1,973 incident TKR cases for severe knee OA had been identified via linkage with nationwide hospital discharge database. We used Cox regression methods to examine smoking in relation to TKR risk with adjustment for age, gender, education, body mass index (BMI), comorbidities and physical activity level. RESULTS: Compared to never smokers, current smokers had a 51% decrease in risk of TKR [Hazards ratio (HR) = 0.49; 95% confidence interval (CI) = 0.40-0.60]. Among current smokers, there was a very strong dose-dependent association between increasing duration and dosage of smoking with decreasing risk of TKR (P for trend <0.0001). Among former smokers, there was a dose-dependent response between decrease in duration of smoking cessation and reduction in TKR risk (P for trend = 0.034). CONCLUSION: Our findings strongly implicate smoking as a protective factor for TKR indicated for severe knee OA. This concurs with experimental data that nicotine promotes proliferation and collagen synthesis in chondrocytes. SN - 1522-9653 UR - https://www.unboundmedicine.com/medline/citation/24680935/Cigarette_smoking_and_risk_of_total_knee_replacement_for_severe_osteoarthritis_among_Chinese_in_Singapore__the_Singapore_Chinese_health_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1063-4584(14)01017-6 DB - PRIME DP - Unbound Medicine ER -