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dc.contributor.authorHellevik, Alf Inge
dc.contributor.authorJohnsen, Marianne Bakke
dc.contributor.authorLanghammer, Arnulf
dc.contributor.authorBaste, Valborg
dc.contributor.authorFurnes, Ove
dc.contributor.authorStorheim, Kjersti
dc.contributor.authorZwart, John-Anker
dc.contributor.authorFlugsrud, Gunnar B
dc.contributor.authorNordsletten, Lars
dc.identifier.citationClinical Epidemiology. 2018, 10 83-96.nb_NO
dc.description.abstractObjective: Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance) were risk factors for subsequent total hip replacement (THR) or total knee replacement (TKR) due to primary osteoarthritis. Design: In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2) were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR. The analyses were stratified by age (<50, 50–69.9 and ≥70 years) and adjusted for gender, body mass index, smoking, physical activity and education. Results: Of the 62,661 participants, 12,593 (20.1%) were identified as having metabolic syndrome, and we recorded 1,840 (2.9%) THRs and 1,111 (1.8%) TKRs during a mean follow-up time of 15.4 years. Cox regression analyses did not show any association between full metabolic syndrome and THR or TKR, except in persons <50 years with metabolic syndrome who had a decreased risk of THR (hazard ratio [HR] 0.58, 95% CI 0.40–0.83). However, when including only participants whose exposure status did not change during follow-up, this protective association was no longer significant. Increased waist circumference was associated with increased risk of TKR in participants <50 years (HR 1.62, 95% CI 1.10–2.39) and 50–69.9 years (HR 1.43, 95% CI 1.14–1.80). Hypertension significantly increased the risk of TKR in participants <50 years (HR 1.38, 95% CI 1.05–1.81), and this risk was greater for men. Conclusion: This study found an increased risk of TKR in men <50 years with hypertension and persons <70 years with increased waist circumference. Apart from this, neither metabolic syndrome nor its components were associated with increased risk of THR or TKR due to primary osteoarthritis.nb_NO
dc.publisherDove Medical Pressnb_NO
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.titleMetabolic syndrome as a risk factor for total hip or knee replacement due to primary osteoarthritis: A prospective cohort study (the HUNT study and the Norwegian arthroplasty register)nb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.source.journalClinical Epidemiologynb_NO
dc.description.localcode© 2018 Hellevik et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (
cristin.unitnameInstitutt for samfunnsmedisin og sykepleie
cristin.unitnameHelseundersøkelsen i Nord-Trøndelag

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Navngivelse-Ikkekommersiell 4.0 Internasjonal
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