TY - JOUR
T1 - Does smoking cessation increase risk of knee replacement? a general population-based cohort study
AU - Zeng, C.
AU - Nguyen, U. S.D.T.
AU - Wu, J.
AU - Wei, J.
AU - Luo, X.
AU - Hu, S.
AU - Lu, N.
AU - Lei, G.
AU - Zhang, Y.
N1 - Funding Information:
This work was supported by the National Natural Science Foundation of China ( 81772413 , 81930071 , 81902265 , 82072502 ), the National Key Research and Development Project ( 2018YFB1105705 ), Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital, 2020LNJJ03 ) and the Key Research and Development Program of Hunan Province ( 2018SK2070 , 2018SK2071 ). No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2021 Osteoarthritis Research Society International
PY - 2021/5
Y1 - 2021/5
N2 - Objective: Smoking represents a major issue for global public health. Owing to methodologic challenges, findings of an association between smoking and risk of knee osteoarthritis (OA) are inconsistent. We sought to assess the relation of onset of smoking cessation to the risk of OA sequelae, i.e., knee replacement, and to perform sub-cohort analysis according to weight change after smoking cessation. Design: Using The Health Improvement Network, we conducted a cohort study to examine the association between smoking cessation and risk of knee replacement among patients with knee OA. Participants who stopped smoking were further grouped into three sub-cohorts: weight gain (body mass index [BMI] increased>1.14 kg/m2), no substantial weight change (absolute value of BMI change<1.14 kg/m2), and weight loss (BMI loss>1.14 kg/m2) after smoking cessation. Results: We identified 108 cases of knee replacement among 1,054 recent quitters (26.7/1,000 person-years) and 1,108 cases among 15,765 current smokers (17.4/1,000 person-years). The rate difference of knee replacement in recent quitter cohort vs current smoker cohort was 10.4 (95% confidence interval [CI]:5.3–15.6)/1,000 person-years and the adjusted hazard ratio (HR) was 1.30 (95%CI:1.05–1.59). Compared with current smokers, risk of knee replacement was higher among quitters with weight gain (HR = 1.42,95%CI:1.01–1.98), but not among those with no substantial weight change (HR = 1.29,95%CI:0.90–1.83) or those with weight loss (HR = 1.11,95%CI:0.71–1.75). Conclusions: Our large population-based cohort study provides the first evidence that smoking cessation was associated with a higher risk of knee replacement among individuals with knee OA, and such an association was due to weight gain after smoking cessation.
AB - Objective: Smoking represents a major issue for global public health. Owing to methodologic challenges, findings of an association between smoking and risk of knee osteoarthritis (OA) are inconsistent. We sought to assess the relation of onset of smoking cessation to the risk of OA sequelae, i.e., knee replacement, and to perform sub-cohort analysis according to weight change after smoking cessation. Design: Using The Health Improvement Network, we conducted a cohort study to examine the association between smoking cessation and risk of knee replacement among patients with knee OA. Participants who stopped smoking were further grouped into three sub-cohorts: weight gain (body mass index [BMI] increased>1.14 kg/m2), no substantial weight change (absolute value of BMI change<1.14 kg/m2), and weight loss (BMI loss>1.14 kg/m2) after smoking cessation. Results: We identified 108 cases of knee replacement among 1,054 recent quitters (26.7/1,000 person-years) and 1,108 cases among 15,765 current smokers (17.4/1,000 person-years). The rate difference of knee replacement in recent quitter cohort vs current smoker cohort was 10.4 (95% confidence interval [CI]:5.3–15.6)/1,000 person-years and the adjusted hazard ratio (HR) was 1.30 (95%CI:1.05–1.59). Compared with current smokers, risk of knee replacement was higher among quitters with weight gain (HR = 1.42,95%CI:1.01–1.98), but not among those with no substantial weight change (HR = 1.29,95%CI:0.90–1.83) or those with weight loss (HR = 1.11,95%CI:0.71–1.75). Conclusions: Our large population-based cohort study provides the first evidence that smoking cessation was associated with a higher risk of knee replacement among individuals with knee OA, and such an association was due to weight gain after smoking cessation.
KW - Cohort
KW - Knee replacement
KW - Osteoarthritis
KW - Smoking
UR - http://www.scopus.com/inward/record.url?scp=85106068958&partnerID=8YFLogxK
U2 - 10.1016/j.joca.2021.02.382
DO - 10.1016/j.joca.2021.02.382
M3 - Article
C2 - 33621706
AN - SCOPUS:85106068958
SN - 1063-4584
VL - 29
SP - 697
EP - 706
JO - Osteoarthritis and Cartilage
JF - Osteoarthritis and Cartilage
IS - 5
ER -