Associations of Insulin Resistance, Type 2 Diabetes, and Physical Activity with Knee Osteoarthritis in Older Women

PURPOSE: This study aimed to analyze the associations among insulin resistance (IR), type 2 diabetes mellitus (T2DM), physical activity, and knee osteoarthritis (KOA) in older women.METHODS: A total of 2,217 women aged ≥65 years who participated in the Korea National Health and Nutrition Examination Survey (2009–2013) were included. IR was assessed using the triglyceride-glucose body mass index, and participants were classified as normal or abnormal based on cutoffs. T2DM was defined as having a fasting glucose level >126 mg/dL, a physician-diagnosed diabetes history, or current treatment for diabetes. Physical activity was assessed using the International Physical Activity Questionnaire and categorized by whether participants engaged in ≥150 min/week of light-intensity physical activity (LPA) or moderate-to-vigorous physical activity (MVPA). KOA was defined as Kellgren-Lawrence (KL) grade ≥2, and categorized as follows: KL 0–1=normal, KL 2=light KOA, KL 3–4=moderate-to-severe KOA.RESULTS: Logistic regression showed significantly higher KOA risk in the abnormal IR group (OR=1.768, 95% CI=1.486–2.105) and T2DM group (OR=1.311, 95% CI=1.054–1.631) compared to the normal group. Participants with <150 min/week of LPA had higher KOA risk (OR=1.378, 95% CI=1.158–1.639) than those with ≥150 min/week. In the IR and T2DM groups, participants engaging in <150 min/week of LPA had significantly higher odds of moderate-to-severe KOA compared to those with ≥150 min/week.CONCLUSIONS: Engaging in >150 min/week of LPA may be a practical and effective strategy for the prevention of KOA in older women with impaired glucose metabolism.