Comparison between UK Biobank and Shanghai Changfeng suggests distinct hip morphology may contribute to ethnic differences in the prevalence of hip osteoarthritis

Jiayi Zheng; Monika Frysz; Benjamin G Faber; Huandong Lin; Raja Ebsim; Jieyu Ge; Yanling Yong; Fiona R Saunders; Jennifer S Gregory; Richard M Aspden; Nicholas C Harvey; Bing-Hua Jiang; Timothy Cootes; Claudia Lindner; Xin Gao; Sijia Wang; Jonathan H Tobias

doi:10.1016/j.joca.2023.10.006

Comparison between UK Biobank and Shanghai Changfeng suggests distinct hip morphology may contribute to ethnic differences in the prevalence of hip osteoarthritis

Osteoarthritis Cartilage. 2023 Nov 5:S1063-4584(23)00958-5. doi: 10.1016/j.joca.2023.10.006. Online ahead of print.

Authors

Jiayi Zheng¹, Monika Frysz², Benjamin G Faber², Huandong Lin³, Raja Ebsim⁴, Jieyu Ge¹, Yanling Yong⁵, Fiona R Saunders⁶, Jennifer S Gregory⁶, Richard M Aspden⁶, Nicholas C Harvey⁷, Bing-Hua Jiang⁵, Timothy Cootes⁴, Claudia Lindner⁴, Xin Gao⁸, Sijia Wang⁹, Jonathan H Tobias¹⁰

Affiliations

¹ CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.
² Musculoskeletal Research Unit, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
³ Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China; Fudan Institute for Metabolic Diseases, Shanghai, China.
⁴ Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK.
⁵ Academy of Medical Science, Zhengzhou University, Zhengzhou, China.
⁶ Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK.
⁷ Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁸ Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China; Fudan Institute for Metabolic Diseases, Shanghai, China. Electronic address: happy20061208@126.com.
⁹ CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China. Electronic address: wangsijia@picb.ac.cn.
¹⁰ Musculoskeletal Research Unit, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK. Electronic address: jon.tobias@bristol.ac.uk.

PMID: 37935324
DOI: 10.1016/j.joca.2023.10.006

Abstract

Objects: Joint morphology is a risk factor for hip osteoarthritis (HOA) and could explain ethnic differences in HOA prevalence. Therefore, we aimed to compare the prevalence of radiographic HOA (rHOA) and hip morphology between the predominantly White UK Biobank (UKB) and exclusively Chinese Shanghai Changfeng (SC) cohorts.

Methods: Left hip iDXA scans were used to quantify rHOA, from a combination of osteophytes (grade ≥1) and joint space narrowing (grade ≥1), and hip morphology. Using an 85-point Statistical Shape Model (SSM) we evaluated cam (alpha angle ≥60°) and pincer (lateral centre-edge angle (LCEA) ≥45°) morphology and acetabular dysplasia (LCEA <25°). Diameter of femoral head (DFH), femoral neck width (FNW), and hip axis length (HAL) were also obtained from these points. Results were adjusted for differences in age, height, and weight and stratified by sex.

Results: Complete data were available for 5924 SC and 39,020 White UKB participants with mean ages of 63.4 and 63.7 years old. rHOA prevalence was considerably lower in female (2.2% versus 13.1%) and male (12.0% and 25.1%) SC compared to UKB participants. Cam morphology, rarely seen in females, was less common in SC compared with UKB males (6.3% versus 16.5%). Composite SSM modes, scaled to the same overall size, revealed SC participants to have a wider femoral head compared to UKB participants. FNW and HAL were smaller in SC compared to UKB, whereas DFH/FNW ratio was higher in SC.

Conclusions: rHOA prevalence is lower in Chinese compared with White individuals. Several differences in hip shape were observed, including frequency of cam morphology, FNW, and DFH/FNW ratio. These characteristics have previously been identified as risk factors for HOA and may contribute to observed ethnic differences in HOA prevalence.

Keywords: DXA; Ethnic differences; Hip morphology; Radiographic hip osteoarthritis.

Grants and funding

MC_PC_21003/MRC_/Medical Research Council/United Kingdom