Essential Fatty Acids and Osteoarthritis: The MOST Study.

Inflammation worsens joint destruction in osteoarthritis (OA) and aggravates pain. While n-3 fatty acids (FAs) reduce inflammation, different n-3 FA's have different effects on inflammation and clinical outcomes with eicosapentanoic acid (EPA) having the strongest effect. We examined whether specific essential FA levels affected the development of OA. We studied participants from the Multicenter Osteoarthritis study (MOST) at risk of developing knee OA. As part of MOST, subjects were asked repeatedly about knee pain and obtained knee x-rays and MRIs. Using baseline fasting samples, serum FAs were analyzed with standard assays. After excluding participants with baseline OA, we defined two sets of cases based on their status through 60 month follow-up: those developing incident radiographic OA and those developing incident symptomatic OA (knee pain and radiographic OA). Controls did not develop these outcomes. Additionally, we examined worsening of MRI cartilage damage and synovitis and worsening knee pain and evaluated the number of hand joints affected by nodules. In regression models, we tested the association of each OA outcome with levels of specific n-3 and n-6 FAs adjusting for age, sex, BMI, education, physical activity, race, baseline pain, smoking, statin use and depressive symptoms. We studied 363 cases with incident symptomatic and 295 with incident radiographic knee OA. Mean age was 62 years (59% women). We found no associations of specific n-3 FA levels including EPA nor of levels of n-6 FA with incident OA. (e.g. for incident symptomatic knee OA, OR per s.d. increase in EPA was 1.0 (0.87, 1.17)). Results for other OA outcomes also failed to suggest a protective effect of specific n-3 FAs with OA outcomes. We found no association of serum levels of EPA nor of other specific n-3 FA's nor of n-6 FAs with risk of incident knee OA or other OA outcomes.

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