Association of Estrogen Replacement Therapy With the Risk of Osteoarthritis of the Hip in Elderly White Women

doi:10.1001/archinte.1996.00440170081009

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Vol. 156 No. 18, 14 OCTOBER 1996

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Association of Estrogen Replacement Therapy With the Risk of Osteoarthritis of the Hip in Elderly White Women

Michael C. Nevitt, PhD; Steven R. Cummings, MD; Nancy E. Lane, MD; Marc C. Hochberg, MD, MPH; Jean C. Scott, DrPH; Alice R. Pressman, MA; Harry K. Genant, MD; Jane A. Cauley, DrPH

Arch Intern Med. 1996;156(18):2073-2080.

Abstract

Objective
To determine whether postmenopausal estrogen replacement therapyis associated with a reduced risk of radiographic findings ofosteoarthritis (OA) of the hip.

Design
Cross-sectional study.

Subjects
White women (N=4366; age, $≥$ 65 years) who were participants ina cohort study of osteoporotic fractures.

Measurements and Methods
Radiographs of the pelvis that were obtained in all subjectswere assessed for radiographic features of OA of the hip ona summary scale of 0 (none) to 4 (severe OA). Postmenopausalestrogen use was assessed by interview. The association of currentand past oral estrogen use with OA of the hip was analyzed byusing logistic regression, adjusting for potential confoundingvariables (eg, indicators of osteoporosis and correlates ofestrogen use).

Results
Five hundred thirty-nine women (12.3%) had

mild or greater radiographic findings of OA of the hip in atleast 1 hip, and 214 women (4.9%) had moderate to severe findings;17% and 24% of the women were current and past users of oralestrogen, respectively. Women who were currently using oralestrogen had a significantly reduced risk of any OA of the hip(adjusted odds ratio [OR], 0.62; 95% confidence interval [CI],0.49-0.86) and moderate to severe manifestation of disease (OR,0.54; 95% CI, 0.33-0.88). Current users who had taken estrogenfor 10 years or longer had a greater reduction in the risk ofany OA of the hip (OR, 0.57; 95% CI, 0.40-0.82) compared withthat of users for less than 10 years (OR, 0.75; 95% CI, 0.47-1.24).Current estrogen use for 10 years or longer was associated witha nonsignificant trend for a reduced risk of moderate to severesymptomatic disease (OR, 0.59; 95% CI, 0.28-1.29).

Conclusion
Postmenopausal estrogen replacement therapy may protect againstOA of the hip in elderly white women.

Arch Intern Med. 1996;156:2073-2080

Author Affiliations

From the Departments of Epidemiology and Biostatistics (Drs Nevitt and Cummings and Ms Pressman) and Radiology (Dr Genant) and Division of General Internal Medicine (Drs Cummings and Lane), University of California, San Francisco; the Departments of Epidemiology and Preventive Medicine (Drs Hochberg and Scott) and Medicine (Dr Hochberg), University of Maryland School of Medicine, Baltimore; and the Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pa (Dr Cauley). Members of the Study of Osteoporotic Fractures Research Group are listed in the box on page 2076.

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