{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:27:12Z","timestamp":1790767632555,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,13]],"date-time":"2021-03-13T00:00:00Z","timestamp":1615593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008272","name":"Novartis Pharmaceuticals Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the relation of symptomatic knee osteoarthritis (OA), knee pain, and radiographic knee OA to All\u2010cause mortality and to identify mediators in the causal pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants from the Osteoarthritis Initiative were divided into 4 groups: 1) symptomatic knee OA (i.e., both radiographic knee OA [Kellgren\/Lawrence grade \u22652] and knee pain); 2) knee pain only; 3) radiographic knee OA only; and 4) neither radiographic knee OA nor knee pain. We examined the relation of knee OA status to All\u2010cause mortality using a multivariable Cox proportional hazards model and assessed the extent to which the association was mediated by disability, physical component summary (PCS) and mental component summary (MCS) scores for quality of life (QoL), and use of oral pain\u2010relief medications (i.e., nonsteroidal antiinflammatory drugs and opioids).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4,796 participants, 282 died over the 96\u2010month follow\u2010up period. Compared with those with neither radiographic knee OA nor knee pain, multivariable\u2010adjusted hazard ratios (HRs) of mortality were 2.2 (95% confidence interval [95% CI] 1.6\u20133.1) for symptomatic knee OA, 0.9 (95% CI 0.6\u20131.4) for knee pain only, and 2.0 (95% CI 1.4\u20132.9) for radiographic knee OA only, respectively. Indirect effects (HRs) of symptomatic knee OA on mortality via disability and PCS of QoL were 1.1 (95% CI 1.0\u20131.4) and 1.2 (95% CI 1.0\u20131.4), respectively. No apparent mediation effect was observed through either MCS of QoL or oral pain\u2010relief medications use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participants with either symptomatic or radiographic knee OA were at an increased risk of All\u2010cause mortality. Increased risk of mortality from symptomatic knee OA was partially mediated through its effect on disability and PCS of QoL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.24151","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T09:09:06Z","timestamp":1579597746000},"page":"566-573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Knee Osteoarthritis, Potential Mediators, and Risk of All\u2010Cause Mortality: Data From the Osteoarthritis Initiative"],"prefix":"10.1002","volume":"73","author":[{"given":"Yilun","family":"Wang","sequence":"first","affiliation":[{"name":"Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uyen\u2010Sa D. T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"University of North Texas Health Science Center Fort Worth, and Boston University School of Medicine  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy E.","family":"Lane","sequence":"additional","affiliation":[{"name":"University of California  Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Lu","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada  Richmond British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Wei","sequence":"additional","affiliation":[{"name":"The Mongan Institute Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, and Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2987-138X","authenticated-orcid":false,"given":"Guanghua","family":"Lei","sequence":"additional","affiliation":[{"name":"Xiangya Hospital Central South University, Hunan Key Laboratory of Joint Degeneration and Injury, and National Clinical Research Center of Geriatric Disorders (Xiangya)  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zeng","sequence":"additional","affiliation":[{"name":"The Mongan Institute Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, and Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7638-0888","authenticated-orcid":false,"given":"Yuqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Mongan Institute Massachusetts General Hospital Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32130-X"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32154-2"},{"key":"e_1_2_7_4_1","first-page":"646","article-title":"Burden of major musculoskeletal conditions","volume":"81","author":"Woolf AD","year":"2003","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.10.012"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204763"},{"key":"e_1_2_7_7_1","first-page":"1","volume-title":"The global burden of disease: generating evidence, guiding policy","author":"Institute for Health Metrics and Evaluation","year":"2013"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2018.12.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208056"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2015.03.021"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d1165"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-03110-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39113"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-010-0214-z"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyy187"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2010.03702.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.03.003"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.02.635"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.089904"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.117.154872"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199601000-00006"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330203"},{"key":"e_1_2_7_24_1","first-page":"1833","article-title":"Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee","volume":"15","author":"Bellamy N","year":"1988","journal-title":"J Rheumatol"},{"key":"e_1_2_7_25_1","volume-title":"SF\u201012: how to score the SF\u201012 physical and mental health summary scales","author":"Ware JE","year":"1995"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199603000-00003"},{"key":"e_1_2_7_27_1","unstructured":"NevittMC FelsonDT LesterG.The Osteoarthritis Initiative: protocol for the cohort study. The Osteoarthritis Initiative;2006."},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr525"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032315-021402"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000477"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.04.002"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60900-9"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c7086"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10116"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1474-9728.2002.00008.x"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.056903"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12384-7"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glq224"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.897"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.111.237271"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.24151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.24151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr.24151","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.24151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T17:45:35Z","timestamp":1759427135000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.24151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,13]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/acr.24151"],"URL":"https:\/\/doi.org\/10.1002\/acr.24151","archive":["Portico"],"relation":{"is-referenced-by":[{"id-type":"doi","id":"10.1038\/s41598-025-14465-3","asserted-by":"object"}]},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,13]]},"assertion":[{"value":"2019-07-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}