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National Center for Chronic Disease Prevention and Health Promotion
Division of Adult and Community Health
Health Care and Aging Studies Branch
Arthritis Program
Mailstop K-51
4770 Buford Highway NE
Atlanta, GA 30341-3724
Phone: 770.488.5464
Fax: 770.488.5964
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CDC-Funded Science
The Johnston County Osteoarthritis Project: Arthritis & Disability
Funding Number
S3486
Project Description
This
project is a unique, community-based, longitudinal study of
approximately 3200 rural
white and black residents aged 45 and older. It is designed to
determine the prevalence, incidence, and risk factors associated with
the occurrence and progression of hip and knee osteoarthritis (OA)—the most
common and disabling types of arthritis.
Results of this study will allow a better understanding of how and why
these conditions occur and what modifiable risk factors can be targeted
to reduce their impact. This project implements surveillance and
epidemiology strategies from the National Arthritis Action Plan—A
Public Health Strategy which are a priority for the primary
funding agency—the Center for Disease Control and Prevention’s (CDC)
Arthritis Program. This project was previously supported by the
CDC’s National Center for Environmental Health’s Office of Disability
and Health and is currently also supported by the National Institutes
of Health's National Institute of Arthritis and Musculoskeletal and Skin
Diseases and National Institute of Mental Health.
Project Objectives
- Determine the prevalence, incidence, and risk factors associated
with the occurrence and progression of hip and knee osteoarthritis.
- Determine racial or ethnic differences in outcome and in the
effect of risk factors upon OA outcomes.
Key Findings
Phase I (Baseline) (1991-1998)—From 1991 to 1998 participants aged
45 years and older were enrolled in the project. Analyses published from
this phase of the project have already demonstrated (1) a
higher rate of osteoarthritis among African Americans than previously
thought, (2) the importance of overweight in the development and
severity of osteoarthritis among African Americans, particularly women,
and (3) the importance of pain in determining functional limitations
among persons with osteoarthritis. A recent publication demonstrates the
high prevalence of four different measures of knee osteoarthritis (knee
symptoms, modest and severe radiographic OA, and symptomatic knee OA). (2007)
As the only study of OA biomarkers to include African Americans,
the study has been pivotal in this burgeoning field, demonstrating that
(1) ethnic differences exist in multiple OA biomarkers, (2) some serum
biomarkers may predict pre-radiographic OA, (3) body mass index, comorbid conditions, and medications can confound associations between
some biomarkers and OA, (4) hormone replacement therapy (HRT) is
associated with lower levels of several OA biomarkers, elucidating
potential mechanisms behind the effect of hormone replacement therapy and OA, and (5) OA should
be accounted for in relationships between C-Reactive Protein and cardiovascular
disease. The study has also examined serum antioxidants as risk factors
for OA and noted that higher levels of serum lutein, beta-cryptoxanthin,
and the ratio of alpha to gamma tocopherol were associated with lower
odds of having knee osteoarthritis. The study is also the only human
study examining metabolomics in OA, showing distinct urinary metabolite
patterns that can distinguish those with OA from controls.
Phase II (First Follow-up) (1999-2005)—Analyses published from this phase
of the project have already demonstrated (1) a higher rate of
progression of osteoarthritis among African Americans than previously thought, (2)
the importance of overweight in osteoarthritis among African American women, and
the contributions of body composition and fat distribution in this
relationship, and (3) higher odds of radiographic OA presence and
severity in those with low levels of toenail selenium, a new and
potentially modifiable risk factor for OA.
Phase III (Second Follow-up)—Data collection for this phase
has begun.
Publications, Abstracts, Presentations
Publications
Golightly YM, Allen KD, Helmick CG, Renner JB, Salazar A, Jordan JM.
Relationship of limb length inequality with radiographic knee and hip
osteoarthritis. Osteoarthritis & Cartilage 2007;15(7):824-829.
abstract
Gossec L, Hawker G, Davis AM, Maillefert JF, Lohmander S, Altman R,
Cibere J, Conaghan P, Dieppe PA, Dreinhofer K, Hochberg MC, Jordan JM,
Katz JN, March L, Mahomed K, Pavelka K, Roos E, Suarez-Almazor M, Zanoli
G, Dougados M. OMERACT/OARSI Initiative to Define States of Severity and
Indication for Joint Replacement in Hip and Knee Osteoarthritis. J
Rheumatol 2007;34(6):1432-1435.
abstract
Elliott AL, Kraus VB, Renner JB, Fang F, Salazar A, Huguenin T,
Hochberg MC, Helmick CG, Jordan JM. Joint-specific hand symptoms and
self-reported and performance-based functional status in
African-Americans and Caucasians: The Johnston County Osteoarthritis
Project. Ann Rheum Dis 2007;66(12):1622–1626. [Epub ahead of print]
abstract
Kraus VB*, Jordan JM* (*co-first authors), Doherty M, Wilson AG,
Moskowitz R, Hochberg M, Loeser R, Hooper M, Renner JB, Crane MM, Hastie
P, Sundseth S, Atif U. The Genetics of Generalized Osteoarthritis (GOGO)
Study: Study design and evaluation of osteoarthritis phenotypes.
Osteoarthritis and Cartilage 2007;15(2):120–127.
Kraus VB, Stabler TV, Luta G, Renner JB, Dragomir AD, Jordan JM.
Interpretation of Serum C-Reactive Protein (CRP) levels for
cardiovascular disease risk is race, pulmonary disease, body mass index,
gender and osteoarthritis. Osteoarthritis
Cartilage 2007;15(8):966-971.
abstract
Murphy L, Schwartz T, Helmick CG, Renner JB, Tudor G, Koch G,
Dragomir AD, Kalsbeek W, Luta G, Jordan JM. Lifetime risk of symptomatic
knee osteoarthritis. 2007 (revision under review).
Nelson AE, Kraus VB, Sullivan PF, Hochberg MC, Jordan JM. Genetics of
Osteoarthritis. 2007 (in press).
Abbate LM, Stevens J, Schwartz TA, Renner JB, Helmick CG, Jordan JM.
Anthropometric measures, body composition, body fat distribution, and
knee osteoarthritis in women. Obesity 2006;14(7):1274–1278.
abstract.
Allen KLD, DeVellis, RF, Renner JB, Kraus VB, Jordan JM. Validity and
factor stucture of the AUSCAN Osteoarthritis Hand Index in a
community-based sample. Arthritis Rheum 2006;52(4):551–556.
Allen KD, Jordan JM, Renner, JB, Kraus, VB. Relationship of global
assessment of change to AUSCAN and pinch and grip strength among
Individuals with hand osteoarthritis. Osteoarthritis & Cartilage 2006;14(12):1281–1287.
Jordan JM, Helmick CG, Renner JB, Luta G, Woodard J, Dragomir AD,
Kalsbeek W, Abbate L, Hochberg MC. Prevalence of knee symptoms and
radiographic and symptomatic knee osteoarthritis in African-Americans
and Caucasians: The Johnston County Osteoarthritis Project. J
Rheumatol 2007;34(1):172–180.
abstract.
Jordan JM, Kraus VB. Biomarkers in osteoarthritis: a clinical trials
perspective. Future Rheumatology 2006;1(5):587–596.
Kong SY, Stabler TV, Criscione LG, Elliott AL, Jordan JM, Kraus VB.
Diurnal variation of serum and urine biomarkers in patients with
radiographic knee osteoarthritis. Arthritis Rheum 2006;54(8):2496–2504.
Kraus VB, Jordan JM. Serum C-Reactive Protein (CRP), Target for
therapy or trouble? Biomarker Insights 2006;2:1–4.
Mofidi M, DeVellis RF, DeVellis BM, Panter AT, Jordan JM. The
relationship between Spirituality and depressive symptoms in a racially
diverse US sample of community-dwelling adults. J Nerv Ment Dis
2006;194(12):975-977.
abstract
Mofidi M, DeVellis RF, Blazer DG, DeVellis BM, Panter AT, Jordan JM.
Spirituality and depressive symptoms in a racially diverse US sample of
community-dwelling adults. J Nerv Ment Dis 2006;94(12):975–977.
Murphy L, Helmick CG, Schwartz T, Tudor G, Koch G, Renner JB,
Dragomir A, Kalsbeek W, Luta G, Jordan JM. The Lifetime Risk of
Symptomatic Hip Osteoarthritis is One in Four. Arthritis Rheum
2006;54(9):S533. In Press.
Elliott A, Kraus VB, Luta G, Stabler T, Renner JB, Dragomir AD,
Helmick CG, Hochberg MC, Jordan JM. Serum hyaluronan levels and
radiographic knee osteoarthritis in African Americans and Caucasians in
the Johnston County Osteoarthritis Project. Arthritis Rheum 2005;52(1):105-111.
abstract.
Lamers RJ, van Nesselrooij JH, Kraus VB, Jordan JM, Renner JB,
Dragomir AD, Luta G, van der Greef J, deGroot J. Identification of a
urinary metabolite profile associated with osteoarthritis.
Osteoarthritis Cartilage 2005;13(9):762-768.
Jordan JM, De Roos AJ, Renner JB, Luta G, Craft N, Helmick CG,
Hochberg MC, Arab L. A case-control study of serum tocopherol levels and the alpha- to gamma-tocopherol
ratio in radiographic knee osteoarthritis: The Johnston County
Osteoarthritis Project. Am J Epidemiol 2004;159(10):968-977.
abstract.
Jordan JM, Luta G, Stabler T, Renner JB, Dragomir AD, Vilim V,
Hochberg MC, Helmick CG, Kraus VB. Ethnic and sex differences in serum
cartilage oligomeric matrix protein: The Johnston County Osteoarthritis
Project. Arthritis Rheum 2003;48(3):675-681.
abstract.
Dragomir AD, Kraus VB, Renner JB, Luta G, Clark AG, Vilim V, Hochberg
MC, Helmick CG, Jordan JM. Serum cartilage oligomeric matrix protein
increases with signs and symptoms of knee and hip arthritis in the
absence of radiographic knee and hip osteoarthritis: The Johnston County
Osteoarthritis Project. Osteoarthritis Cartilage 2002;10(9):687-691.
abstract.
DeRoos AJ, Arab L, Renner JB, Luta G, Craft N, Helmick CG, Hochberg
MC, Jordan JM. Serum carotenoids and radiographic knee osteoarthritis:
The Johnston County Osteoarthritis Project. Public Health Nutrition
2001;4(5):935-942.
abstract.
Clark AG, Jordan JM, Vilim V, Renner JB, Dragomir AD, Luta G, Kraus
VB. Serum cartilage oligomeric matrix protein reflects osteoarthritis
presence and severity: The Johnston County Osteoarthritis Project.
Arthritis Rheum 1999;42(11):2356-2364.
Jordan JM, Luta G, Renner JB, Dragomir A, Hochberg MC, Fryer JG. Knee
pain and knee osteoarthritis severity in self-reported task-specific
disability: The Johnston County Osteoarthritis Project. J Rheumatol
1997; 24:1344-1349.
Jordan JM, Luta G, Renner JB, Dragomir A, Hochberg MC, Fryer JG.
Ethnic differences in self-reported functional status in the rural
South: the Johnston County Osteoarthritis Project. Arthritis Care Res
1996: 9(6):483-491.
abstract.
Jordan JM, Luta G, Renner JB, Linder GF, Dragomir A, Helmick CG,
Fryer JG. Self-reported functional status in osteoarthritis of the knee
in a rural, Southern community: the role of sociodemographic factors,
obesity, and knee pain. Arthritis Care Res 1996;9(4):273-278.
abstract.
Jordan JM, Linder GF, Renner JB, Fryer JG. The impact of arthritis in
rural populations. Arthritis Care Res 1995;8(4):242-250.
abstract.
Abstracts
Allen KD, DeVellis RF, Renner JB, Kraus VB, Jordan JM. Validity and
Factor Structure of the AUSCAN Osteoarthritis Hand Index in an African
American and White Community Sample. Arthritis Rheum 2006;54(9):S150.
Allen KD, Helmick CG, Renner JB, Woodard J, Jordan JM. Differences in
Osteoarthritis (OA) Symptoms and Function Between African Americans and
Caucasians with Knee or Hip OA in a Community Sample. Arthritis Rheum
2006;54(9):S150.
Golightly Y, Allen KD, Renner JB, Helmick CG, Jordan JM. Relationship
of Limb Length Inequality with Hip and Knee Osteoarthritis. Arthritis
Rheum 2006;54(9):S307.
Jordan JM, Renner JB, Braga L, Woodard, J. Ethnic differences in
severity and location of radiographic features of tibiofemoral and
patellofemoral osteoarthritis in African-Americans and Caucasians.
Arthritis Rheum 2006;54(9):S307.
Purser JL, Renner JB, Woodard J, Jordan JM. Knee and Hip
Osteoarthritis and Walking Speed in the Johnston County Osteoarthritis
Project. Arthritis Rheum 2006;54(9):S153.
Jordan JM, Fang F, Renner JB, Chen JC. Blood levels are associated
with more severe radiographic knee osteoarthritis. Osteoarthritis
Research Society International (OARSI) 2006
Chaudhary S, Kraus VB, Fang F, Shergy K, Renner JB, Stabler TV,
Helmick CG, Jordan JM. Whole blood lead levels and putative
osteoarthritis biomarkers in African American and Caucasian Women.
Osteoarthritis Research Society International (OARSI) 2006
Jordan JM, Fang F, Arab L, Morris SJ, Renner JB, Helmick CG, Hochberg
MC. Low selenium levels are associated with increased risk for
osteoarthritis of the knee. Arthritis Rheum 2005;52:(9):S455
(#1189).
Dragomir AD, Kraus VB, Renner JB, Luta G, Stabler T, Hochberg MC,
Helmick CG, Jordan JM. Lower levels of 2 putative biomarkers of
osteoarthritis in postmenopausal African-American and Caucasian women on
current hormone replacement therapy. Arthritis Rheum 2003;47:S211.
Jordan JM, Renner JB, Luta G, Dragomir AD, Hochberg MC, Helmick CG.
Incidence and progression of radiographic hip osteoarthritis in African
Americans and Caucasians. Arthritis Rheum 2003;47:S212.
Jordan JM, Renner JB, Luta G, Dragomir AD, Hochberg MC, Helmick CG.
Incidence and progression of radiographic knee osteoarthritis in African
Americans and Caucasians. Arthritis Rheum 2003;47:S1738.
Dragomir AD, Jordan JM, Arab L, Kraus VB, Luta G, Stabler T, Vilim V,
Renner JB, Hochberg MC, Helmick CG. Lower levels of serum cartilage
oligomeric matrix protein in postmenopausal African-American and
Caucasian women on current hormone replacement therapy. Arthritis Rheum
2002;46(9):S373.
Jordan JM, Luta G, Renner JB, Dragomir AD, Fryer JG,
Helmick CG, et al. African-Americans face an increased risk of
bilateral knee osteoarthritis (OA) from obesity.
Arthritis Rheum 1997;40(9):S331
(#1796).
Jordan JM, Renner JB, Luta G, Dragomir AD, Fryer JG,
Helmick CG et al. Hip osteoarthritis (OA) is not rare in
African-Americans and is different than in Caucasians. Arthritis
Rheum 1997;40(9):S236 (#1232).
Principal Investigator
Joanne M. Jordan, M.D., M.P.H.
Thurston Arthritis Research Center
3300 Doc J. Thurston, Jr. Building
CB#7280
University of North Carolina
Chapel Hill, NC 27599-7280
Back to Funded Science
Page last reviewed: June 8, 2008
Page last modified: February 1, 2007
Content Source: Division of
Adult and Community Health,
National Center for Chronic Disease Prevention and Health Promotion
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