Objective: The aim of this study was to determine the association between total serum cholesterol levels and knee osteoarthritis (OA), and also to investigate the effect of serum cholesterol levels in the development of knee OA.

Materials and Methods: The study group consisted of 112 patients with bilateral knee OA, 36 of whom were grade 1, 48 of whom were grade 2, and 28 of whom were grade 3 according to Kellgren-Lawrence radiological grading. Age, body mass index (BMI) and total serum cholesterol levels of all subjects were recorded. Presence of hypertension, diabetes mellitus, smoking and heavy physical activity were asked. 

Results: Age, BMI, serum cholesterol levels, presence of hypertension and heavy physical activity were significantly higher in the patient group than the control group. There was no significant difference in terms of total serum cholesterol levels between the three patient groups. It was found that presence of hypercholesterolemia, high BMI, hypertension and heavy physical activity increase the risk of OA development. Logistic regression analysis was conducted in both sexes to predict development of OA from total cholesterol levels, presence of hypertension, age and BMI scores. It was found that age, BMI, total cholesterol levels predict the development of OA in women while only age and total cholesterol levels predict it in men.

Conclusion: Prediction development of OA from total cholesterol levels, with age and BMI indicates that hypercholesterolemia is an important factor in development of OA like age and BMI.