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Chong TKY, Tan JR, Ma CA, Wong SBS, Leung YY. Association of adipokines with severity of knee osteoarthritis assessed clinically and on magnetic resonance imaging. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100405. [PMID: 37664871 PMCID: PMC10469549 DOI: 10.1016/j.ocarto.2023.100405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 08/09/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives We aimed to evaluate the association between the adipokines: Leptin, Adiponectin, Resistin, and high sensitive-C-reactive protein (hs-CRP) with clinical, radiographical and magnetic resonance imaging (MRI) assessment of knee osteoarthritis (OA) severity. Design We performed a cross-sectional study in participants with earlier knee OA. Demographics, clinical (WOMAC), radiographical and MRI (BLOKS scoring) severity of knee OA were assessed. Serum leptin, adiponectin, resistin and hs-CRP were measured. Association of adipokines and hs-CRP with clinical, radiographic and MRI severity outcomes were evaluated using regression models with adjustment with age, sex, and body mass index (BMI). Results 137 participants with earlier knee OA (82% women, mean ± SD age: 55.5 ± 7.8 years) were included. Participants had moderate knee OA symptoms, mean WOMAC pain and function were 30.6 ± 18.0, and 31.7 ± 19.8 respectively. Mean BMI was 27.0 ± 5.9 kg/m2. After adjustment with age, sex and BMI, serum leptin was positively associated with osteophyte size, cartilage integrity, infrapatellar synovitis and effusion. While hs-CRP was associated with meniscus extrusion and adiponectin was associated with WOMAC pain and function. Conclusion Serum adipokines, particularly leptin was associated with severity of various structural defects of the knee joint on MRI beyond age, sex and BMI in earlier knee OA.
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Affiliation(s)
| | - Jin-Rong Tan
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
| | - Cheryl Ann Ma
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Steven, Bak Siew Wong
- Duke-NUS Medical School, Singapore, Singapore
- Department of Radiology, SengKang General Hospital, Singapore, Singapore
| | - Ying-Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Tarabeih N, Kalinkovich A, Shalata A, Higla O, Livshits G. Pro-Inflammatory Biomarkers Combined with Body Composition Display a Strong Association with Knee Osteoarthritis in a Community-Based Study. Biomolecules 2023; 13:1315. [PMID: 37759715 PMCID: PMC10527309 DOI: 10.3390/biom13091315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Knee osteoarthritis (KOA) is one of the most common progressive, age-dependent chronic degenerative joint diseases. KOA often develops as a result of a gradual articular cartilage loss caused by its wear and tear. Numerous studies suggest that the degradation of the knee joint involves inflammatory components. This process is also associated with body composition, particularly being overweight and muscle mass loss. The present study aimed to search for novel circulating KOA inflammatory biomarkers, taking into account body composition characteristics. To this aim, we recruited 98 patients diagnosed and radiologically confirmed with KOA and 519 healthy controls from the Arab community in Israel. A panel of soluble molecules, related to inflammatory, metabolic, and musculoskeletal disorders, was measured by ELISA in plasma samples, while several body composition parameters were assessed with bioimpedance analysis. Statistical analysis, including multivariable logistic regression, revealed a number of the factors significantly associated with KOA, independently of age and sex. The most significant independent associations [OR (95% CI)] were fat body mass/body weight index-1.56 (1.20-2.02), systemic immune-inflammation index-4.03 (2.23-7.27), circulating vaspin levels-1.39 (1.15-1.68), follistatin/FSTL1 ratio-1.32 (1.02-1.70), and activin A/FSTL1 ratio-1.33 (1.01-1.75). Further clinical studies are warranted to confirm the relevance of these KOA-associated biological factors. Hereafter, they could serve as reliable biomarkers for KOA in the general human population.
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Affiliation(s)
- Nader Tarabeih
- Department of Morphological Studies, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Alexander Kalinkovich
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6905126, Israel;
| | - Adel Shalata
- The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 32000, Israel;
| | - Orabi Higla
- Orthopedics Clinic, Clalit, Migdal HaMeah, Tel-Aviv 6203854, Israel;
| | - Gregory Livshits
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6905126, Israel;
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Nakajima K, Miyahara J, Ohtomo N, Nagata K, Kato S, Doi T, Matsubayashi Y, Taniguchi Y, Kawamura N, Higashikawa A, Takeshita Y, Fukushima M, Ono T, Hara N, Azuma S, Iwai H, Oshina M, Sugita S, Hirai S, Masuda K, Tanaka S, Oshima Y. Impact of body mass index on outcomes after lumbar spine surgery. Sci Rep 2023; 13:7862. [PMID: 37188788 DOI: 10.1038/s41598-023-35008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
The impact of body mass index (BMI) on outcomes after lumbar spine surgery is currently unknown. Previous studies have reported conflicting evidence for patients with high BMI, while little research has been conducted on outcomes for underweight patients. This study aims to examine the impact of BMI on outcomes after lumbar spine surgery. This prospective cohort study enrolled 5622 patients; of which, 194, 5027, and 401 were in the low (< 18.5 kg/m2), normal (18.5-30), and high (≥ 30) BMI groups, respectively. Pain was assessed via the numerical pain rating scale (NPRS) for the lower back, buttock, leg, and plantar area. Quality of life was assessed via the EuroQol 5 Dimension (EQ-5D) and Oswestry Disability Index (ODI). Inverse probability weighting with propensity scores was used to adjust patient demographics and clinical characteristics between the groups. After adjustment, the 1-year postoperative scores differed significantly between groups in terms of leg pain. The proportion of patients who achieved a 50% decrease in postoperative NPRS score for leg pain was also significantly different. Obese patients reported less improvement in leg pain after lumbar spine surgery. The outcomes of patients with low BMI were not inferior to those of patients with normal BMI.
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Affiliation(s)
- Koji Nakajima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - Junya Miyahara
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - Nozomu Ohtomo
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - Kosei Nagata
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - So Kato
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - Toru Doi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - Yoshitaka Matsubayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
| | - Naohiro Kawamura
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Spine and Orthopedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Akiro Higashikawa
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Kanto Rosai Hospital, Kanagawa, Japan
| | - Yujiro Takeshita
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Masayoshi Fukushima
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Spine Center, Toranomon Hospital, Tokyo, Japan
| | - Takashi Ono
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Spinal Surgery, Japan Community Health-Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Nobuhiro Hara
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - Seiichi Azuma
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Saitama Red Cross Hospital, Saitama, Japan
| | - Hiroki Iwai
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Iwai Orthopaedic Medical Hospital, Tokyo, Japan
| | - Masahito Oshina
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Spine Center, NTT Medical Center Tokyo, Tokyo, Japan
| | - Shurei Sugita
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Shima Hirai
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Sagamihara National Hospital, Kanagawa, Japan
| | - Kazuhiro Masuda
- University of Tokyo Spine Group (UTSG), Tokyo, Japan
- Department of Orthopedic Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yasushi Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
- University of Tokyo Spine Group (UTSG), Tokyo, Japan.
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Meert L, Mertens MG, Meeus M, Vervullens S, Baert I, Beckwée D, Verdonk P, Smeets RJEM. Identification of Metabolic Factors and Inflammatory Markers Predictive of Outcome after Total Knee Arthroplasty in Patients with Knee Osteoarthritis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105796. [PMID: 37239524 DOI: 10.3390/ijerph20105796] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To identify metabolic factors and inflammatory markers that are predictive of postoperative total knee arthroplasty (TKA) outcome. METHOD A systematic search of the existing literature was performed using the electronic databases PubMed, Web of Science and Embase until the 1st of August 2022. Studies that evaluated the influence of metabolic or inflammatory markers (I) on postsurgical outcome (O) in end-stage knee osteoarthritis patients awaiting primary TKA (P) were included in this review. RESULTS In total, 49 studies were included. Risk of bias of the included studies was low for one study, moderate for 10 studies and high for the remaining 38 studies. Conflicting evidence was found for the influence of body mass index, diabetes, cytokine levels and dyslipidaemia on pain, function, satisfaction and quality of life at more than six months after TKA. CONCLUSIONS Several limitations such as not taking into account known confounding factors, the use of many different outcome measures and a widely varying follow-up period made it challenging to draw firm conclusions and clinical implications. Therefore large-scaled longitudinal studies assessing the predictive value of metabolic and inflammatory factors pre-surgery in addition to the already evidenced risk factors with follow-up of one year after TKA are warranted.
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Affiliation(s)
- Lotte Meert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Michel Gcam Mertens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Sophie Vervullens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Isabel Baert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - David Beckwée
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Peter Verdonk
- Antwerp Orthopaedic Center, AZ Monica Hospitals, 2018 Antwerp, Belgium
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University and CIR Revalidatie, 5628 WB Eindhoven, The Netherlands
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Gonzalez PA, Simcox J, Raff H, Wade G, Von Bank H, Weisman S, Hainsworth K. Lipid signatures of chronic pain in female adolescents with and without obesity. Lipids Health Dis 2022; 21:80. [PMID: 36042489 PMCID: PMC9426222 DOI: 10.1186/s12944-022-01690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/05/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Chronic pain in adolescence is associated with diminished outcomes, lower socioeconomic status in later life, and decreased family well-being. Approximately one third of adolescents with chronic pain have obesity compared to the general population. In obesity, lipid signals regulate insulin sensitivity, satiety, and pain sensation. We determined whether there is a distinct lipid signature associated with chronic pain and its co-occurrence with obesity in adolescents. METHODS We performed global lipidomics in serum samples from female adolescents (N = 67, 13-17 years old) with no pain/healthy weight (Controls), chronic pain/healthy weight (Pain Non-obese), no pain/obesity (Obese), or chronic pain/obesity (Pain Obese). RESULTS The Pain Non-obese group had lipid profiles similar to the Obese and Pain Obese groups. The major difference in these lipids included decreased lysophosphatidylinositol (LPI), lysophosphatidylcholine (LPC), and lysophosphatidylethanolamine (LPE) in the three clinical groups compared to the Control group. Furthermore, ceramides and sphingomyelin were higher in the groups with obesity when compared to the groups with healthy weight, while plasmalogens were elevated in the Pain Obese group only. CONCLUSIONS Serum lipid markers are associated with chronic pain and suggest that specific lipid metabolites may be a signaling mechanism for inflammation associated with co-occurring chronic pain and obesity.
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Affiliation(s)
- Paula A Gonzalez
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI, USA
| | - Judith Simcox
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI, USA
| | - Hershel Raff
- Departments of Medicine (Endocrinology and Molecular Medicine), Surgery, and Physiology, Medical College of Wisconsin, Milwaukee, WI, USA
- Endocrine Research Laboratory, Aurora St. Luke's Medical Center, Advocate Aurora Research Institute, Milwaukee, WI, USA
| | - Gina Wade
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI, USA
| | - Helaina Von Bank
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI, USA
| | - Steven Weisman
- Departments of Anesthesiology and Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
- Jane B. Pettit Pain and Headache Center, Children's Wisconsin, Wauwatosa, WI, 53226, USA
| | - Keri Hainsworth
- Jane B. Pettit Pain and Headache Center, Children's Wisconsin, Wauwatosa, WI, 53226, USA.
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
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Neurohumoral Profiles and Childhood Adversity of Patients with Multisomatoform Disorder and Pain as the Leading Bodily Symptom. DISEASE MARKERS 2022; 2022:7958375. [PMID: 35242246 PMCID: PMC8888045 DOI: 10.1155/2022/7958375] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/08/2022] [Indexed: 12/16/2022]
Abstract
Objective Patients suffering from chronic pain often present with multifactorial underlying conditions, sometimes without concrete pathological physical findings. Functional somatic syndromes (FSS) and somatoform disorders show a high prevalence of 8-20% and are often associated with adverse childhood experiences (ACE) and chronic stress. As many different FSS have overlapping symptoms, the concept of multisomatoform disorder (MSD) has been introduced as an encompassing concept. We hypothesize that a common neurohumoral profile is present in patients with MSD that is distinct from gender- and age-matched controls and thus provides insight into possible common underlying mechanisms. Design In 151 patients with MSD (138 females) and 149 matched controls (131 females), we determined ACE by the Childhood Trauma Questionnaire (CTQ) and chronic stress by the Trier Inventory for Chronic Stress (TICS). Furthermore, the serum levels of leptin, FSH, LH, cortisol, DHEA-S, and IGF-1 have been assessed. Results There were significant differences in the levels of leptin, FSH, IGF-1, and cortisol between patients and controls, mainly driven by female participants. Levels of leptin were significantly correlated with BMI in patients, in controls, and in the female subgroup. This correlation was exaggerated in female patients when compared to female controls. Both CTQ and TICS predicted MSD directly and indirectly through the levels of leptin. Conclusion There is evidence of a distinct neurohumoral profile in female patients with MSD when compared to matched healthy controls, similar to what has been demonstrated in other chronic pain states. The observed profile can be taken as possible evidence for a dysregulated response to chronic stress and metabolic balance as well as a state of hypocortisolism and HPA-axis dysfunction. ACE and chronic stress play a major role in the development of MSD and altered neurohumoral profile.
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Zhang K, Ji Y, Dai H, Khan AA, Zhou Y, Chen R, Jiang Y, Gui J. High-Density Lipoprotein Cholesterol and Apolipoprotein A1 in Synovial Fluid: Potential Predictors of Disease Severity of Primary Knee Osteoarthritis. Cartilage 2021; 13:1465S-1473S. [PMID: 33870758 PMCID: PMC8808802 DOI: 10.1177/19476035211007919] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The aim of this study was to detect levels of common lipid species in serum and synovial fluid (SF) of primary knee osteoarthritis (OA) patients and investigate their correlations with disease severity. MATERIALS AND METHODS The study enrolled 184 OA patients receiving arthroscopic debridement or total knee arthroplasty and 180 healthy controls between April 2012 and March 2018. Total triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB) levels were analyzed in serum and SF of OA patients, and in serum of healthy individuals. The Noyes rating criteria, Kellgren-Lawrence (KL) grading system, and Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores were, respectively, used to assess cartilage damage, radiographic severity, and symptomatic severity of OA. RESULTS No significant differences were found in serum TG and ApoB levels between the 2 groups, while OA patients had higher TC and LDL-C levels and lower HDL-C and ApoA1 levels (P < 0.05). Pearson correlation analysis revealed SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage scores, KL grades as well as WOMAC scores (P < 0.05), which were still significant after adjusting for confounding factors (P < 0.05). Receiver operating characteristic curve analysis revealed SF HDL-C (area under the curve [AUC]: 0.816) and ApoA1 (AUC: 0.793) were also good predictors of advanced-stage OA (P < 0.001). CONCLUSION SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage, radiographic severity, and symptomatic severity of primary knee OA, emerging as potential biomarkers for radiographic advanced-stage OA, which may serve as predictors of disease severity.
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Affiliation(s)
- Kaibin Zhang
- Department of Orthopaedics, Nanjing
First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s
Republic of China
| | - Yisheng Ji
- The First Clinical College, Nanjing
Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Hanhao Dai
- Department of Orthopedics, Shengli
Clinical Medical College of Fujian Medical University, Fujian Medical University,
Fuzhou, Fujian Province, People’s Republic of China
| | - Abdul Aleem Khan
- Department of Orthopaedics, Nanjing
First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s
Republic of China
| | - Yang Zhou
- Department of Orthopaedics, Nanjing
First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s
Republic of China
| | - Ran Chen
- Department of Orthopaedics, Nanjing
First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s
Republic of China
| | - Yiqiu Jiang
- Department of Orthopaedics, Nanjing
First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s
Republic of China
| | - Jianchao Gui
- Department of Orthopaedics, Nanjing
First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s
Republic of China,Jianchao Gui, Department of Orthopaedics,
Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing,
Jiangsu Province 210000, People’s Republic of China.
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Heuts EAF, de Jong LD, Hazebroek EJ, Wagener M, Somford MP. The influence of bariatric surgery on hip and knee joint pain: a systematic review. Surg Obes Relat Dis 2021; 17:1637-1653. [PMID: 34116961 DOI: 10.1016/j.soard.2021.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/02/2021] [Accepted: 04/21/2021] [Indexed: 12/26/2022]
Abstract
Obesity increases the risk of osteoarthritis and the chance of needing joint replacement arthroplasty to reduce lower limb joint pain. Although nonsurgical weight loss interventions can reduce hip and knee joint pain, bariatric surgery may be a more feasible treatment option for people with severe obesity. However, it is unclear whether weight loss through bariatric surgery can positively influence hip and knee joint pain. Our objective was to evaluate the influence of bariatric surgery on hip and knee joint pain in people with obesity by conducting a systematic review of the literature. The PubMed, EMBASE, and Cochrane bibliographic databases were searched for studies published between 1947 and September 2019. Risk of bias of the identified studies was independently assessed by 2 reviewers using JBI's Critical Appraisal Checklist for Case Series and the Newcastle-Ottawa Scale. This review included 23 studies, all of which evaluated knee pain and 9 of which also evaluated hip pain. Reported results regarding hip pain intensity and the proportion of participants with hip pain were too limited to draw useful conclusions. Reported results regarding knee pain suggest that weight loss after bariatric surgery reduced knee pain intensity, as well as the proportion of participants with knee pain. The overall risk of bias of the majority of included studies (83%; n = 19) was judged to be unclear to high. Four small studies were judged as having a low risk of bias. Results of this systematic review suggest that bariatric surgery can positively influence hip and knee joint pain, but conclusive evidence is lacking because most of the included studies were judged as having plausible bias overall and in their key domains. Well-designed randomized controlled trials evaluating the influence of bariatric surgery on hip and knee joint pain using standardized joint pain measures are needed.
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Affiliation(s)
- Elise A F Heuts
- Department of Orthopaedics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Lex D de Jong
- Department of Orthopaedics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Eric J Hazebroek
- Department of Bariatric Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Marc Wagener
- Department of Orthopaedics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Matthijs P Somford
- Department of Orthopaedics, Rijnstate Hospital, Arnhem, The Netherlands.
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Circulating inflammatory biomarkers in adolescents: evidence of interactions between chronic pain and obesity. Pain Rep 2021; 6:e916. [PMID: 33977184 PMCID: PMC8104468 DOI: 10.1097/pr9.0000000000000916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 01/21/2023] Open
Abstract
Introduction The negative effects of chronic pain and obesity are compounded in those with both conditions. Despite this, little research has focused on the pathophysiology in pediatric samples. Objective To examine the effects of comorbid chronic pain and obesity on the concentration of circulating inflammatory biomarkers. Methods We used a multiple-cohort observational design, with 4 groups defined by the presence or absence of obesity and chronic pain: healthy controls, chronic pain alone, obesity alone, as well as chronic pain and obesity. Biomarkers measured were leptin, adiponectin, leptin/adiponectin ratio (primary outcome), tumor necrosis factor-alpha, interleukin 6, and C-reactive protein (CRP). Results Data on 125 adolescents (13-17 years) were analyzed. In females, there was an interaction between chronic pain and obesity such that leptin and CRP were higher in the chronic pain and obesity group than in chronic pain or obesity alone. Within the chronic pain and obesity group, biomarkers were correlated with worsened pain attributes, and females reported worse pain than males. The highest levels of interleukin 6 and CRP were found in youth with elevated weight and functional disability. We conclude that in adolescents, chronic pain and obesity interact to cause dysregulation of the inflammatory system, and this effect is more pronounced in females. Conclusion The augmented levels of inflammatory biomarkers are associated with pain and functional disability, and may be an early marker of future pain and disability.
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Bonakdari H, Jamshidi A, Pelletier JP, Abram F, Tardif G, Martel-Pelletier J. A warning machine learning algorithm for early knee osteoarthritis structural progressor patient screening. Ther Adv Musculoskelet Dis 2021; 13:1759720X21993254. [PMID: 33747150 PMCID: PMC7905723 DOI: 10.1177/1759720x21993254] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/18/2020] [Indexed: 12/23/2022] Open
Abstract
Aim In osteoarthritis (OA) there is a need for automated screening systems for early detection of structural progressors. We built a comprehensive machine learning (ML) model that bridges major OA risk factors and serum levels of adipokines/related inflammatory factors at baseline for early prediction of at-risk knee OA patient structural progressors over time. Methods The patient- and gender-based model development used baseline serum levels of six adipokines, three related inflammatory factors and their ratios (36), as well as major OA risk factors [age and bone mass index (BMI)]. Subjects (677) were selected from the Osteoarthritis Initiative (OAI) progression subcohort. The probability values of being structural progressors (PVBSP) were generated using our previously published prediction model, including five baseline structural features of the knee, i.e. two X-rays and three magnetic resonance imaging variables. To identify the most important variables amongst the 47 studied in relation to PVBSP, we employed the ML feature classification methodology. Among five supervised ML algorithms, the support vector machine (SVM) demonstrated the best accuracy and use for gender-based classifiers development. Performance and sensitivity of the models were assessed. A reproducibility analysis was performed with clinical trial OA patients. Results Feature selections revealed that the combination of age, BMI, and the ratios CRP/MCP-1 and leptin/CRP are the most important variables in predicting OA structural progressors in both genders. Classification accuracies for both genders in the testing stage (OAI) were >80%, with the highest sensitivity of CRP/MCP-1. Reproducibility analysis showed an accuracy ⩾92%; the ratio CRP/MCP-1 demonstrated the highest sensitivity in women and leptin/CRP in men. Conclusion This is the first time that such a framework was built for predicting knee OA structural progressors. Using this automated ML patient- and gender-based model, early prediction of knee structural OA progression can be performed with high accuracy using only three baseline serum biomarkers and two risk factors. Plain language summary Machine learning model for early knee osteoarthritis structural progression Knee osteoarthritis is a well-known debilitating disease leading to reduced mobility and quality of life - the main causes of chronic invalidity. Disease evolution can be slow and span many years; however, for some individuals, the progression/evolution can be fast. Current treatments are only symptomatic and conventional diagnosis of osteoarthritis is not very effective in early identification of patients who will progress rapidly. To improve therapeutic approaches, we need a robust prediction model to stratify osteoarthritis patients at an early stage according to risk of joint structure disease progression.We hypothesize that a prediction model using a machine learning system would enable such an early identification of individuals for whom osteoarthritis knee structure will degrade rapidly. Data were from the Osteoarthritis Initiative, a National Institute of Health (United States) databank, and the robustness and generalizability of the developed model was further evaluated using osteoarthritis patients from an external cohort. Using the supervised machine learning system (support vector machine), we developed an automated patient- and gender-based model enabling an early clinical prognosis for individuals at high risk of structural progressive osteoarthritis. In brief, this model employed at baseline (when the subject sees a physician) easily obtained features consisting of the two main osteoarthritis risk factors, age and bone mass index (BMI), in addition to the serum levels of three molecules. Two of these molecules belong to a family of factors names adipokines and one to a related inflammatory factor. In brief, the model comprising a combination of age, BMI, and the ratios CRP/MCP-1 and leptin/CRP were found very robust for both genders, and the high accuracy persists when tested with an external cohort conferring the gender-based model generalizability. This study offers a new automated system for identifying early knee osteoarthritis structural progressors, which will significantly improve clinical prognosis with real time patient monitoring.
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Affiliation(s)
- Hossein Bonakdari
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Afshin Jamshidi
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - François Abram
- Medical Imaging Research and Development, ArthroLab Inc., Montreal, QC, Canada
| | - Ginette Tardif
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis, Suite R11.412, Montreal, QC H2X 0A9, Canada
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11
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Therapeutic Applications of Type 2 Diabetes Mellitus Drug Metformin in Patients with Osteoarthritis. Pharmaceuticals (Basel) 2021; 14:ph14020152. [PMID: 33668426 PMCID: PMC7918864 DOI: 10.3390/ph14020152] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) and osteoarthritis (OA) are common chronic diseases that frequently co-exist. The link between OA and T2DM is attributed to common risk factors, including age and obesity. Several reports suggest that hyperglycemia and accumulated advanced glycosylation end-products might regulate cartilage homeostasis and contribute to the development and progression of OA. Metformin is used widely as the first-line treatment for T2DM. The drug acts by regulating glucose levels and improving insulin sensitivity. The anti-diabetic effects of metformin are mediated mainly via activation of adenosine monophosphate (AMP)-activated protein kinase (AMPK), which is an energy sensing enzyme activated directly by an increase in the AMP/ATP ratio under conditions of metabolic stress. Dysregulation of AMPK is strongly associated with development of T2DM and metabolic syndrome. In this review, we discuss common risk factors, the association between OA and T2DM, and the role of AMPK. We also address the adaptive use of metformin, a known AMPK activator, as a new drug for treatment of patients with OA and T2DM.
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12
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Gaspar LS, Sousa C, Álvaro AR, Cavadas C, Mendes AF. Common risk factors and therapeutic targets in obstructive sleep apnea and osteoarthritis: An unexpectable link? Pharmacol Res 2020; 164:105369. [PMID: 33352231 DOI: 10.1016/j.phrs.2020.105369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/11/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Osteoarthritis (OA) and Obstructive Sleep Apnea (OSA) are two highly prevalent chronic diseases for which effective therapies are urgently needed. Recent epidemiologic studies, although scarce, suggest that the concomitant occurrence of OA and OSA is associated with more severe manifestations of both diseases. Moreover, OA and OSA share risk factors, such as aging and metabolic disturbances, and co-morbidities, including cardiovascular and metabolic diseases, sleep deprivation and depression. Whether this coincidental occurrence is fortuitous or involves cause-effect relationships is unknown. This review aims at collating and integrating present knowledge on both diseases by providing a brief overview of their epidemiology and pathophysiology, analyzing current evidences relating OA and OSA and discussing potential common mechanisms by which they can aggravate each other. Such mechanisms constitute potential therapeutic targets whose pharmacological modulation may provide more efficient ways of reducing the consequences of OA and OSA and, thus, lessen the huge individual and social burden that they impose.
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Affiliation(s)
- Laetitia S Gaspar
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal; PhD Programme in Experimental Biology and Biomedicine (PDBEB), Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - Cátia Sousa
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Ana Rita Álvaro
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - Cláudia Cavadas
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
| | - Alexandrina Ferreira Mendes
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
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13
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Pain in women with knee and/or hip osteoarthritis is related to systemic inflammation and to adipose tissue dysfunction: Cross-sectional results of the KHOALA cohort. Semin Arthritis Rheum 2020; 51:129-136. [PMID: 33383288 DOI: 10.1016/j.semarthrit.2020.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Considering the role of metabolic diseases in osteoarthritis (OA), we investigated whether biomarkers of adipose tissue dysfunction could be associated with OA-related pain. DESIGN We cross-sectionally analyzed patients with knee and/or hip OA at inclusion in the KHOALA cohort. We used visual analogic scale (VAS) for pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) pain subscores. At inclusion, we measured ultra-sensitive CRP (usCRP), leptin and adiponectin for calculation of leptin:adiponectin ratio (LAR), a marker of adipose tissue dysfunction associated with central adiposity, high-molecular-weight adiponectin, visfatin and apolipoproteins. Univariate and multivariable analyses using stepwise linear regression models were performed to search for correlation between pain assessments and these biomarkers, with systematic adjustment on age. RESULTS In 596 women with hip and/or knee OA, multivariable analyses indicated that higher pain intensity was associated with higher LAR (VAS pain: β=0.49; p = 0.0001, OAKHQOL pain: β=-0.46; p = 0.0002, WOMAC pain: β=0.30; p = 0.001) in the whole group as well as in hip or knee OA patients considered separately. Pain intensity correlated also with usCRP level (VAS pain: β= 0.27; p = 0.02, OAKHQOL pain: β =-0.30; p = 0.01) and Kellgren-Lawrence score. In 267 men, no correlation between biomarkers and pain was found. CONCLUSION Serum LAR and usCRP level are associated with pain level, independently of radiographic structural severity in women with hip and/or knee OA, emphasizing the role of adipose tissue dysfunction and of meta-inflammation in pain experience in the female population.
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14
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Martins GC, Fraga PHG, Teixeira LB, Valle BRG, Martins Filho LF, Gama MDP. Functional Evaluation and Pain Symptomatology of the Foot and Ankle in Individuals with Severe Obesity - Controlled Transversal Study. Rev Bras Ortop 2020; 56:235-243. [PMID: 33935320 PMCID: PMC8075649 DOI: 10.1055/s-0040-1713757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 04/15/2020] [Indexed: 11/09/2022] Open
Abstract
Objective
The present study aims to evaluate the prevalence of foot and ankle pain complaints, radiographic parameters, and functional performance in subjects with severe obesity (body mass index [BMI] > 40) who are candidates to bariatric surgery.
Methods
Forty severely obese patients were evaluated at a bariatric surgery outpatient facility. These severely obese subjects (BMI > 40) were divided into two subgroups: those with BMI < 50 (n = 24) and BMI > 50 (n = 16). These patients were compared with a control group of 42 volunteers with a mean BMI value of 24. The following parameters were assessed: foot pain (according to the visual analog scale [VAS]), functional performance (according to the American Orthopeadic Foot and Ankle Society [AOFAS] scale, including forefoot, midfoot and hindfoot domains), age, gender, hallux metatarsal-phalangeal angle, hallux intermetatarsal angle, talocalcaneal angle, calcanean pitch angle and Meary angle.
Results
Incidence of foot pain was higher in the severely obese group compared with the control group (
p
< 0.0001; odds ratio [OR]: 4.2). Functional performance according to the AOFAS scale was lower in obese subjects compared with the control group (
p
< 0.0001; OR for hindfoot, 4.81; OR for midfoot, 3.33).
Conclusion
The incidence of foot pain was higher in the group of severely obese patients compared with the control group. According to the AOFAS scale, functional forefoot, midfoot and hindfoot performance was worse in severely obese individuals.
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Affiliation(s)
- Glaucus Cajaty Martins
- Serviço de Ortopedia e Traumatologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil.,Serviço de Estatística Médica, Hospital Universitário da Universidade Federal do Rio de Janeiro, RJ, Brasil
| | | | - Lucas Braga Teixeira
- Serviço de Ortopedia e Traumatologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil
| | | | | | - Maurício de Pinho Gama
- Serviço de Estatística Médica, Hospital Universitário da Universidade Federal do Rio de Janeiro, RJ, Brasil
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15
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Serum soluble urokinase plasminogen activator receptor in adolescents: interaction of chronic pain and obesity. Pain Rep 2020; 5:e836. [PMID: 32766470 PMCID: PMC7382552 DOI: 10.1097/pr9.0000000000000836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/05/2020] [Accepted: 06/18/2020] [Indexed: 12/24/2022] Open
Abstract
Pediatric chronic pain is exacerbated by obesity. Serum soluble urokinase plasminogen activator receptor, a novel inflammation biomarker, was increased in obese adolescents with chronic pain indicating interactive inflammatory conditions. Introduction: Obesity in adolescents is increasing in frequency and is associated with short-term and long-term negative consequences that include the exacerbation of co-occurring chronic pain. Objective: To determine whether the interaction between chronic pain and obesity would be reflected in changes in serum soluble urokinase plasminogen activator receptor (suPAR) concentrations, a novel marker of systemic inflammation associated with obesity, insulin resistance, and cardiovascular disease. Methods: We measured serum suPAR levels in 146 adolescent males and females with no pain or obesity (healthy controls; n = 40), chronic pain with healthy weight (n = 37), obesity alone (n = 41), and the combination of chronic pain and obesity (n = 28). Results: Serum suPAR (median [interquartile range]) was not increased by chronic pain alone (2.2 [1.8–2.4] ng/mL) or obesity alone (2.2 [2.0–2.4] ng/mL) but was increased significantly with the combination of chronic pain and obesity (2.4 [2.1–2.7] ng/mL; P < 0.019). This finding confirms the proposition that pain and obesity are inflammatory states that display a classic augmenting interaction. Conclusion: We propose that measurement of serum suPAR can be added to the armamentarium of serum biomarkers useful in the evaluation of mechanisms of inflammation in adolescent obesity and chronic pain.
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16
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Bonakdari H, Tardif G, Abram F, Pelletier JP, Martel-Pelletier J. Serum adipokines/related inflammatory factors and ratios as predictors of infrapatellar fat pad volume in osteoarthritis: Applying comprehensive machine learning approaches. Sci Rep 2020; 10:9993. [PMID: 32561782 PMCID: PMC7305166 DOI: 10.1038/s41598-020-66330-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/08/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The infrapatellar fat pad (IPFP) has been associated with knee osteoarthritis onset and progression. This study uses machine learning (ML) approaches to predict serum levels of some adipokines/related inflammatory factors and their ratios on knee IPFP volume of osteoarthritis patients. METHODS Serum and MRI were from the OAI at baseline. Variables comprised the 3 main osteoarthritis risk factors (age, gender, BMI), 6 adipokines, 3 inflammatory factors, and their 36 ratios. IPFP volume was assessed on MRI with a ML methodology. The best variables and models were identified in Total-cohort (n = 678), High-BMI (n = 341) and Low-BMI (n = 337), using a selection approach based on ML methods. RESULTS The best model for each group included three risk factors and adipsin/C-reactive protein combined for Total-cohort, adipsin/chemerin; High-BMI, chemerin/adiponectin HMW; and Low-BMI, interleukin-8. Gender separation improved the prediction (13-16%) compared to the BMI-based models. Reproducibility with osteoarthritis patients from a clinical trial was excellent (R: female 0.83, male 0.95). Pseudocodes based on gender were generated. CONCLUSION This study demonstrates for the first time that the combination of the serum levels of adipokines/inflammatory factors and the three main risk factors of osteoarthritis could predict IPFP volume with high reproducibility, with the superior performance of the model accounting for gender separation.
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Affiliation(s)
- Hossein Bonakdari
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Soils and Agri-Food Engineering, Laval University, Quebec, Quebec, Canada
| | - Ginette Tardif
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - François Abram
- Medical Imaging, ArthroLab Inc., Montreal, Quebec, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
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17
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Hu S, Shao Z, Zhang C, Chen L, Mamun AA, Zhao N, Cai J, Lou Z, Wang X, Chen J. Chemerin facilitates intervertebral disc degeneration via TLR4 and CMKLR1 and activation of NF-kB signaling pathway. Aging (Albany NY) 2020; 12:11732-11753. [PMID: 32526705 PMCID: PMC7343479 DOI: 10.18632/aging.103339] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 05/18/2020] [Indexed: 12/25/2022]
Abstract
Now days, obesity is a major risk factor for intervertebral disc degeneration (IDD). However, adipokine, such as chemerin is a novel cytokine, which is secreted by adipose tissue, and are thought to be played major roles in various degenerative diseases. Obese individuals are known to have high concentration of serum chemerin. Our purpose was to study whether chemerin acts as a biochemical relationship between obesity, and IDD. In this study, we found that the expression level of chemerin was significantly increased in the human degenerated nucleus pulposus (NP) tissues, and had higher level in the obese people than the normal people. Chemerin significantly increased the inflammatory mediator level, contributing to ECM degradation in nucleus pulposus cells (NPCs). Furthermore, chemerin overexpression aggravates the puncture-induced IVDD progression in rats, while knockdown CMKLR1 reverses IVDD progression. Chemerin activates the NF-kB signaling pathway via its receptors CMKLR1, and TLR4 to release inflammatory mediators, which cause matrix degradation, and cell aging. These findings generally provide novel evidence supporting the causative role of obesity in IDD, which is essentially important to literally develop novel preventative or generally therapeutic treatment in the disc degenerative disorders.
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Affiliation(s)
- Sunli Hu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Zhenxuan Shao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chenxi Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Liang Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Abdullah Al Mamun
- Molecular Pharmacology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Ning Zhao
- The First School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jinfeng Cai
- The First School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Zhiling Lou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiangyang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jiaoxiang Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
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18
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Gao YH, Zhao CW, Liu B, Dong N, Ding L, Li YR, Liu JG, Feng W, Qi X, Jin XH. An update on the association between metabolic syndrome and osteoarthritis and on the potential role of leptin in osteoarthritis. Cytokine 2020; 129:155043. [PMID: 32078923 DOI: 10.1016/j.cyto.2020.155043] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/22/2020] [Accepted: 02/11/2020] [Indexed: 12/23/2022]
Abstract
Metabolic syndrome (MetS) has been associated with osteoarthritis (OA). Leptin, which is one of the markers of MetS, has been associated with OA pathophysiology. This study aimed to provide an update on the association between MetS and OA and on the potential role of leptin in OA. In this review, we summarized the current knowledge of the association between MetS and OA and updated the evidence on the potential role of leptin in OA. Clinical studies have investigated the epidemiologic association between MetS or its components and OA. Results suggested strong epidemiologic associations between MetS and OA, especially in the Asian population. Animal studies also indicated that metabolic dysregulation may lead to OA pathogenesis. The systemic role of MetS in OA pathophysiology is associated with obesity-related inflammation, the beneficial role of n-3 polyunsaturated fatty acids and deleterious role of cholesterol, physical inactivity, hypertension-induced subchondral ischemia, dyslipidemia-induced ectopic lipid deposition in chondrocytes, hyperglycemia-induced local effects of oxidative stress and advanced glycation end-products, low-grade systemic inflammation, and obesity-related adipokines by inducing the expression of proinflammtory factors. Leptin levels in serum/plasma and synovial fluid were associated with joint pain, radiographic progression, bone formation biomarkers, cartilage volume, knee OA incidence, and total joint arthroplasty in OA patients. Elevated leptin expression and increased effect of leptin on infrapatellar fat pad, synovium, articular cartilage, and bone were also involved in the pathogenesis of OA. Current knowledge indicates a convincing epidemiologic association between MetS and OA, especially in the Asian population. Animal studies have also shown that metabolic dysregulation may lead to OA pathogenesis. Accumulating evidence suggests that leptin may play a potential role in OA pathogenesis. Therefore, leptin and its receptor may be an emerging target for intervention in metabolic-associated OA.
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Affiliation(s)
- Yu-Hang Gao
- Department of Orthopaedic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Cheng-Wu Zhao
- Department of Sports Medicine, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Bo Liu
- Department of Ultrasound, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Ning Dong
- Department of Pediatric Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Lu Ding
- Department of Orthopaedic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Ye-Ran Li
- Department of Orthopaedic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Jian-Guo Liu
- Department of Orthopaedic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Wei Feng
- Department of Orthopaedic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Xin Qi
- Department of Orthopaedic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China.
| | - Xian-Hua Jin
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, Jilin 130022, China.
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Vázquez-Del Mercado M, Martínez-García EA. Leptin as an open secret in the physiopathology of rheumatic diseases. Clin Rheumatol 2020; 39:301-303. [DOI: 10.1007/s10067-019-04908-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 12/15/2019] [Accepted: 12/19/2019] [Indexed: 11/28/2022]
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20
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Zuñiga JA, Harrison ML, Henneghan A, García AA, Kesler S. Biomarkers panels can predict fatigue, depression and pain in persons living with HIV: A pilot study. Appl Nurs Res 2019; 52:151224. [PMID: 31987713 DOI: 10.1016/j.apnr.2019.151224] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/13/2019] [Accepted: 12/21/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Persons living with HIV experience high symptom burden that can negatively impact medication adherence, work productivity, and quality of life. Symptoms are highly subjective, which can lead to under- or improper treatment. The purpose of this exploratory study was to examine relationships between circulating biomarkers representative of inflammatory, coagulation, and vascular function pathways and prevalent HIV symptoms. SETTING AND SAMPLE Adults >18 years who were diagnosed with HIV and spoke English for this cross-sectional study were recruited from community clinics and organizations. METHODS Symptom burden was measured with the HIV Symptom Index; depression with the Patient Health Questionnaire. Human multiplex kits were used to determine serum concentrations of select biomarkers representing inflammatory, coagulation, and vascular function pathways. The biomarkers were included as features in machine learning models to determine which biomarkers predicted the most prevalent HIV symptoms (fatigue and muscle/joint pain) and the symptom of depression. RESULTS Participants (N = 32) were representative of the local population of people with HIV, being mostly Black (54.4%) and male (60.6%). Depression was predicted by age, gender, glucose, hemoglobin A1c, and inflammation. Muscle/joint pain was predicted by adiponectin, C-reactive protein, and serum amyloid A (SAA). Fatigue was predicted by adiponectin, SAA, and soluble interleukin-1 receptor type II (sIL-1RII). CONCLUSION Biomarker clusters can be a tool to monitor symptoms. Adding an objective measure to subjective patient experiences could improve management and monitoring of symptoms. Defining a biomarker cluster for the objective assessment of HIV symptoms warrants further investigation; however, the presence of comorbid conditions needs to be controlled.
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Affiliation(s)
- Julie A Zuñiga
- The University of Texas at Austin, School of Nursing, United States of America.
| | - Michelle L Harrison
- The University of Texas at Austin, College of Education, Department of Kinesiology and Health Education, United States of America
| | - Ashley Henneghan
- The University of Texas at Austin, School of Nursing, United States of America
| | - Alexandra A García
- The University of Texas at Austin, School of Nursing, United States of America
| | - Shelli Kesler
- MD Anderson, Department of Neuro-Oncology, Division of Cancer Medicine, United States of America
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Patterson SL, Schmajuk G, Jafri K, Yazdany J, Katz P. Obesity is Independently Associated With Worse Patient-Reported Outcomes in Women with Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2019; 71:126-133. [PMID: 29740985 DOI: 10.1002/acr.23576] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/03/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine whether obesity in women with systemic lupus erythematosus (SLE) is independently associated with worse patient-reported outcomes (PROs). METHODS Data were derived from a prospective study of adult women with a diagnosis of SLE that was verified by medical record review. Two established definitions for obesity were used: fat mass index (FMI) ≥13 kg/m2 and body mass index (BMI) ≥30 kg/m2 . Dependent variables included 4 validated PROs: disease activity as assessed by the Systemic Lupus Activity Questionnaire (SLAQ), depressive symptoms as assessed by the Center for Epidemiologic Studies Depression Scale (CES-D), pain as assessed by the Short Form 36 (SF-36) pain subscale, and fatigue as assessed by the SF-36 vitality subscale. We used multivariable linear regression to evaluate the associations of obesity with PROs, while controlling for potential confounders (age, race, education, income, smoking, disease duration, disease damage, and prednisone use). RESULTS The analysis included 148 participants, 32% of whom were obese. In the multivariate regression model, obesity was associated with worse scores for each PRO. Mean adjusted scores for the SLAQ and CES-D comparing obese versus non-obese participants were 14.8 versus 11.5 (P = 0.01) and 19.8 versus 13.1 (P < 0.01), respectively. The obese group also reported worse mean adjusted scores for pain (38.7 versus 44.2; P < 0.01) and fatigue (39.6 versus 45.2; P = 0.01). CONCLUSION In a representative sample of women with SLE, obesity (as defined by both FMI and BMI) was independently associated with worse PROs, including disease activity, depressive symptoms, and symptoms of pain and fatigue. Obesity may represent a modifiable target for improving outcomes among obese women with SLE.
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Affiliation(s)
| | - Gabriela Schmajuk
- University of California, San Francisco, and San Francisco VA Hospital, San Francisco, California
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22
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Franco-Trepat E, Guillán-Fresco M, Alonso-Pérez A, Jorge-Mora A, Francisco V, Gualillo O, Gómez R. Visfatin Connection: Present and Future in Osteoarthritis and Osteoporosis. J Clin Med 2019; 8:jcm8081178. [PMID: 31394795 PMCID: PMC6723538 DOI: 10.3390/jcm8081178] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 07/29/2019] [Accepted: 08/04/2019] [Indexed: 12/15/2022] Open
Abstract
Musculoskeletal pathologies (MSPs) such as osteoarthritis (OA) and osteoporosis (OP), are a set of disorders that cause severe pain, motion difficulties, and even permanent disability. In developed countries, the current incidence of MSPs reaches about one in four adults and keeps escalating as a consequence of aging and sedentarism. Interestingly, OA and OP have been closely related to similar risk factors, including aging, metabolic alterations, and inflammation. Visfatin, an adipokine with an inflammatory and catabolic profile, has been associated with several OA and OP metabolic risk factors, such as obesity, insulin resistance, and type II diabetes. Furthermore, visfatin has been associated with the innate immune receptor toll-like receptor 4 (TLR4), which plays a key role in cartilage and bone inflammatory and catabolic responses. Moreover, visfatin has been related to several OA and OP pathologic features. The aim of this work is to bring together basic and clinical data regarding the common role of visfatin in these pathologies and their major shared risk factors. Finally, we discuss the pitfalls of visfatin as a potential biomarker and therapeutic target in both pathologies.
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Affiliation(s)
- Eloi Franco-Trepat
- Musculoskeletal Pathology Group, Institute IDIS, Santiago University Clinical Hospital, SERGAS, 15706 Santiago de Compostela, Spain
| | - María Guillán-Fresco
- Musculoskeletal Pathology Group, Institute IDIS, Santiago University Clinical Hospital, SERGAS, 15706 Santiago de Compostela, Spain
| | - Ana Alonso-Pérez
- Musculoskeletal Pathology Group, Institute IDIS, Santiago University Clinical Hospital, SERGAS, 15706 Santiago de Compostela, Spain
| | - Alberto Jorge-Mora
- Musculoskeletal Pathology Group, Institute IDIS, Santiago University Clinical Hospital, SERGAS, 15706 Santiago de Compostela, Spain
| | - Vera Francisco
- Research laboratory 9, Institute IDIS, Santiago University Clinical Hospital, SERGAS, 15706 Santiago de Compostela, Spain
| | - Oreste Gualillo
- Research laboratory 9, Institute IDIS, Santiago University Clinical Hospital, SERGAS, 15706 Santiago de Compostela, Spain
| | - Rodolfo Gómez
- Musculoskeletal Pathology Group, Institute IDIS, Santiago University Clinical Hospital, SERGAS, 15706 Santiago de Compostela, Spain.
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Martel-Pelletier J, Tardif G, Rousseau Trépanier J, Abram F, Dorais M, Raynauld JP, Pelletier JP. The ratio adipsin/MCP-1 is strongly associated with structural changes and CRP/MCP-1 with symptoms in obese knee osteoarthritis subjects: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2019; 27:1163-1173. [PMID: 31102776 DOI: 10.1016/j.joca.2019.04.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/18/2019] [Accepted: 04/27/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is a need to identify reliable biomarkers that can predict knee osteoarthritis (OA) progression. We investigated a panel of adipokines and some related inflammatory factors alone and their ratios for their associative value at assessing cartilage volume loss over time and symptoms in obese [High body mass index (BMI)] and non-obese (Low BMI) OA subjects. DESIGN Human OA serum was from the Osteoarthritis Initiative Progression subcohort. Baseline levels of adiponectin (high and low molecular weight forms), adipsin, chemerin, leptin, visfatin, C-reactive protein (CRP), interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) were evaluated with specific assays. Cartilage volume was assessed at baseline and 48 months by quantitative magnetic resonance imaging (MRI), and symptoms using baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Data were analysed by linear regression with confounding factors at baseline, followed by multiple comparison adjustment. RESULTS The levels of the nine biomarkers and their ratios (36) were studied. Among High BMI subjects, only the ratio adipsin/MCP-1 was associated with cartilage volume loss over time in the lateral compartment [β, -2.95; 95% confidence interval (CI), -4.42, -1.49; P = 0.010], whereas MCP-1 was associated with WOMAC pain (-1.74; -2.75, -0.73; P = 0.030) and the ratio CRP/MCP-1 with WOMAC pain (0.76; 0.37, 1.14; P = 0.023), function (2.43; 1.20, 3.67; P = 0.020) and total (3.29; 1.58, 5.00; P = 0.027). No associations were found for biomarkers or ratios in Low BMI OA. CONCLUSION In this study, the ratio adipsin/MCP-1 was found to be associated with the knee structural changes and that of CRP/MCP-1 with symptoms in obese OA subjects. Our data further underline the relevance of ratios as biomarkers to a stronger association to OA progression and symptoms.
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Affiliation(s)
- J Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
| | - G Tardif
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
| | - J Rousseau Trépanier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
| | - F Abram
- Medical Imaging Research & Development, ArthroLab Inc., Montreal, Quebec, Canada.
| | - M Dorais
- StatSciences Inc., Notre-Dame-de-l'Île-Perrot, Quebec, Canada.
| | - J-P Raynauld
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
| | - J-P Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
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Fernández-Torres J, Martínez-Nava GA, Zamudio-Cuevas Y, Martínez-Flores K, Espinosa-Morales R. Epistasis between ADIPOQ rs1501299 and PON1 rs662 polymorphisms is potentially associated with the development of knee osteoarthritis. Mol Biol Rep 2019; 46:2049-2058. [PMID: 30734899 DOI: 10.1007/s11033-019-04654-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/24/2019] [Indexed: 01/08/2023]
Abstract
Overweight produces oxidative stress (OS) on the articular cartilage, with the subsequent risk of developing knee osteoarthritis (OA). Associations between genetic polymorphisms related to OS and OA have been reported, but it is currently unknown whether there exist interactions among them that affect OA development. To identify and evaluate interactions between multiple SNPs related to OS in Mexican knee OA patients. Ninety-two knee OA patients were included in the study, which were compared to 147 healthy controls. Nine variants of six genes (PEPD, AGER, IL6, ADIPOQ, PON1, and CA6) related to OS were genotyped in both study groups through the OpenArray system. Epistasis was analyzed with the multifactor dimensionality reduction (MDR) method. The MDR analysis revealed a significant interaction (p = 0.0107) between polymorphisms rs1501299 (ADIPOQ) and rs662 (PON1), with an entropy value of 9.84%; in addition, high and low risk genotypes were identified between these two polymorphisms. The effect of the interaction between rs1501299 (ADIPOQ) and rs662 (PON1) polymorphisms seems to play an important role in OA pathogenesis; so the epistasis analysis may provide an excellent tool for identifying individuals at high risk for developing OA.
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Affiliation(s)
- Javier Fernández-Torres
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico.
| | - Gabriela Angélica Martínez-Nava
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico
| | - Yessica Zamudio-Cuevas
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico
| | - Karina Martínez-Flores
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico
| | - Rolando Espinosa-Morales
- Rheumatology Department, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico
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25
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Tu C, He J, Wu B, Wang W, Li Z. An extensive review regarding the adipokines in the pathogenesis and progression of osteoarthritis. Cytokine 2019; 113:1-12. [DOI: 10.1016/j.cyto.2018.06.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 05/12/2018] [Accepted: 06/12/2018] [Indexed: 12/13/2022]
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26
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Xiong H, Li W, Ke J, Fang W, Li B, Wei L. Leptin Levels in the Synovial Fluid of Patients With Temporomandibular Disorders. J Oral Maxillofac Surg 2018; 77:493-498. [PMID: 30321519 DOI: 10.1016/j.joms.2018.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/10/2018] [Accepted: 09/10/2018] [Indexed: 01/15/2023]
Abstract
PURPOSE This study was conducted to measure concentrations of leptin and interleukin-6 (IL-6) in the synovial fluid (SF) of 38 patients with temporomandibular disorders (TMDs) and 7 healthy controls and to analyze the correlation between leptin and IL-6. PATIENTS AND METHODS Patients with TMDs were divided into 3 subgroups according to imaging and clinical findings: displaced disc with reduction (DDR; n = 12), displaced disc without reduction (DDNR; n = 13), and osteoarthritis (OA; n = 13). SF samples were collected, and leptin and IL-6 levels were measured by enzyme-linked immunosorbent assay. RESULTS No relevant difference in leptin level was found between the control group and the DDR or DDNR group, whereas the OA group presented a higher leptin concentration than all other groups. IL-6 concentrations were markedly higher in all patient groups than in the control group. Levels were markedly higher in the OA group than in the DDR or DDNR group, but no relevant differences were found between the DDR and DDNR groups. No relevant correlation was found between leptin and IL-6 concentrations. CONCLUSION Distinct changes in leptin and IL-6 concentrations in the SF occurred at different stages of TMDs, suggesting their potential role in the pathogenesis of TMDs.
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Affiliation(s)
- Haofei Xiong
- Associate Professor, Department of Oral Emergency, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Li
- Senior Registrar, Department of Oral Radiology, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jin Ke
- Associate Professor, Department of Oral and Maxillofacial Surgery, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Fang
- Associate Professor, Department of Oral and Maxillofacial Surgery, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bo Li
- Associate Professor and Head, Department of Oral Radiology, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lili Wei
- Senior Registrar, Department of Oral Radiology, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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27
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Chialà A, Rotondo C, Praino E, Natuzzi D, Cacciapaglia F, Iannone F. Possible role of adipocytokines in systemic sclerosis–associated small pericardial effusion. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2018; 3:153-158. [DOI: 10.1177/2397198318762893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/04/2017] [Indexed: 11/17/2022]
Abstract
Introduction: Pericardial effusion is a common manifestation of systemic sclerosis, but its pathogenesis has been poorly investigated. Adipokines and interleukins may play a role in the pathophysiology of pericardial effusion. This study aimed at evaluating serum levels of adipokines and interleukins in systemic sclerosis patients with and without pericardial effusion. Methods: A total of 87 systemic sclerosis patients (age 52.6 ± 14 years; disease duration 8.2 ± 6.7 years) were recruited in this study. Demographics, body mass index, and clinical characteristics were recorded in each patient. Pericardial effusion was considered pathologic when ≥50 mL was detected by echocardiography. Serum levels of adiponectin, leptin, resistin, visfatin, tumor necrosis factor-α, interferon-γ, interlueukin-2, interlueukin-10, and interlueukin-17 were measured using Multiplex Immunoassay (Bioplex 200 System). Results: In all, 11 (13%) systemic sclerosis patients had pericardial effusion. Systemic sclerosis patients with and without pericardial effusion did not differ in age, sex, and body mass index. Systemic sclerosis patients with pericardial effusion had significantly higher levels of visfatin (median/interquartile range: 1546 pg/mL (interquartile range: 8590) vs 388 pg/mL (interquartile range: 103), p = 0.03) and interlueukin-17 (1.33 pg/mL (interquartile range: 3.5) vs 0.05 pg/mL (interquartile range: 0.56), p = 0.04), but lower levels of adiponectin (2,845,000 pg/mL (interquartile range: 4,132,900) vs 5,272,100 pg/mL (interquartile range 8,243,600), p = 0.02) than patients without pericardial effusion. Interstitial lung disease, pulmonary arterial hypertension, and “limited” or “diffuse” cutaneous subset did not correlate to adipokines or interleukin levels. Conclusion: Visfatin and adiponectin may play an important role in the pathogenesis of systemic sclerosis–related pericardial effusion. Further longitudinal studies are needed to unravel a possible role of these molecules as biomarkers of pericardial effusion in systemic sclerosis patients.
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Affiliation(s)
- Angela Chialà
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Cinzia Rotondo
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Emanuela Praino
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Dorotea Natuzzi
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Fabio Cacciapaglia
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Florenzo Iannone
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
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28
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Association between the severity of symptomatic knee osteoarthritis and cumulative metabolic factors. Aging Clin Exp Res 2018; 30:481-488. [PMID: 28762210 DOI: 10.1007/s40520-017-0808-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/25/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The association between cumulative metabolic syndrome (MS) factors and knee osteoarthritis (KOA) has been highlighted over the past two decades. AIMS To clarify the relationship between cumulative MS factors and symptomatic KOA. METHODS A cross-sectional survey involving 119 women aged 45-88 years who were scheduled to undergo knee surgery was conducted. They were stratified into tertiles of symptoms as assessed by the Japanese Orthopedic Association score for KOA. Multinomial logistic regressions were performed using the severity of symptomatic KOA as the dependent variable and each MS factor or the cumulative MS factors as the independent variables. RESULTS Logistic regression analyses were performed with the upper tertile of stratified symptoms of subjects used as the reference group. After adjustment for confounders, KOA patients who had two (p = 0.004) or three or more (p < 0.0001) MS factors were significantly more likely to have severe symptoms compared to those who had no MS factors. MS factors excluding obesity were similarly analyzed. Even after additional adjustment for body mass index (BMI), KOA patients who had two or more (p = 0.005) MS factors were significantly more likely to have severe symptoms. CONCLUSION Among KOA female patients diagnosed using radiographic definition, the severity of symptomatic KOA was significantly associated with hypertension, dyslipidemia, and the number of MS factors after adjustment for age, BMI, strength of the knee extensor, and Kellgren-Lawrence grade. The severity of radiographic KOA was not associated with any MS factor or cumulative MS factors.
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The Role of Adipokines in Intervertebral Disc Degeneration. Med Sci (Basel) 2018; 6:medsci6020034. [PMID: 29695079 PMCID: PMC6024372 DOI: 10.3390/medsci6020034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/17/2018] [Accepted: 04/19/2018] [Indexed: 12/19/2022] Open
Abstract
Intervertebral disc degeneration (IDD) is an important cause of low back pain. Recent evidence suggests that in addition to abnormal and excessive mechanical loading, inflammation may be a key driver for both IDD and low back pain. Obesity, a known mechanical risk factor of IDD, is now increasingly being recognized as a systemic inflammatory state with adipokines being postulated as likely inflammatory mediators. The aim of this review was to summarize the current literature regarding the inflammatory role of adipokines in the pathophysiology of IDD. A systematic literature search was performed using the OVID Medline, EMBASE and PubMed databases to identify all studies assessing IDD and adipokines. Fifteen studies were included in the present review. Leptin was the most commonly assessed adipokine. Ten of 15 studies were conducted in humans; three in rats and two in both humans and rats. Studies focused on a variety of topics ranging from receptor identification, pathway analysis, genetic associations, and proteonomics. Currently, data from both human and animal experiments demonstrate significant effects of leptin and adiponectin on the internal milieu of intervertebral discs. However, future studies are needed to determine the molecular pathway relationships between adipokines in the pathophysiology of IDD as avenues for future therapeutic targets.
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30
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Sadowska A, Hausmann ON, Wuertz-Kozak K. Inflammaging in the intervertebral disc. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2018. [DOI: 10.1177/2514183x18761146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
| | | | - Karin Wuertz-Kozak
- ETH Zurich, Zurich, Switzerland
- Department of Health Sciences, University of Potsdam, Potsdam, Germany
- Schön Klinik München Harlaching, Spine Center, Munich, Germany
- Academic Teaching Hospital and Spine Research Institute, Paracelsus Private Medical University Salzburg, Salzburg, Austria
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31
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Urban H, Little CB. The role of fat and inflammation in the pathogenesis and management of osteoarthritis. Rheumatology (Oxford) 2018; 57:iv10-iv21. [DOI: 10.1093/rheumatology/kex399] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Hema Urban
- Institute of Bone and Joint Research, Sydney, New South Wales, Australia
- Raymond Purves Bone and Joint Research Labs, Kolling Institute, Northern Sydney Local Health District, University of Sydney at Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia
- Rheumatology Department, Royal North Shore Hospital, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher B Little
- Institute of Bone and Joint Research, Sydney, New South Wales, Australia
- Raymond Purves Bone and Joint Research Labs, Kolling Institute, Northern Sydney Local Health District, University of Sydney at Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia
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Association between Dietary Glycemic Index and Knee Osteoarthritis: The Korean National Health and Nutrition Examination Survey 2010-2012. J Acad Nutr Diet 2018; 118:1673-1686.e2. [PMID: 29428452 DOI: 10.1016/j.jand.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 12/04/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Obesity and metabolic abnormalities are important risk factors for knee osteoarthritis (KOA). Recent epidemiologic studies have found that a high glycemic index (GI) and glycemic load (GL) diet are associated with a higher risk for metabolic complications and cardiovascular mortality. OBJECTIVE We aimed to examine the association between dietary GI, dietary GL, and KOA among Korean adults. DESIGN This was a cross-sectional study that analyzed data obtained from the Korean National Health and Nutrition Examination Survey 2010-2012. PARTICIPANTS/SETTING A total of 9,203 participants (5,275 women) aged ≥50 years were included. MAIN OUTCOME MEASURES KOA was defined as the presence of radiographic features of Kellgren-Lawrence grade ≥2. Chronic knee pain was defined as the presence of knee pain for more than 30 days during the past 3 months. Dietary information was collected using a single 24-hour recall method. STATISTICAL ANALYSES PERFORMED The association between the quintiles of dietary GI and dietary GL and knee conditions was analyzed using a multinomial logistic regression analysis adjusting for age, physical activity, obesity, hypertension and diabetes, serum low-density lipoprotein, and total energy intake. RESULTS Among the women, the association between dietary GI and symptomatic KOA was: quintile 1: 1.00 (reference); quintile 2: 1.29 (95% CI 0.87 to 1.92); quintile 3: 1.59 (95% CI 1.11 to 2.28); quintile 4: 1.74 (95% CI 1.21 to 2.51); and quintile 5: 1.77 (95% CI 1.20 to 2.60) (P=0.001). Chronic knee pain without KOA was associated with dietary GI; however, this association was not linear across quintiles. There was no significant association between dietary GI and asymptomatic KOA. Among the men, no significant association was found between dietary GI and any knee conditions. There was no significant association between dietary GL and KOA in both men and women. CONCLUSIONS There was a significant positive association between dietary GI and symptomatic KOA in women.
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Differential involvement of synovial adipokines in pain and physical function in female patients with knee osteoarthritis. A cross-sectional study. Osteoarthritis Cartilage 2018; 26:276-284. [PMID: 29196131 DOI: 10.1016/j.joca.2017.11.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/09/2017] [Accepted: 11/16/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Adipokines have been reported to play a role in the development, progression and severity of knee osteoarthritis but the influence of the different adipokines are not well known. The aim of this study was to evaluate the association between different synovial fluid adipokines with pain and disability knee osteoarthritis patients. METHODS Cross-sectional study with systematic inclusion of 115 symptomatic primary knee osteoarthritis female patients with ultrasound-confirmed joint effusion. Age, physical exercise, symptoms duration and different anthropometric measurements were collected. Radiographic severity was evaluated according to Kellgren-Lawrence scale. Pain and disability were assessed by WOMAC-total, -pain, -function subscales and Knee injury and Osteoarthritis Outcome Score (KOOS) pain and function scales. Seven adipokines and three inflammatory markers were measured by ELISA in synovial fluid. Partial Correlation Coefficient (PCC) and corresponding 95% confidence interval were used as a measure of association. RESULTS Leptin, osteopontin and inflammatory factors, especially TNF-alpha, were associated to pain and function. After adjustment for potential confounders including inflammatory factors and all adipokines, an association was found for adiponectin with pain (PCC 0.240 [0.012, 0.444]) and for resistin and visfatin with function (PCC 0.336 [0.117, 0.524] and -0.262 [-0.463, -0.036]). No other adipokines or inflammatory markers were statistically and independently associated. An association between physical exercise and pain and disability remained after adjustment, whereas an attenuation of the influence of anthropometric measurements was observed. CONCLUSIONS Different patterns of association between synovial fluid adipokines were observed regarding pain and disability in knee osteoarthritis patients. Specifically, adiponectin was associated to pain while resistin and visfatin were mainly related to function.
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Atukorala I, Makovey J, Lawler L, Messier SP, Bennell K, Hunter DJ. Is There a Dose-Response Relationship Between Weight Loss and Symptom Improvement in Persons With Knee Osteoarthritis? Arthritis Care Res (Hoboken) 2017; 68:1106-14. [PMID: 26784732 DOI: 10.1002/acr.22805] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/04/2015] [Accepted: 11/24/2015] [Indexed: 01/11/2023]
Abstract
OBJECTIVE We examined the dose-response relationship between weight reduction and pain/functional improvement in persons with symptomatic knee osteoarthritis (KOA) participating in a community-based weight loss program. METHODS Consecutive participants with KOA and enrolled in the 18-week Osteoarthritis Healthy Weight for Life weight-loss program were selected. In this completer-type analysis, participants were assessed at baseline, 6 weeks, and 18 weeks for body weight and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales. The dose-response relationship between weight-change categories (>10%, 7.6-10%, 5.1-7.5%, 2.6-5.0%, and <2.5% of body weight loss) and change in KOOS scores was assessed by repeated-measures analysis of variance, controlling for sex and age, body mass index (BMI), and KOOS. The Western Ontario McMaster Universities Osteoarthritis Index function score derived from the KOOS was used to assess a meaningful clinical functional improvement. RESULTS A total of 1,383 persons (71% females) were enrolled. Mean ± SD age, height, and weight were 64 ± 8.7 years, 1.66 ± 0.09 meters, and 95.1 ± 17.2 kg, respectively. Mean ± SD BMI was 34.4 ± 5.2 kg/m(2) with 82% of participants obese at baseline. A total of 1,304 persons (94%) achieved a >2.5% reduction in body weight. There was a significant dose-response relationship between all KOOS subscales and percentage of weight change across all weight-change categories. Participants required ≥7.7% (95% confidence interval 5.2, 13.3) body weight loss to achieve a minimal clinically important improvement in function. CONCLUSION There is a significant dose-response relationship between percentage of weight loss and symptomatic improvement. This study confirms the feasibility of weight loss as a therapeutic intervention in KOA in a community-based setting.
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Affiliation(s)
| | - Joanna Makovey
- Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Luke Lawler
- Prima Health Solutions, Sydney, New South Wales, Australia
| | | | - Kim Bennell
- University of Melbourne, Melbourne, Victoria, Australia
| | - David J Hunter
- Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
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Adipokine Contribution to the Pathogenesis of Osteoarthritis. Mediators Inflamm 2017; 2017:5468023. [PMID: 28490838 PMCID: PMC5401756 DOI: 10.1155/2017/5468023] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/25/2017] [Accepted: 03/07/2017] [Indexed: 12/13/2022] Open
Abstract
Recent studies have shown that overweight and obesity play an important role in the development of osteoarthritis (OA). However, joint overload is not the only risk factor in this disease. For instance, the presence of OA in non-weight-bearing joints such as the hand suggests that metabolic factors may also contribute to its pathogenesis. Recently, white adipose tissue (WAT) has been recognized not only as an energy reservoir but also as an important secretory organ of adipokines. In this regard, adipokines have been closely associated with obesity and also play an important role in bone and cartilage homeostasis. Furthermore, drugs such as rosuvastatin or rosiglitazone have demonstrated chondroprotective and anti-inflammatory effects in cartilage explants from patients with OA. Thus, it seems that adipokines are important factors linking obesity, adiposity, and inflammation in OA. In this review, we are focused on establishing the physiological mechanisms of adipokines on cartilage homeostasis and evaluating their role in the pathophysiology of OA based on evidence derived from experimental research as well as from clinical-epidemiological studies.
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Koskinen-Kolasa A, Vuolteenaho K, Korhonen R, Moilanen T, Moilanen E. Catabolic and proinflammatory effects of leptin in chondrocytes are regulated by suppressor of cytokine signaling-3. Arthritis Res Ther 2016; 18:215. [PMID: 27716333 PMCID: PMC5048607 DOI: 10.1186/s13075-016-1112-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/05/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Previous studies provide evidence that adipokine leptin increases production of catabolic and proinflammatory factors in chondrocytes and serves as a link between obesity and osteoarthritis (OA). However, the magnitude of the response to leptin treatment varies greatly between chondrocytes from different donor patients. In the present study, we investigated the regulatory role of suppressor of cytokine signaling-3 (SOCS-3) in the leptin-induced responses in OA cartilage. METHODS Cartilage and synovial fluid samples from 97 patients with OA undergoing knee replacement surgery were collected. Cartilage samples were cultured with leptin (10 μg/ml), and the levels of proinflammatory and catabolic factors in synovial fluid and in the cartilage culture media, and SOCS-3 expression in the cartilage were measured. The role of SOCS-3 in leptin signaling was further studied in H4 murine chondrocytes by downregulating SOCS-3 with siRNA. RESULTS Leptin-induced expression of matrix metalloproteinases MMP-1, MMP-3, MMP-13, interleukin-6 (IL-6), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) were higher in the cartilage samples with low SOCS-3 expression. Accordingly, downregulation of SOCS-3 by siRNA in H4 chondrocytes led to enhanced leptin-induced expression of MMP-3, MMP-13, IL-6 and iNOS. Synovial fluid leptin was associated positively, and cartilage SOCS-3 negatively with synovial fluid levels of MMPs in a multivariate model in obese (body mass index (BMI) >30 kg/m2) but not in non-obese (BMI <30 kg/m2) patients. CONCLUSIONS Our results show, for the first time, that SOCS-3 regulates leptin-induced responses in cartilage, and could thus be a future drug target in the treatment or prevention of OA, especially in obese patients.
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Affiliation(s)
- Anna Koskinen-Kolasa
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Katriina Vuolteenaho
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Riku Korhonen
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Teemu Moilanen
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland.,Coxa Hospital for Joint Replacement, Tampere, Finland
| | - Eeva Moilanen
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland.
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Preston S, Petrera M, Kim C, Zywiel MG, Gandhi R. Towards an understanding of the painful total knee: what is the role of patient biology? Curr Rev Musculoskelet Med 2016; 9:388-395. [PMID: 27613710 DOI: 10.1007/s12178-016-9363-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Total knee arthroplasty (TKA) remains the treatment of choice for end-stage osteoarthritis of the knee. With an aging population, the demand for TKA continues to increase, placing a significant burden on a health care system that must function with limited resources. Although generally accepted as a successful procedure, 15-30 % of patients report persistent pain following TKA. Classically, pain generators have been divided into intra-articular and extra-articular causes. However, there remains a significant subset of patients for whom pain remains unexplained. Recent studies have questioned the role of biology (inflammation) in the persistence of pain following TKA. This article aims to serve as a review of previously identified causes of knee pain following TKA, as well as to explore the potential role of biology as a predictor of pain following knee replacement surgery.
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Affiliation(s)
- Stephen Preston
- Division of Orthopaedic Surgery, Arthritis Program, Toronto Western Hospital, University Health Network, Toronto, Ontario Canada
| | - Massimo Petrera
- Division of Orthopaedic Surgery, Arthritis Program, Toronto Western Hospital, University Health Network, Toronto, Ontario Canada
| | - Christopher Kim
- Division of Orthopaedic Surgery, Arthritis Program, Toronto Western Hospital, University Health Network, Toronto, Ontario Canada
| | - Michael G Zywiel
- Division of Orthopaedic Surgery, Arthritis Program, Toronto Western Hospital, University Health Network, Toronto, Ontario Canada
| | - Rajiv Gandhi
- Division of Orthopaedic Surgery, Arthritis Program, Toronto Western Hospital, University Health Network, Toronto, Ontario Canada.,Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, 399 Bathurst St, Room 1E439, Toronto, Ontario M5T 2S8 Canada
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Neogi T, Guermazi A, Roemer F, Nevitt MC, Scholz J, Arendt-Nielsen L, Woolf C, Niu J, Bradley LA, Quinn E, Law LF. Association of Joint Inflammation With Pain Sensitization in Knee Osteoarthritis: The Multicenter Osteoarthritis Study. Arthritis Rheumatol 2016; 68:654-61. [PMID: 26554395 DOI: 10.1002/art.39488] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 10/22/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Pain sensitization is associated with pain severity in knee osteoarthritis (OA), but its cause in humans is not well understood. We examined whether inflammation, assessed as synovitis and effusion on magnetic resonance imaging (MRI), or mechanical load, assessed as bone marrow lesions (BMLs), was associated with sensitization in knee OA. METHODS Subjects in the Multicenter Osteoarthritis Study, a National Institutes of Health-funded cohort of persons with or at risk of knee OA, underwent radiography and MRI of the knee, and standardized quantitative sensory testing (temporal summation and pressure pain threshold [PPT]) of the wrist and patellae at baseline and 2 years later. We examined the relation of synovitis, effusion, and BMLs to temporal summation and PPT cross-sectionally and longitudinally. RESULTS There were 1,111 subjects in the study sample (mean age 67 years, mean body mass index 30 kg/m(2) , 62% female). Synovitis was associated with a significant decrease in PPT at the patella (i.e., more sensitized) over 2 years (adjusted β -0.30 [95% confidence interval (95% CI) -0.52, -0.08]). Effusion was similarly associated with a decrease in PPT at the wrist (adjusted β -0.24 [95% CI -0.41, -0.08]) and with risk of incident temporal summation at the patella (adjusted OR 1.54 [95% CI 1.01, 2.36]). BMLs were not associated with either quantitative sensory testing measure. CONCLUSION Inflammation, as evidenced by synovitis or effusion, is associated with pain sensitization in knee OA. In contrast, BMLs do not appear to contribute to sensitization in knee OA. Early targeting of inflammation is a reasonable strategy to test for prevention of sensitization and through this, reduction of pain severity, in knee OA.
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Affiliation(s)
| | | | | | | | - Joachim Scholz
- Columbia University College of Physicians and Surgeons, New York, New York
| | | | | | - Jingbo Niu
- Boston University, Boston, Massachusetts
| | | | | | - Laura Frey Law
- University of Iowa Carver College of Medicine, Iowa City
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Quantitative relationship of thigh adipose tissue with pain, radiographic status, and progression of knee osteoarthritis: longitudinal findings from the osteoarthritis initiative. Invest Radiol 2015; 50:268-74. [PMID: 25419827 DOI: 10.1097/rli.0000000000000113] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study was to explore the relationship of thigh subcutaneous fat (SCF) and intermuscular fat (IMF) content with knee osteoarthritis (KOA) cross-sectionally and longitudinally, using quantitative magnetic resonance imaging. Specifically, we examined relationships with frequent knee pain, various radiographic strata, and structural progression status of KOA. MATERIALS AND METHODS Subjects who showed between-knee discordance of frequent versus no pain (n = 48), osteophyte versus no radiographic KOA (n = 55), and radiographic joint space narrowing versus no joint space narrowing (n = 44) were selected from the Osteoarthritis Initiative. Knees with structural progression of KOA (n = 23) were compared with knees without progression. Axial thigh magnetic resonance images were used to determine IMF and SCF. Differences between knees and between baseline and 2-year follow-up were examined using paired t tests. RESULTS Women displayed similar amounts of IMF, but twice the SCF of men. Limbs of women with frequently painful knees had statistically significant greater IMF areas (+4.2%; P = 0.05) than contralateral pain-free limbs did. No significant cross-sectional differences were observed between other strata. Men with structural progression appeared to have a greater longitudinal increase in SCF (+13.2%; P < 0.05) than did men without progression (-1.9%), and women with progression appeared to have a greater increase in IMF (+11.6%) than did those without progression (+1.5%). CONCLUSION In women, painful knees display greater IMF content than do contralateral pain-free knees. Other between-knee comparisons did not reveal a regional association between radiographic KOA and thigh adipose tissue status. Structural progression of KOA may be associated with greater longitudinal increases in SCF in men and greater increases of IMF in women, compared with nonprogressive controls.
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Cuzdan Coskun N, Ay S, Evcik FD, Oztuna D. Adiponectin: is it a biomarker for assessing the disease severity in knee osteoarthritis patients? Int J Rheum Dis 2015; 20:1942-1949. [PMID: 26544540 DOI: 10.1111/1756-185x.12790] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM The results of previous studies regarding the role of adiponectin in the pathogenesis of osteoarthritis (OA) are controversial. The aim of this study is to investigate the relation of plasma adiponectin levels with clinical and radiological disease severity in knee OA patients. METHOD Sixty patients with knee OA and 25 healthy controls were included in the study. Patients were divided into two subgroups: lean (Group 1, n = 30) and obese (Group 2, n = 30). Healthy controls were accepted as Group 3 (n = 25). Pain intensity was measured with a visual analogue scale (VAS), functional disability with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Quality of Life (QoL) with Short Form-36 (SF-36). Also all patients were radiologically evaluated and graded according to Kellgren-Lawrence (KL) scale. Plasma concentrations of adiponectin levels were measured by enzyme-linked immune-sorbent assay (ELISA). RESULTS Serum adiponectin levels were higher in OA patient subgroups than those in the control group but the difference did not reach a significant level after adjustments for age, gender and body mass index (P = 0.078). There was a positive correlation between adiponectin concentration and KL grading scores. Additionally, there was a positive correlation between adiponectin levels and clinical variables (VAS and WOMAC total scores) in patient subgroups (r = 0.326 P = 0.012, r = 0.583 P < 0.001, respectively). SF-36 scores were inversely associated with adiponectin levels. CONCLUSION Plasma adiponectin concentrations were associated with both clinical and radiological disease severity in knee OA patients. Thus, adiponectin hormone might be a potential clinically useful biomarker while assessing disease severity in the future.
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Affiliation(s)
- Nihan Cuzdan Coskun
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cukurova University School of Medicine, Adana, Turkey
| | - Saime Ay
- Department of Physical Medicine and Rehabilitation, Ufuk University School of Medicine, Ankara, Turkey
| | - Fatma Deniz Evcik
- Haymana Vocational School, Department of Therapy and Rehabilitation, Ankara University, Ankara, Turkey
| | - Derya Oztuna
- Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
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Wang X, Hunter D, Xu J, Ding C. Metabolic triggered inflammation in osteoarthritis. Osteoarthritis Cartilage 2015; 23:22-30. [PMID: 25452156 DOI: 10.1016/j.joca.2014.10.002] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/23/2014] [Accepted: 10/06/2014] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is a common chronic joint disorder with a multifactorial etiology including genetic and environmental factors. Metabolic triggered inflammation, induced by nutrient overload and metabolic surplus, consists of components such as obesity, pro-inflammatory cytokines and adipokines, abnormal metabolites, acute phase proteins, vitamin D deficiency, and deregulated microRNAs that may play a role in OA pathophysiology. Obesity-related metabolic factors, especially adipokines, contribute to OA development by inducing pro-inflammatory cytokines and degradative enzymes, leading to cartilage matrix impairment and subchondral bone remodeling. Ectopic metabolite deposition and low-grade systemic inflammation can contribute to a toxic internal environment that exacerbates OA. Complement components highly expressed in osteoarthritic joints have also been proposed as causative factors. Vitamin D deficiency has been associated with obesity and is implicated to be associated with cartilage loss in OA. Metabolic microRNAs may explain the inflammatory link between obesity and OA. Therapies targeting metabolic-triggered inflammation and its components are anticipated to have potential for the treatment of OA.
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Affiliation(s)
- X Wang
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - D Hunter
- Institute of Bone and Joint Research, Kolling Institute and Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia
| | - J Xu
- Department of Rheumatology and Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, China
| | - C Ding
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia; Institute of Bone and Joint Research, Kolling Institute and Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia; Department of Rheumatology and Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, China.
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Sánchez JC, López-Zapata DF. Effects of Adipokines and Insulin on Intracellular pH, Calcium Concentration, and Responses to Hypo-Osmolarity in Human Articular Chondrocytes from Healthy and Osteoarthritic Cartilage. Cartilage 2015; 6:45-54. [PMID: 26069708 PMCID: PMC4462245 DOI: 10.1177/1947603514553095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To evaluate the effects of adipokines and insulin on intracellular calcium concentration ([Ca(2+)]i) and pH (pHi) in human articular chondrocytes from healthy (CHC) and osteoarthritic cartilage (COC). DESIGN pHi and [Ca(2+)]i were measured using BCECF and Fura-2 fluorometric probes in CHC and COC under control conditions and following a hypotonic shock. The effects of interleukin-1β (IL1β), tumor necrosis factor-α (TNFα), insulin, leptin, resistin, and adiponectin were assessed. RESULTS pHi was lower in COC than in CHC. Only IL1β β decreased pHi in both cell types; all the agents enhanced pHi recovery following an ammonium prepulse in CHC, effect that was attenuated by Na(+)-H(+) exchanger inhibitors, but they had no effect in COC. Hypotonic shock (HTS) caused a pHi increase, which was significantly smaller in COC. All the hormones attenuated this response and the effect of IL1β was greater. The basal [Ca(2+)]i was similar in COC and CHC; IL1β, TNFα, and insulin increased the [Ca(2+)]i, but leptin, resistin, and adiponectin did not. These effects were greater in COC. This [Ca(2+)]i increase was dependent on extracellular Ca(2+) and attenuated by Na(+)-Ca(2+) exchanger inhibitors. HTS caused a [Ca(2+)]i increase, which was inhibited by transient receptor potential vanilloid blockers and attenuated by all the hormones tested with the exception of adiponectin. CONCLUSIONS These findings may help explain the association between obesity and osteoarthritis, in which these hormones are altered. The responses of CHC and COC are different, which suggests that a modification of pH and Ca(2+) homeostasis is part of the osteoarthritis pathophysiology.
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Affiliation(s)
- Julio C. Sánchez
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
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Lee S, Kim TN, Kim SH, Kim YG, Lee CK, Moon HB, Koh EM, Yoo B. Obesity, metabolic abnormality, and knee osteoarthritis: A cross-sectional study in Korean women. Mod Rheumatol 2014; 25:292-7. [DOI: 10.3109/14397595.2014.939393] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Poonpet T, Honsawek S. Adipokines: Biomarkers for osteoarthritis? World J Orthop 2014; 5:319-327. [PMID: 25035835 PMCID: PMC4095025 DOI: 10.5312/wjo.v5.i3.319] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 04/03/2014] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA) is one of the most common degenerative joint diseases in aging population. Obesity is an important risk factor for initiation and progression of OA. It is accepted that excess body weight may lead to cartilage degeneration by increasing the mechanical forces across weight-bearing joints. However, emerging data suggest that additional metabolic factors released mainly by white adipose tissue may also be responsible for the high prevalence of OA among obese people. Adipocyte-derived molecules ‘‘adipokines’’ have prompt much interest in OA pathophysiological research over the past decade since they play an important role in cartilage and bone homeostasis. Therefore, the aim of this review is to summarize the current knowledge on the role of adipokines including leptin, adiponectin, visfatin and resistin in OA and their potential to be used as biomarkers for earlier diagnosis, classifying disease severity, monitoring disease progression, and testing pharmacological interventions for OA. In OA patients, leptin, visfatin and resistin showed increased production whereas adiponectin showed decreased production. Leptin and adiponectin are far more studied than visfatin and resistin. Importantly, altered adipokine levels also contribute to a wide range of diseases. Further experiments are still crucial for understanding the relationship between adipokines and OA.
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Bas S, Finckh A, Puskas GJ, Suva D, Hoffmeyer P, Gabay C, Lübbeke A. Adipokines correlate with pain in lower limb osteoarthritis: different associations in hip and knee. INTERNATIONAL ORTHOPAEDICS 2014; 38:2577-83. [PMID: 25005460 DOI: 10.1007/s00264-014-2416-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/04/2014] [Indexed: 01/23/2023]
Abstract
PURPOSE Our aim was to investigate whether serum and synovial-fluid (SF) concentrations of interleukin-6 (IL-6), leptin, adiponectin, resistin or visfatin are associated with joint pain in hip and knee in end-stage osteoarthritis (OA). METHODS A cross-sectional study assessing patients with hip and knee OA undergoing total joint arthroplasty between January and December 2010 was conducted at a large university hospital. Serum and SF cytokine and adipokine concentrations were determined in samples obtained on the day of surgery. The main outcome was pain severity measured pre-operatively using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) pain scores. RESULTS A total of 206 patients were involved (112 with hip and 94 with knee OA). Median age was 72 years [interquartile range (IQR) 66-79], 59% were women. All adipokine levels were significantly higher in the SF of hip joints than in that of knee joints, except for leptin, which tended to be higher in the knee. In both hip and knee OA, median serum concentrations of leptin, adiponectin, resistin and visfatin exceeded those in SF, whereas for IL-6, median concentrations were much higher in SF than in serum. In hip OA, worse pain was significantly associated with high SF concentrations of IL-6, visfatin and leptin; in knee OA, it was associated with high SF leptin and low SF adiponectin concentrations and a low adiponectin-leptin ratio. CONCLUSION Our findings support a connection between intra-articular concentrations of several adipokines and severity of preoperative OA pain. However, the specific adipokines differed by joints: in hip OA, pain was associated with IL-6 and visfatin and in knee OA with adiponectin; leptin played a role in both hip and knee OA.
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Affiliation(s)
- Sylvette Bas
- Division of Rheumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Perruccio AV, Mahomed NN, Chandran V, Gandhi R. Plasma Adipokine Levels and Their Association with Overall Burden of Painful Joints among Individuals with Hip and Knee Osteoarthritis. J Rheumatol 2013; 41:334-7. [DOI: 10.3899/jrheum.130709] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective.To investigate the association between plasma adipokine levels and the burden of painful joints among individuals with hip and knee osteoarthritis (OA).Methods.Adipokines (leptin, adiponectin, adipsin, resistin) were determined by ELISA (n = 78). Individuals reported painful joints on a homunculus. Associations were examined by sex-stratified Poisson analyses.Results.Adjusted for age, body mass index, and hip/knee OA, higher leptin and adiponectin and lower adipsin levels were associated with greater painful joint burden (i.e., counts) among women (p < 0.01). Among men, higher resistin levels were associated with lower counts (p = 0.03).Conclusion.Findings support the likelihood of a systemic-dependent sex-specific pain burden among individuals with OA.
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Gandhi R, Santone D, Takahashi M, Dessouki O, Mahomed NN. Inflammatory predictors of ongoing pain 2 years following knee replacement surgery. Knee 2013; 20:316-8. [PMID: 23157967 DOI: 10.1016/j.knee.2012.10.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 10/09/2012] [Accepted: 10/20/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The prevalence of unrelieved pain following total knee arthroplasty (TKA) is substantial. OBJECTIVE We asked if cytokine markers of inflammation in preoperative serum or knee synovial fluid (SF) would predict pain 2 years following TKA. METHODS Demographic data and functional outcomes were recorded at baseline and 2 years with the WOMAC index. Serum and SF tissue samples were collected at the time of surgery. Linear regression modeling was used to determine the relationship between SF/serum inflammatory markers and a lesser improvement in self reported pain at two years follow-up. RESULTS Of our 28 patient cohort, significant correlations between serum and SF levels were found for IL-1β (p<0.002), MIP-1β (p<0.001), adiponectin (p<0.001) and leptin (p<0.001). Adjusted analysis showed that greater SF concentrations of TNF-α, MMP-13 and IL-6 were independent predictors of less pain improvement at two years follow-up (p<0.05). CONCLUSIONS Those patients, having ongoing pain despite no clinical or radiological cause, may have an inflammatory profile characterizing a predisposition to ongoing pain after TKA. LEVEL OF EVIDENCE Prognosis study, Level 2.
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Affiliation(s)
- Rajiv Gandhi
- Division of Orthopaedic Surgery, University Health Network, University of Toronto, Toronto ON, Canada.
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Lübbeke A, Finckh A, Puskas GJ, Suva D, Lädermann A, Bas S, Fritschy D, Gabay C, Hoffmeyer P. Do synovial leptin levels correlate with pain in end stage arthritis? INTERNATIONAL ORTHOPAEDICS 2013; 37:2071-9. [PMID: 23835555 DOI: 10.1007/s00264-013-1982-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 06/12/2013] [Indexed: 12/21/2022]
Abstract
PURPOSE We evaluated whether synovial fluid (SF) leptin concentrations correlate with pain severity in patients with hip or knee endstage osteoarthritis (OA) and whether they mediate the association between increased joint pain and (1) female gender and (2) obesity. METHODS We conducted a cross-sectional study including patients with primary hip and knee OA undergoing joint replacement between January and December 2010. SF leptin concentrations obtained on the day of surgery were assessed. Main outcome was pain severity measured pre-operatively using WOMAC and VAS pain scales. RESULTS A total of 219 patients were included, 123 hip and 96 knee arthroplasties. Mean age was 72 years, 59% were women. Mean SF leptin levels were 22.9 (±25.6) ng/ml in women and 5.4 (±5.9) ng/ml in men. Levels >19.6 ng/ml (highest quartile) were significantly associated with increased pain on both WOMAC (mean difference -9.6, 95% CI -15.1 to -4.0) and VAS scale (mean difference 0.8, 95% CI 0.2-1.3). Associations remained unchanged after adjusting for age, co-morbidities, contra-lateral arthritic joint, OA site, and disability. The associations observed between increased pain and female gender or obesity were substantially reduced after adjusting for SF leptin. CONCLUSION Joint pain is associated with SF leptin concentrations. Increased pre-operative pain observed in women and obese may be related to high intra-articular leptin levels.
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Affiliation(s)
- Anne Lübbeke
- Division of Orthopaedics and Trauma Surgery, University of Geneva and Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Genève, Switzerland,
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Samartzis D, Karppinen J, Cheung JPY, Lotz J. Disk degeneration and low back pain: are they fat-related conditions? Global Spine J 2013; 3:133-44. [PMID: 24436864 PMCID: PMC3854598 DOI: 10.1055/s-0033-1350054] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 06/05/2013] [Indexed: 01/30/2023] Open
Abstract
Low back pain (LBP) is the world's most debilitating condition. Disk degeneration has been regarded as a strong determinant associated with LBP. Overweight and obesity are public health concerns that affect every population worldwide and whose prevalence continues to rise. Studies have indicated strong associations between overweight/obesity and disk degeneration as well as with LBP. This broad narrative review article addresses the various mechanisms that may be involved leading to disk degeneration and/or LBP in the setting of overweight/obesity. In particular, our goal is to raise awareness of the role of fat cells and their involvement via altered metabolism or the release of adipokines as well as other pathways that may lead to the development of disk degeneration and LBP. Understanding the role of fat in this process may aid in the development of novel biological therapies and technologies to halt the progression or regenerate the disk. Moreover, with genetic advancements and the appreciation of genetic epidemiology, a more personalized approach to spine care may have to consider the role of fat in any preventative, therapeutic, and/or prognosis modalities toward the disk and LBP.
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Affiliation(s)
- Dino Samartzis
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, SAR, China
| | - Jaro Karppinen
- Department of Physical and Rehabilitation Medicine, Institute of Clinical Medicine, University of Oulu, and Medical Research Center Oulu, Oulu, Finland
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, SAR, China
| | - Jeffrey Lotz
- Department of Orthopaedic Surgery, University of California at San Francisco, San Francisco, California, United States
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Yusuf E, Kloppenburg M. Epidemiological studies on adipokines and osteoarthritis. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/ijr.13.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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