1
|
Legrand J, Marzin C, Neogi T, Norberciak L, Budzik JF, Pascart T. Associations of Changes in Knee Hyaline Cartilage Composition Measured With Dual-Energy Computed Tomography in Gout, Aging and Osteoarthritis. Cartilage 2024; 15:283-292. [PMID: 37312537 DOI: 10.1177/19476035231172152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE To characterize dual-energy computed tomography (DECT) changes depicting hyaline cartilage changes in gout patients with and without osteoarthritis (OA) and in comparators without gout. DESIGN Patients with suspected crystal-associated arthropathy were enrolled and underwent bilateral DECT scans of the knees. Standardized regions of interest were defined in the femorotibial hyaline cartilage. Five DECT parameters were obtained: CT numbers in Hounsfield units (HU) at 80 and 140 kV, the electron density (Rho), the effective atomic number (Zeff), and the dual-energy index (DEI). Zones were compared between patients with gout, with and without knee OA, and between patients with gout and comparators without gout, after adjustment for confounders. RESULTS A total of 113 patients with gout (mean age 63.5 ± 14.3 years) and 15 comparators without gout (mean age 75.8 ± 11.5 years) were included, n = 65 (51%) had knee OA, and 466 zones of hyaline cartilage were analyzed. Older age was associated with lower attenuations at 80 kV (P < 0.01) and 140 kV (P < 0.01), and with Rho (P < 0.01). OA was characterized by lower attenuation at 140 kV (P = 0.03), but the lower Rho was nonsignificant after adjustment for confounders. In gout, hyaline cartilage exhibited lower Rho values (adjusted P = 0.04). Multivariable coefficients of association with Rho were -0.21 [-0.38;-0.04] (P = 0.014) for age, -4.15 [-9.0;0.7] (P = 0.093) for OA and 0.73 [-0.1;1.56] (P = 0.085) for monosodium urate volume. CONCLUSION Gout was associated with DECT-detected changes in cartilage composition, similar to those observed in older patients, with some similarities and some differences to those seen in OA. These results suggest the possibility of potential DECT biomarkers of OA.
Collapse
Affiliation(s)
- Julie Legrand
- Department of Diagnostic and Interventional Imaging, Lille Catholic Hospitals, University of Lille, Lomme, France
- Imaging Department, Saint-Philibert Hospital, Lomme, France
| | - Claire Marzin
- Department of Diagnostic and Interventional Imaging, Lille Catholic Hospitals, University of Lille, Lomme, France
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA
| | - Laurène Norberciak
- Department of Medical Research, Biostatistics, Lille Catholic Hospitals, University of Lille, Lomme, France
| | - Jean-François Budzik
- Department of Diagnostic and Interventional Imaging, Lille Catholic Hospitals, University of Lille, Lomme, France
- MabLab UR4490/Lille and Boulogne-sur-Mer Universities/University of Lille Nord de France, Lomme, France
| | - Tristan Pascart
- MabLab UR4490/Lille and Boulogne-sur-Mer Universities/University of Lille Nord de France, Lomme, France
- Department of Rheumatology, Lille Catholic Hospitals, University of Lille, Lomme, France
| |
Collapse
|
2
|
Chang H, Liu L, Zhang Q, Xu G, Wang J, Chen P, Li C, Guo X, Yang Z, Zhang F. A comparative metabolomic analysis reveals the metabolic variations among cartilage of Kashin-Beck disease and osteoarthritis. Bone Joint Res 2024; 13:362-371. [PMID: 39013544 PMCID: PMC11251783 DOI: 10.1302/2046-3758.137.bjr-2023-0403.r1] [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] [Indexed: 07/18/2024] Open
Abstract
Aims The metabolic variations between the cartilage of osteoarthritis (OA) and Kashin-Beck disease (KBD) remain largely unknown. Our study aimed to address this by conducting a comparative analysis of the metabolic profiles present in the cartilage of KBD and OA. Methods Cartilage samples from patients with KBD (n = 10) and patients with OA (n = 10) were collected during total knee arthroplasty surgery. An untargeted metabolomics approach using liquid chromatography coupled with mass spectrometry (LC-MS) was conducted to investigate the metabolomics profiles of KBD and OA. LC-MS raw data files were converted into mzXML format and then processed by the XCMS, CAMERA, and metaX toolbox implemented with R software. The online Kyoto Encyclopedia of Genes and Genomes (KEGG) database was used to annotate the metabolites by matching the exact molecular mass data of samples with those from the database. Results A total of 807 ion features were identified for KBD and OA, including 577 positive (240 for upregulated and 337 for downregulated) and 230 negative (107 for upregulated and 123 for downregulated) ions. After annotation, LC-MS identified significant expressions of ten upregulated and eight downregulated second-level metabolites, and 183 upregulated and 162 downregulated first-level metabolites between KBD and OA. We identified differentially expressed second-level metabolites that are highly associated with cartilage damage, including dimethyl sulfoxide, uric acid, and betaine. These metabolites exist in sulphur metabolism, purine metabolism, and glycine, serine, and threonine metabolism. Conclusion This comprehensive comparative analysis of metabolism in OA and KBD cartilage provides new evidence of differences in the pathogenetic mechanisms underlying cartilage damage in these two conditions.
Collapse
Affiliation(s)
- Hong Chang
- Shaanxi Provincial Institute for Endemic Disease Control, Xi'an, China
| | - Li Liu
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Qingping Zhang
- Shaanxi Provincial Institute for Endemic Disease Control, Xi'an, China
| | - Gangyao Xu
- Shaanxi Provincial Institute for Endemic Disease Control, Xi'an, China
| | - Jianpeng Wang
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Ping Chen
- Shaanxi Provincial Institute for Endemic Disease Control, Xi'an, China
| | - Cheng Li
- Shaanxi Provincial Institute for Endemic Disease Control, Xi'an, China
| | - Xianni Guo
- Shaanxi Provincial Institute for Endemic Disease Control, Xi'an, China
| | - Zhengjun Yang
- Shaanxi Provincial Institute for Endemic Disease Control, Xi'an, China
| | - Feng Zhang
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
3
|
Zhao J, Sha B, Zeng L, Dou Y, Huang H, Liang G, Pan J, Hong K, Zhou G, Yang W, Liu J. J-shaped association of serum uric acid concentrations with all-cause mortality in individuals with osteoarthritis: A prospective cohort study. Joint Bone Spine 2024; 91:105679. [PMID: 38143017 DOI: 10.1016/j.jbspin.2023.105679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the relationship between serum uric acid (SUA) concentrations and all-cause mortality in individuals with osteoarthritis (OA). METHODS All participant data were retrieved from the National Health and Nutrition Examination Survey database. A total of 4671 participants (age range: 20 to 85 years old), including 2988 females and 1683 males, were included in this study. The determination of death outcome was based on the National Death Index (up to December 31, 2019). We explored the nonlinear relationship between SUA concentrations and all-cause mortality in OA patients by establishing a Cox proportional risk model and a two-segment Cox proportional risk model and ran an interaction test to identify the high-risk population for all-cause mortality. RESULTS During 30,645 person-years of follow-up, the number of all-cause deaths for females and males was 736 and 516, respectively. After multivariate adjustment, we found a nonlinear relationship between SUA concentrations and all-cause mortality in both females and males with OA. In addition, we found a J-shaped relationship between SUA concentrations and all-cause mortality. The SUA concentration thresholds for all-cause mortality of females and males were stable at 5.6mg/dl and 6.2mg/dl, respectively. Compared with SUA concentrations below the inflection point, the all-cause mortality risk at higher SUA concentrations in females and males with OA increased by 20% (hazard ratio [HR]: 1.2, 95% confidence interval [CI]: 1.1 to 1.2) and 25% (HR: 1.2, 95% CI: 1.12 to 1.39), respectively. CONCLUSIONS There is a nonlinear relationship between SUA concentrations and all-cause mortality in the American OA population (J-shaped association). The all-cause mortality thresholds for SUA concentrations in females and males are 5.6mg/dl and 6.2mg/dl, respectively.
Collapse
Affiliation(s)
- Jinlong Zhao
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Bangxin Sha
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Lingfeng Zeng
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Yaoxing Dou
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Hetao Huang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China
| | - Guihong Liang
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Jianke Pan
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China
| | - Kunhao Hong
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; Guangdong Second Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), 510095 Guangzhou, China
| | - Guanghui Zhou
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Weiyi Yang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China.
| | - Jun Liu
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China; The Fifth Clinical College of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; Guangdong Second Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), 510095 Guangzhou, China.
| |
Collapse
|
4
|
Coppola C, Greco M, Munir A, Musarò D, Quarta S, Massaro M, Lionetto MG, Maffia M. Osteoarthritis: Insights into Diagnosis, Pathophysiology, Therapeutic Avenues, and the Potential of Natural Extracts. Curr Issues Mol Biol 2024; 46:4063-4105. [PMID: 38785519 PMCID: PMC11119992 DOI: 10.3390/cimb46050251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/05/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
Osteoarthritis (OA) stands as a prevalent and progressively debilitating clinical condition globally, impacting joint structures and leading to their gradual deterioration through inflammatory mechanisms. While both non-modifiable and modifiable factors contribute to its onset, numerous aspects of OA pathophysiology remain elusive despite considerable research strides. Presently, diagnosis heavily relies on clinician expertise and meticulous differential diagnosis to exclude other joint-affecting conditions. Therapeutic approaches for OA predominantly focus on patient education for self-management alongside tailored exercise regimens, often complemented by various pharmacological interventions primarily targeting pain alleviation. However, pharmacological treatments typically exhibit short-term efficacy and local and/or systemic side effects, with prosthetic surgery being the ultimate resolution in severe cases. Thus, exploring the potential integration or substitution of conventional drug therapies with natural compounds and extracts emerges as a promising frontier in enhancing OA management. These alternatives offer improved safety profiles and possess the potential to target specific dysregulated pathways implicated in OA pathogenesis, thereby presenting a holistic approach to address the condition's complexities.
Collapse
Affiliation(s)
- Chiara Coppola
- Department of Mathematics and Physics “E. De Giorgi”, University of Salento, Via Lecce-Arnesano, 73100 Lecce, Italy; (C.C.); (A.M.)
| | - Marco Greco
- Department of Biological and Environmental Science and Technology, University of Salento, Via Lecce-Monteroni, 73100 Lecce, Italy; (M.G.); (D.M.); (S.Q.); (M.G.L.)
| | - Anas Munir
- Department of Mathematics and Physics “E. De Giorgi”, University of Salento, Via Lecce-Arnesano, 73100 Lecce, Italy; (C.C.); (A.M.)
| | - Debora Musarò
- Department of Biological and Environmental Science and Technology, University of Salento, Via Lecce-Monteroni, 73100 Lecce, Italy; (M.G.); (D.M.); (S.Q.); (M.G.L.)
| | - Stefano Quarta
- Department of Biological and Environmental Science and Technology, University of Salento, Via Lecce-Monteroni, 73100 Lecce, Italy; (M.G.); (D.M.); (S.Q.); (M.G.L.)
| | - Marika Massaro
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy;
| | - Maria Giulia Lionetto
- Department of Biological and Environmental Science and Technology, University of Salento, Via Lecce-Monteroni, 73100 Lecce, Italy; (M.G.); (D.M.); (S.Q.); (M.G.L.)
| | - Michele Maffia
- Department of Experimental Medicine, University of Salento, Via Lecce-Monteroni, 73100 Lecce, Italy
| |
Collapse
|
5
|
Bashekah KA, Zagzoug ME, Banaja AW, Alghamdi AA, Mishiming OS, Jan MA, Kemawi OA, Alharbi BA, Althagafi AA, Aljifri SM. Prevalence and Characteristics of Knee Osteoarthritis Among the General Public in Saudi Arabia. Cureus 2023; 15:e47666. [PMID: 38021677 PMCID: PMC10670982 DOI: 10.7759/cureus.47666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Knee osteoarthritis (OA) is a chronic and progressive knee joint condition that is influenced by multiple factors. This research aims to examine the prevalence and characteristics of knee OA among the general public in Saudi Arabia. Methodology This cross-sectional online survey was conducted in September 2023 in Saudi Arabia. This research used a previously developed questionnaire to validate the diagnosis of OA, which was performed in accordance with the diagnostic criteria established by the American College of Rheumatology (ACR). The Western Ontario and McMaster Universities Arthritis Index questionnaire (WOMAC) was used to examine the severity and characteristics of knee OA patients. A binary logistic regression analysis was conducted to determine the variables that influence the severity of knee OA and the likelihood of developing OA. Results A total of 1,019 individuals participated in this study. Around one-third of the participants (34.5%) fulfilled the ACR criteria for knee OA diagnosis. Overall, the mean WOMAC score was 34.1 (18.8) out of 96, which represents 35.5% of the maximum obtainable score and demonstrates a low degree of knee OA severity. The mean pain sub-scale score was 7.4 (3.8) out of 20, which represents 37.0% of the maximum obtainable score and demonstrates a low level of pain intensity. The mean stiffness sub-scale score was 2.7 (1.8) out of 8, which represents 33.8% of the maximum obtainable score and demonstrates a low degree of stiffness in joints. The mean physical function sub-scale score was 24.0 (14.0) out of 68, which represents 35.3% of the maximum obtainable score and demonstrates a low level of physical function difficulty. Females, older participants (above 40 years), those with high body mass index (28.8 kg/cm2 and higher), non-smokers, those with comorbidities, those who did not practice daily physical activity, those who had a family history of knee OA, and those who suffered from flat feet, rheumatoid arthritis, gout, lupus, or back or hip pain were more likely to develop knee OA and have severe OA (p < 0.05). Conclusions The findings of this study demonstrated a significant prevalence rate of knee OA and highlighted a discrepancy between the rates obtained by diagnostic criteria and those determined through clinical diagnosis. Several significant factors that contribute to the development of OA encompass lifestyle choices such as food and exercise, familial predisposition, genetic influences, and the presence of comorbidities. To effectively tackle this intricate matter, it is imperative to adopt a patient-centered strategy and prioritize early intervention.
Collapse
|
6
|
Xu H, Zhang B, Chen Y, Zeng F, Wang W, Chen Z, Cao L, Shi J, Chen J, Zhu X, Xue Y, He R, Ji M, Hua Y. Type II collagen facilitates gouty arthritis by regulating MSU crystallisation and inflammatory cell recruitment. Ann Rheum Dis 2023; 82:416-427. [PMID: 36109143 DOI: 10.1136/ard-2022-222764] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/03/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Increasing evidence suggests that impaired cartilage is a substantial risk factor for the progression from hyperuricaemia to gout. Since the relationship between cartilage matrix protein and gout flares remains unclear, we investigated its role in monosodium urate (MSU) crystallisation and following inflammation. METHODS Briefly, we screened for cartilage matrix in synovial fluid from gouty arthritis patients with cartilage injuries. After identifying a correlation between crystals and matrix molecules, we conducted image analysis and classification of crystal phenotypes according to their morphology. We then evaluated the differences between the cartilage matrix protein-MSU complex and the pure MSU crystal in their interaction with immune cells and identified the related signalling pathway. RESULTS Type II collagen (CII) was found to be enriched around MSU crystals in synovial fluid after cartilage injury. Imaging analysis revealed that CII regulated the morphology of single crystals and the alignment of crystal bows in the co-crystalline system, leading to greater phagocytosis and oxidative stress in macrophages. Furthermore, CII upregulated MSU-induced chemokine and proinflammatory cytokine expression in macrophages, thereby promoting the recruitment of leucocytes. Mechanistically, CII enhanced MSU-mediated inflammation by activating the integrin β1(ITGB1)-dependent TLR2/4-NF-κB signal pathway. CONCLUSION Our study demonstrates that the release of CII and protein-crystal adsorption modifies the crystal profile and promotes the early immune response in MSU-mediated inflammation. These findings open up a new path for understanding the relationship between cartilage injuries and the early immune response in gout flares.
Collapse
Affiliation(s)
- HanLin Xu
- Department of Sports Medicine, Huashan Hospital,Fudan University, Shanghai, China
| | - Bohan Zhang
- State Key Laboratory of Surface Physics and Department of Physics, Human Phenome Institute, Academy for Engineering and Technology, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Yiwu Research Institute, Fudan University, Shanghai, China
| | - Yaxin Chen
- State Key Laboratory of Surface Physics and Department of Physics, Human Phenome Institute, Academy for Engineering and Technology, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Yiwu Research Institute, Fudan University, Shanghai, China
| | - Fengzhen Zeng
- School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Wenjuan Wang
- Department of Sports Medicine, Huashan Hospital,Fudan University, Shanghai, China
| | - Ziyi Chen
- Department of Sports Medicine, Huashan Hospital,Fudan University, Shanghai, China
| | - Ling Cao
- Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Shi
- School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Jun Chen
- Department of Sports Medicine, Huashan Hospital,Fudan University, Shanghai, China
| | - Xiaoxia Zhu
- Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu Xue
- Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Rui He
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China .,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - MinBiao Ji
- State Key Laboratory of Surface Physics and Department of Physics, Human Phenome Institute, Academy for Engineering and Technology, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Yiwu Research Institute, Fudan University, Shanghai, China
| | - YingHui Hua
- Department of Sports Medicine, Huashan Hospital,Fudan University, Shanghai, China
| |
Collapse
|
7
|
Guedes M, Zhao J, LaMoreaux B, Marder B, Gorlitsky B, Domingues V, Rivara MB, Lew S, Robinson B, Pecoits-Filho R, Karaboyas A. Gout Prevalence, Practice Patterns, and Associations with Outcomes in North American Dialysis Patients. KIDNEY360 2023; 4:54-62. [PMID: 36700904 PMCID: PMC10101580 DOI: 10.34067/kid.0005392022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Gout occurs frequently in patients with kidney disease and can lead to a significant burden on quality of life. Gout prevalence, and its association with outcomes in hemodialysis (HD) and peritoneal dialysis (PD) populations located in North America, is unknown. METHODS We used data from North America cohorts of 70,297 HD patients (DOPPS, 2012-2020) and 5117 PD patients (PDOPPS, 2014-2020). We used three definitions of gout for this analysis: (1) having an active prescription for colchicine or febuxostat; (2) having an active prescription for colchicine, febuxostat, or allopurinol; or (3) having an active prescription for colchicine, febuxostat, or allopurinol, or prior diagnosis of gout. Propensity score matching was used to compare outcomes among patients with versus without gout. Outcomes included erythropoietin resistance index (ERI=erythropoiesis stimulating agent dose per week/(hemoglobin×weight)), all-cause mortality, hospitalization, and patient-reported outcomes (PROs). RESULTS The gout prevalence was 13% in HD and 21% in PD; it was highest among incident dialysis patients. Description of previous history of gout was rare, and identification of gout defined by colchicine (2%-3%) or febuxostat (1%) prescription was less frequent than by allopurinol (9%-12%). Both HD and PD patients with gout (versus no gout) were older, were more likely male, had higher body mass index, and had higher prevalence of cardiovascular comorbidities. About half of patients with a gout history were prescribed urate-lowering therapy. After propensity score matching, mean ERI was 3%-6% higher for gout versus non-gout patients while there was minimal evidence of association with clinical outcomes or PROs. CONCLUSION In a large cohort of PD and HD patients in North America, we found that gout occurs frequently and is likely under-reported. Gout was not associated with adverse clinical or PROs.
Collapse
Affiliation(s)
- Murilo Guedes
- School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | - Junhui Zhao
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | | | | | | | | | - Matthew B. Rivara
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
| | - Susie Lew
- Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, Washington, DC
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Roberto Pecoits-Filho
- School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | | |
Collapse
|
8
|
Chen D, Xu H, Sun L, Li Y, Wang T, Li Y. Assessing causality between osteoarthritis with urate levels and gout: a bidirectional Mendelian randomization study. Osteoarthritis Cartilage 2022; 30:551-558. [PMID: 34896305 DOI: 10.1016/j.joca.2021.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/04/2021] [Accepted: 12/02/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The bidirectional association between osteoarthritis (OA) and urate levels and gout, though well-documented, is inconclusive. This Mendelian randomization (MR) study aims to examine the bidirectional causality between OA and urate levels as well as gout. METHODS We used summary statistics data for serum urate levels from 288,649 CKDGen participants and gout from 69,374 Global Urate Genetics Consortium participants. The summary statistics data for OA were obtained from genome-wide association studies including up to 826,690 participants of mainly European ancestry. MR was performed using established analytical methods including the Wald ratio, inverse variance weighted (IVW), weighted median (WM) and MR-Egger. RESULTS Genetically determined urate levels [IVW odds ratio (OR) = 0.99, 95% confidence interval (CI) = 0.96, 1.02, P = 0.484] and gout (Wald ratio OR = 1.00, 95% CI = 0.98, 1.02, P = 0.908) were not associated with the risk of total OA. In site-specific OA analyses, there was no causal effect of urate levels on knee, hip, spine, thumb and hand OA, and no evidence was provided that gout increased the risk of OA at any site. In the reverse MR analyses, we found no causal effect of total OA on urate levels (IVW Beta = -0.011, 95% CI = -0.095, 0.074, P = 0.807) or gout (IVW OR = 1.05, 95% CI = 0.66, 1.68, P = 0.839). A null effect of site-specific OA was also observed. CONCLUSION Our MR study supports no bidirectional causal effect of urate levels and gout on total and site-specific OA.
Collapse
Affiliation(s)
- D Chen
- School of Public Health, Hangzhou Medical College, Hangzhou, 310053, China
| | - H Xu
- School of Public Health, Hangzhou Medical College, Hangzhou, 310053, China
| | - L Sun
- Department of Orthopaedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Y Li
- Department of Rheumatology and Immunology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - T Wang
- Department of Rheumatology and Immunology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Y Li
- School of Public Health, Hangzhou Medical College, Hangzhou, 310053, China.
| |
Collapse
|
9
|
Go DJ, Kim DH, Kim JY, Guermazi A, Crema MD, Hunter DJ, Kim HA. Serum uric acid and knee osteoarthritis in community residents without gout: a longitudinal study. Rheumatology (Oxford) 2021; 60:4581-4590. [PMID: 33493331 DOI: 10.1093/rheumatology/keab048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/26/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Emerging evidence suggests a potential link between OA and gout; however, the association between serum uric acid (UA) itself and knee OA remains uncertain due to a lack of longitudinal studies. Here, we investigated the association between serum UA and knee OA according to cartilage status in elderly community residents without gout. METHODS In this longitudinal study, participants without a history of gout were recruited from among the Korean cohort of the Hallym Aging Study (n = 296 for radiography study and n = 223 for MRI study). Weight-bearing knee radiographs and 1.5-T MRI scans, along with blood collection for analysis of serum UA, were performed at baseline and after 3 years. The severity and structural progression of knee OA were evaluated using the Kellgren-Lawrence grading system and the Whole-Organ MRI Score (WORMS) cartilage scoring method. Multivariable logistic regression analysis was conducted using generalized estimating equation (GEE) models. RESULTS Serum UA levels were not associated with radiographic progression after adjusting for age, sex and BMI. There was no significant association between serum UA and tibiofemoral cartilage loss on MRI. However, baseline serum UA levels were negatively associated with patellofemoral cartilage loss over 3 years (adjusted odd ratio 0.70 per 1 mg/dl increase, 95% CI: 0.49, 0.98). CONCLUSION In this population-based cohort, serum UA was not a risk factor for knee OA progression. Further large-scale longitudinal studies in other populations are needed to validate the effects of UA on cartilage damage.
Collapse
Affiliation(s)
- Dong Jin Go
- Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul
| | - Dong Hyun Kim
- Department of Social and Preventive Medicine, Hallym Research Institute of Clinical Epidemiology, Hallym University, Chuncheon
| | - Jie Young Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang.,Institute for Skeletal Aging, Hallym University, Chuncheon, Republic of Korea
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Michel Daoud Crema
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, Australia
| | - Hyun Ah Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang.,Institute for Skeletal Aging, Hallym University, Chuncheon, Republic of Korea
| |
Collapse
|
10
|
Zhu M, Pan J, Hu X, Zhang G. Epicatechin Gallate as Xanthine Oxidase Inhibitor: Inhibitory Kinetics, Binding Characteristics, Synergistic Inhibition, and Action Mechanism. Foods 2021; 10:2191. [PMID: 34574301 PMCID: PMC8464939 DOI: 10.3390/foods10092191] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 01/03/2023] Open
Abstract
Epicatechin gallate (ECG) is one of the main components of catechins and has multiple bioactivities. In this work, the inhibitory ability and molecular mechanism of ECG on XO were investigated systematically. ECG was determined as a mixed xanthine oxidase (XO) inhibitor with an IC50 value of 19.33 ± 0.45 μM. The promotion of reduced XO and the inhibition of the formation of uric acid by ECG led to a decrease in O2- radical. The stable ECG-XO complex was formed by hydrogen bonds and van der Waals forces, with the binding constant of the magnitude of 104 L mol-1, and ECG influenced the stability of the polypeptide skeleton and resulted in a more compact conformation of XO. Computational simulations further characterized the binding characteristics and revealed that the inhibitory mechanism of ECG on XO was likely that ECG bound to the vicinity of flavin adenine dinucleotide (FAD) and altered the conformation of XO, hindering the entry of substrate and the diffusion of catalytic products. ECG and allopurinol bound to different active sites of XO and exerted a synergistic inhibitory effect through enhancing their binding stability with XO and changing the target amino acid residues of XO. These findings may provide a theoretical basis for the further application of ECG in the fields of food nutrition and functional foods.
Collapse
Affiliation(s)
| | | | | | - Guowen Zhang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China; (M.Z.); (J.P.); (X.H.)
| |
Collapse
|
11
|
Słowiak J, Szczygielski T, Rothschild BM, Surmik D. Dinosaur senescence: a hadrosauroid with age-related diseases brings a new perspective of "old" dinosaurs. Sci Rep 2021; 11:11947. [PMID: 34117305 PMCID: PMC8196189 DOI: 10.1038/s41598-021-91366-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/26/2021] [Indexed: 02/05/2023] Open
Abstract
Senile vertebrates are extremely rare in the fossil record, making their recognition difficult. Here we present the largest known representative of the Late Cretaceous hadrosauriform Gobihadros mongoliensis showing features of cessation of growth indicating attainment of the terminal size. Moreover, this is the first non-avian dinosaur with an age-related pathology recognized as primary calcium pyrophosphate deposition disease indicating its advanced age. Because senile dinosaurs are so rare and thus "senescence" in dinosaurs is unclear, we also propose a new unified definition of a senile dinosaur: an individual which achieved the terminal size as revealed by the presence of the external fundamental system and closed transcortical channels, has completely secondary remodeled weight-bearing bones and possesses non-traumatic, non-contagious bone pathologies correlated with advanced age.
Collapse
Affiliation(s)
- Justyna Słowiak
- Institute of Paleobiology, Polish Academy of Sciences, Twarda 51/55, 00-818, Warsaw, Poland
| | - Tomasz Szczygielski
- Institute of Paleobiology, Polish Academy of Sciences, Twarda 51/55, 00-818, Warsaw, Poland.
| | - Bruce M Rothschild
- Carnegie Museum of Natural History, 4400 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Dawid Surmik
- Institute of Earth Sciences, Faculty of Natural Sciences, University of Silesia, Będzińska 60, 41-200, Sosnowiec, Poland
| |
Collapse
|
12
|
Bassiouni SARAK, El Adalany MA, Abdelsalam M, Gharbia OM. Association of serum uric acid with clinical and radiological severity of knee osteoarthritis in non-gouty patients. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-020-00055-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Abstract
Background
A growing body of evidence suggested that uric acid (UA) may contribute in the pathways underlying osteoarthritis (OA) pathogenesis; however, studies that investigated the relationship between UA and OA emerged inconclusive results. The purpose of the study was to explore the association of serum uric acid (sUA) levels with clinical severity, radiological severity of knee osteoarthritis (KOA) based on Kellgren-Lawrence (KL) grading system, and MRI changes in non-gouty patients.
Results
WOMAC scores: pain, stiffness, function, and total score are significantly higher in H-sUA group than L-sUA group (p = 0.004, p = 0.019, p = 0.018, p = 0.008 respectively). Joint space width (JSW) is significantly narrower in H-sUA group than L-sUA group (p = 0.013). H-sUA group had more frequent KL grade 4 (p < 0.001), osteophytes grade 4 (p < 0.001), focal bone erosion (p < 0.001), bone marrow lesions (p = 0.023), and synovitis (p = 0.011) than L-sUA group. Female KOA patients in H-sUA group had significantly higher pain, stiffness, and function and total WOMAC scores than L-sUA group (p = 0.003, p = 0.015, p = 0.008, p = 0.004), more frequently had KL grade 4 and osteophytes grade 4 (p = 0.003, p < 0.001), significantly narrower JSW (p = 0.016), more frequently show focal bone erosion (p = 0.002), bone marrow lesions (p = 0.019), and synovitis (p = 0.004) than L-sUA group. In regression analysis, female sex (p = 0.035), duration of KOA (p = 0.031), and sUA level (p = 0.025) were associated with KL severity. For female patients with KOA, KL severity is associated with duration of KOA (p = 0.045) and sUA (p = 0.009).
Conclusion
Higher sUA level is associated with higher clinical severity, higher radiographic KL grades, and more frequent MRI findings in patients with primary KOA patients. Our results also indicated that sUA level was significantly associated with KOA severity in female patients, but not in male patients. More studies are warranted to explore whether the two conditions exist simultaneously or there is a direct causal relationship between the two conditions.
Collapse
|
13
|
Alyami AH, Alswat MM, Omer IA, Ahmed MEH, Alshammari SH, Alsaggaf KW, Amoudi JH, Aljafari DA. General population knowledge about osteoarthritis and its related risk factors in Jeddah Saudi Arabia. Saudi Med J 2021; 41:516-523. [PMID: 32373919 PMCID: PMC7253844 DOI: 10.15537/smj.2020.5.25061] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objectives: To identify the knowledge gap and misconceptions about osteoarthritis (OA) and its risk factors among the general population of Jeddah, Saudi Arabia. Methods: This is a cross-sectional study conducted Jeddah, Saudi Arabia, between 11-13 April, 2019. The study was approved by King Abdullah International Medical Research Center. A representative sample of the public in well-known mall was asked to complete the questionnaire to assess their knowledge regarding OA. The questionnaire consisted of 3 parts: 1) demographic data, 2) general knowledge regarding OA, and 3) a quiz of 20 questions. A descriptive analysis was carried out with t-test and F-test-based method. Results: The study had 1238 respondents. Approximately 55% of them were females, with 51.8% between the ages of 18 to 29. Approximately 62% held a bachelor’s degree and 63% had a family member or a friend afflicted with OA. Relatives and friends were the main source of information regarding OA. Only 37% correctly identified the mechanism behind OA. The mean score for the 20-item quiz was 9.84. No significant differences were found when comparing scores of males and females or those of age groups. However, significant differences in scores were identified between respondents of varying educational levels (p<0.001), participants’ knowledge of the mechanism leading to OA (p<0.001), information sources (p<0.001), and knowing someone with it (p<0.001). Conclusion: The results of our study suggest a low level of knowledge regarding OA among Jeddah population. Many misconceptions regarding OA were identified, so more information be brought to the public.
Collapse
Affiliation(s)
- Ali H Alyami
- Orthopedic Division, Department of Surgery, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Lee YH, Tsou HK, Kao SL, Gau SY, Bai YC, Lin MC, Wei JCC. Patients With Rheumatoid Arthritis Increased Risk of Developing Osteoarthritis: A Nationwide Population-Based Cohort Study in Taiwan. Front Med (Lausanne) 2020; 7:392. [PMID: 33015077 PMCID: PMC7511507 DOI: 10.3389/fmed.2020.00392] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/23/2020] [Indexed: 01/12/2023] Open
Abstract
Objective: To investigate the risk of developing OA in patients diagnosed with RA. Methods: In this study, we presented gender, age, urbanization, occupation and, comorbidities in a RA cohort and a non-RA cohort based on number and percentage. We investigated the OA risk in patients with RA. We conducted a retrospective cohort study with a 13-year longitudinal follow-up in Taiwan. Patients who received RA diagnoses between 2000 and 2012 were enrolled in the study cohort. The non-RA cohort were 1:1 propensity score matched with the RA cohort by age, gender, index year, urbanization, occupation, and comorbidities. The hazard ratios (HRs) and adjusted HRs (aHRs) were estimated after confounders were adjusted. Sensitivity analysis utilizing the Longitudinal Health Insurance Database (LHID) was conducted. Results: We totally enrolled 63,626 cases in RA patients (study cohort) and matched controls. In the RA cohort, the crude HR for OA was 2.86 (95% confidence interval (CI), 2.63–3.11, p < 0.001), and the aHR was 2.75 (95% CI, 2.52–2.99, p < 0.001). (The study demonstrated that patients with RA had a higher risk for developing OA compared with the non-RA controls. Conclusion: Developing effective OA prevention strategies are necessary in patients with RA. This finding may be extended to evaluate the risk of OA among other kinds of inflammatory autoimmune diseases. Identifying the key pathogenesis mechanisms are necessary in the future study.
Collapse
Affiliation(s)
- Yung-Heng Lee
- Department of Health Services Administration, China Medical University, Taichung, Taiwan.,Department of Public Health, China Medical University, Taichung, Taiwan.,Department of Orthopedics, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan.,Department of Center for General Education, National United University, Miaoli, Taiwan
| | - Hsi-Kai Tsou
- Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Houlong, Taiwan
| | - Su-Ling Kao
- Department of Human Resource, Cishan General Hospital, Kaohsiung, Taiwan
| | - Shuo-Yan Gau
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Chiao Bai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Department of Rheumatology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| |
Collapse
|
15
|
Lee YH, Song GG. The Uric Acid and Gout have No Direct Causality With Osteoarthritis: A Mendelian Randomization Study. JOURNAL OF RHEUMATIC DISEASES 2020. [DOI: 10.4078/jrd.2020.27.2.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Young Ho Lee
- Department of Rheumatology, Korea University College of Medicine, Seoul, Korea
| | - Gwan Gyu Song
- Department of Rheumatology, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
16
|
Neogi T, Krasnokutsky S, Pillinger MH. Urate and osteoarthritis: Evidence for a reciprocal relationship. Joint Bone Spine 2019; 86:576-582. [PMID: 30471419 PMCID: PMC6531371 DOI: 10.1016/j.jbspin.2018.11.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/17/2018] [Accepted: 11/09/2018] [Indexed: 01/02/2023]
Abstract
Hyperuricemia is a common condition, and in a subset of patients leads to gout, the most common inflammatory arthritis. Osteoarthritis is the most common form of arthritis overall, and gout and osteoarthritis frequently coexist in the same patient. However, the relationship between the two remains poorly defined. More particularly, the impact of osteoarthritis on the development of gout, and the impact of gout on the development of osteoarthritis, remain to be determined. Additionally, whether hyperuricemia mediates osteoarthritis in the absence of gout is uncertain. Here, we review the evidence linking gout and osteoarthritis, with a special focus on the role of hyperuricemia in the presence or absence of gout. Since disease modifying agents are currently available for hyperuricemia and gout but not for osteoarthritis, a contributory role for urate in the pathogenesis of osteoarthritis could have important clinical implications.
Collapse
Affiliation(s)
- Tuhina Neogi
- Sections of Clinical Epidemiology and Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Svetlana Krasnokutsky
- Rheumatology Section, Department of Medicine, New York Harbor Health Care System, New York Campus, US Department of Veterans Affairs, New York, NY, 10003, USA; Crystal Diseases Study Group, Division of Rheumatology, Department of Medicine, New York University School of Medicine/NYU Langone Health, New York, NY, 10016, USA
| | - Michael H Pillinger
- Rheumatology Section, Department of Medicine, New York Harbor Health Care System, New York Campus, US Department of Veterans Affairs, New York, NY, 10003, USA; Crystal Diseases Study Group, Division of Rheumatology, Department of Medicine, New York University School of Medicine/NYU Langone Health, New York, NY, 10016, USA; NYU Langone Orthopedic Hospital, 301 East 17th Street, Suite 1410, New York, NY 10003, USA.
| |
Collapse
|
17
|
Haj-Mirzaian A, Mohajer B, Guermazi A, Shakoor D, Haugen IK, Roemer FW, Demehri S. Heberden's Nodes and Knee Osteoarthritis-Related Osseous Structural Damage: Exploratory Study From the Osteoarthritis Initiative. Arthritis Rheumatol 2019; 71:935-940. [PMID: 30623610 DOI: 10.1002/art.40811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 12/04/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore whether Heberden's nodes (HNs) could predict magnetic resonance imaging (MRI)-based knee osteoarthritis (OA)-related osseous structural progression. METHODS Five hundred seventy-five subjects from the Foundation for the National Institutes of Health project underwent clinical examination to evaluate HNs at baseline and knee MRI at baseline and 24 months. The MRI was read according to the semiquantitative MRI OA Knee Score and quantitative periarticular bone morphology measures. Adjusted linear/logistic regression models were implemented to assess the association between the presence of HNs at baseline examination and worsening of MRI-defined osseous structural damage, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated. RESULTS Comparing patients with HNs (n = 395) and patients without HNs (n = 180), more periarticular bone area expansion in the knee joint was seen in the patients with HNs over 24 months (adjusted OR [ORadj ] 1.39 [95% CI 1.06, 1.83], corrected P [Pcorr ] = 0.019), especially in the medial femur (ORadj 1.49 [95% CI 1.05, 2.13], Pcorr = 0.026) and lateral femur (ORadj 2.51 [95% CI 1.58, 3.97], Pcorr < 0.001), femoral notch (ORadj 1.37 [95% CI 1.02, 1.84], Pcorr = 0.04), and lateral trochlea (ORadj 1.44 [95% CI 1.08, 1.9], Pcorr = 0.012). However, a trend toward less osteophyte worsening was seen in patients with HNs in the whole knee joint (ORadj 0.63 [95% CI 0.40, 1.02], Pcorr = 0.058), particularly in the femur region (ORadj 0.54 [95% CI 0.31, 0.95], Pcorr = 0.03), compared to patients without HNs. CONCLUSION The presence of HNs was associated with increased MRI-based periarticular bone area expansion, but less osteophyte worsening over 24 months in the knee joint, especially in the femoral region.
Collapse
Affiliation(s)
| | | | - Ali Guermazi
- Boston University School of Medicine, Boston, Massachusetts
| | - Delaram Shakoor
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Frank W Roemer
- Boston University School of Medicine, Boston, Massachusetts, and University of Erlangen-Nuremberg, Erlangen, Germany
| | - Shadpour Demehri
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
18
|
Bieber A, Schlesinger N, Fawaz A, Mader R. Chronic tophaceous gout as the first manifestation of gout in two cases and a review of the literature. Semin Arthritis Rheum 2018; 47:843-848. [DOI: 10.1016/j.semarthrit.2017.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/03/2017] [Accepted: 11/22/2017] [Indexed: 12/28/2022]
|
19
|
Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective - A review. J Adv Res 2017; 8:495-511. [PMID: 28748116 PMCID: PMC5512152 DOI: 10.1016/j.jare.2017.04.008] [Citation(s) in RCA: 264] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/11/2017] [Accepted: 04/13/2017] [Indexed: 12/11/2022] Open
Abstract
Gout is a picturesque presentation of uric acid disturbance. It is the most well understood and described type of arthritis. Its epidemiology is studied. New insights into the pathophysiology of hyperuricemia and gouty arthritis; acute and chronic allow for an even better understanding of the disease. The role of genetic predisposition is becoming more evident. The clinical picture of gout is divided into asymptomatic hyperuricemia, acute gouty arthritis, intercritical period, and chronic tophaceous gout. Diagnosis is based on laboratory and radiological features. The gold standard of diagnosis is identification of characteristic MSU crystals in the synovial fluid using polarized light microscopy. Imaging modalities include conventional radiography, ultrasonography, conventional CT, Dual-Energy CT, Magnetic Resonance Imaging, nuclear scintigraphy, and positron emission tomography. There is remarkable progress in the application of ultrasonography and Dual-Energy CT which is bound to influence the diagnosis, staging, follow-up, and clinical research in the field. Management of gout includes management of flares, chronic gout and prevention of flares, as well as management of comorbidities. Newer drugs in the pharmacological armamentarium are proving successful and supplement older ones. Other important points in its management include patient education, diet and life style changes, as well as cessation of hyperuricemic drugs.
Collapse
Affiliation(s)
- Gaafar Ragab
- Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Egypt
| | - Mohsen Elshahaly
- Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine, Suez Canal University, Egypt
| | - Thomas Bardin
- Rhumatologie, Lariboisière Hospital, and Université Paris Diderot Sorbonne Cité, Paris, France
| |
Collapse
|
20
|
Krasnokutsky S, Oshinsky C, Attur M, Ma S, Zhou H, Zheng F, Chen M, Patel J, Samuels J, Pike VC, Regatte R, Bencardino J, Rybak L, Abramson S, Pillinger MH. Serum Urate Levels Predict Joint Space Narrowing in Non-Gout Patients With Medial Knee Osteoarthritis. Arthritis Rheumatol 2017; 69:1213-1220. [PMID: 28217895 DOI: 10.1002/art.40069] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 02/07/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The pathogenesis of osteoarthritis (OA) includes both mechanical and inflammatory features. Studies have implicated synovial fluid uric acid (UA) as a potential OA biomarker, possibly reflecting chondrocyte damage. Whether serum UA levels reflect/contribute to OA is unknown. We investigated whether serum UA levels predict OA progression in a non-gout knee OA population. METHODS Eighty-eight patients with medial knee OA (body mass index [BMI] <33 kg/m2 ) but without gout were studied. Baseline serum UA levels were measured in previously banked serum samples. At 0 and 24 months, patients underwent standardized weight-bearing fixed-flexion posteroanterior knee radiography to determine joint space width (JSW) and Kellgren/Lawrence grades. Joint space narrowing (JSN) was calculated as the change in JSW from 0 to 24 months. Twenty-seven patients underwent baseline contrast-enhanced 3T knee magnetic resonance imaging for assessment of synovial volume. RESULTS Serum UA levels correlated with JSN values in both univariate (r = 0.40, P < 0.01) and multivariate (r = 0.28, P = 0.01) analyses. There was a significant difference in mean JSN after dichotomization at a serum UA cut point of 6.8 mg/dl, the solubility point for serum urate, even after adjustment (JSN of 0.90 mm for a serum UA ≥6.8 mg/dl and 0.31 mm for a serum UA <6.8 mg/dl; P < 0.01). Baseline serum UA levels distinguished progressors (JSN >0.2 mm) and fast progressors (JSN >0.5 mm) from nonprogressors (JSN ≤0.0 mm) in multivariate analyses (area under the receiver operating characteristic curve 0.63 [P = 0.03] and 0.62 [P = 0.05], respectively). Serum UA levels correlated with the synovial volume (r = 0.44, P < 0.01), a possible marker of JSN, although this correlation did not persist after controlling for age, sex, and BMI (r = 0.13, P = 0.56). CONCLUSION In non-gout patients with knee OA, the serum UA level predicted future JSN and may serve as a biomarker for OA progression.
Collapse
Affiliation(s)
| | | | - Mukundan Attur
- New York University School of Medicine, New York, New York
| | - Sisi Ma
- New York University School of Medicine, New York, New York
| | - Hua Zhou
- New York University School of Medicine, New York, New York
| | - Fangfei Zheng
- New York University School of Medicine, New York, New York
| | - Meng Chen
- New York University School of Medicine, New York, New York
| | - Jyoti Patel
- New York University School of Medicine, New York, New York
| | | | | | | | | | - Leon Rybak
- New York University School of Medicine, New York, New York
| | | | | |
Collapse
|