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Chen Z, Zhang S, Duan P, Yin Z, Dong S, Pang R, Tan H. Intra-articular injection of ascorbic acid enhances microfracture-mediated cartilage repair. Sci Rep 2024; 14:3811. [PMID: 38361039 PMCID: PMC10869716 DOI: 10.1038/s41598-024-54514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/13/2024] [Indexed: 02/17/2024] Open
Abstract
Previous studies have confirmed that ascorbic acid (AA) can promote cartilage repair and improve cartilage differentiation in bone marrow mesenchymal stem cells. However, the use of microfracture (MFX) combined with AA to repair cartilage damage has not been studied. This study established a rabbit animal model and treated cartilage injury with different concentrations of AA combined with MFX. Macroscopic observations, histological analysis, immunohistochemical analysis and reverse transcription quantitative polymerase chain reaction analysis of TGF-β, AKT/Nrf2, and VEGF mRNA expression were performed. The results showed that intra-articular injection of AA had a positive effect on cartilage repair mediated by microfractures. Moreover, 10 mg/ml AA was the most effective at promoting cartilage repair mediated by microfractures. Intra-articular injection of AA promoted the synthesis of type II collagen and the formation of glycosaminoglycans by downregulating the mRNA expression of TGF-β and VEGF. In summary, this study confirmed that AA could promote cartilage repair after MFX surgery.
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Affiliation(s)
- Zhian Chen
- Graduate School, Kunming Medical University, Kunming City, Yunnan Province, China
| | - Sihe Zhang
- Department of Cell Biology, School of Medicine, Nankai University, Tianjin, China
| | - Peiya Duan
- Neurology Department, Longling County People's Hospital, Baoshan City, Yunnan Province, China
| | - Zhengbo Yin
- Graduate School, Kunming Medical University, Kunming City, Yunnan Province, China
| | - Shuangbin Dong
- Graduate School, Kunming Medical University, Kunming City, Yunnan Province, China
| | - Rongqing Pang
- Basic Medical Laboratory, People's Liberation Army Joint Logistic Support Force 920th Hospital, Kunming City, Yunnan Province, China.
| | - Hongbo Tan
- Department of Orthopaedics, People's Liberation Army Joint Logistic Support Force 920th Hospital, Kunming City, Yunnan Province, China.
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Saengsiwaritt W, Ngamtipakon P, Udomsinprasert W. Vitamin D and autophagy in knee osteoarthritis: A review. Int Immunopharmacol 2023; 123:110712. [PMID: 37523972 DOI: 10.1016/j.intimp.2023.110712] [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: 05/05/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/02/2023]
Abstract
Knee osteoarthritis (KOA), the highly prevalent degenerative disease affecting the joint, perpetually devastates the health of the elderly. Of various mechanisms known to participate in KOA etiology, apoptosis of chondrocytes is widely regarded as the primary cause of cartilage degradation. It has been suggested that the induction of autophagy in chondrocytes could potentially prolong the progression of KOA by modulating intracellular metabolic processes, which may be helpful for ameliorating chondrocyte apoptosis and eventual cartilage degeneration. Autophagy, a physiological process characterized by intracellular self-degradation, has been reportedly implicated in various pathologic conditions including KOA. Interestingly, vitamin D has been shown to regulate autophagy in human chondrocytes through multiple pathways, specifically AMPK/mTOR signaling pathway. This observation underscores the potential of vitamin D as a novel approach for restoring the functionality and survivability of chondrocytes in KOA. Supporting vitamin D's clinical significance, previous studies have demonstrated its substantial involvement in the symptoms and irregular joint morphology observed in KOA patients, strengthening potential therapeutic efficacy of vitamin D in treatment of KOA. Herein, the purpose of this review was to determine the mechanisms underlying the multi-processes of vitamin D implicated in autophagy in several cells including chondrocytes, which would bring unique insights into KOA pathogenesis.
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Affiliation(s)
| | - Phatchana Ngamtipakon
- Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
| | - Wanvisa Udomsinprasert
- Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.
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Kenny L, Brown L, Ortea P, Tuytten R, Kell D. Relationship between the concentration of ergothioneine in plasma and the likelihood of developing pre-eclampsia. Biosci Rep 2023; 43:BSR20230160. [PMID: 37278746 PMCID: PMC10326187 DOI: 10.1042/bsr20230160] [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: 01/23/2023] [Revised: 03/22/2023] [Accepted: 06/06/2023] [Indexed: 06/07/2023] Open
Abstract
Ergothioneine, an antioxidant nutraceutical mainly at present derived from the dietary intake of mushrooms, has been suggested as a preventive for pre-eclampsia (PE). We analysed early pregnancy samples from a cohort of 432 first time mothers as part of the Screening for Endpoints in Pregnancy (SCOPE, European branch) project to determine the concentration of ergothioneine in their plasma. There was a weak association between the ergothioneine levels and maternal age but none for BMI. Of these 432 women, 97 went on to develop pre-term (23) or term (74) PE. If a threshold was set at the 90th percentile of the reference range in the control population (≥462 ng/ml), only one of these 97 women (1%) developed PE, versus 96/397 (24.2%) whose ergothioneine level was below this threshold. One possible interpretation of these findings, consistent with previous experiments in a reduced uterine perfusion model in rats, is that ergothioneine may indeed prove protective against PE in humans. An intervention study of some kind now seems warranted.
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Affiliation(s)
- Louise C. Kenny
- Department of Women’s and Children’s Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L7 8TX, U.K
| | | | | | | | | | - Douglas B. Kell
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown St, Liverpool L69 7BX, U.K
- Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Kemitorvet 200, 2800 Kgs Lyngby, Denmark
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Shahid A, Inam‐Ur‐Raheem M, Iahtisham‐Ul‐Haq , Nawaz MY, Rashid MH, Oz F, Proestos C, Aadil RM. Diet and lifestyle modifications: An update on non‐pharmacological approach in the management of osteoarthritis. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.16786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Arashi Shahid
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
| | - Muhammad Inam‐Ur‐Raheem
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
| | - Iahtisham‐Ul‐Haq
- Kauser Abdulla Malik School of Life Sciences Forman Christian College (A Chartered University) Punjab Pakistan
| | - Muhammad Yasir Nawaz
- Department of Pathology Faculty of Veterinary Science, University of Agriculture Faisalabad Faisalabad Pakistan
| | - Muhammad Hamdan Rashid
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
| | - Fatih Oz
- Department of Food Engineering, Faculty of Agriculture Ataturk University Erzurum Turkey
| | - Charalampos Proestos
- Laboratory of Food Chemistry, Department of Chemistry National and Kapodistrian University of Athens Zografou Athens Greece
| | - Rana Muhammad Aadil
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
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Xu C, Wang S, Ti W, Yang J, Yasen Y, Memetsidiq M, Shi SQ. Role of dietary patterns and factors in determining the risk of knee osteoarthritis: A meta-analysis. Mod Rheumatol 2021; 32:815-821. [PMID: 34918108 DOI: 10.1093/mr/roab059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/28/2021] [Accepted: 08/07/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluates the role of diet in determining knee osteoarthritis risk. METHODS Literature search was conducted in Ovid, PubMed, Science Direct, and Springer. To estimate knee osteoarthritis risk with high use of vegetarian, prudent, and omnivorous diets, dairy products, vitamin C/E, and carotenoids, the odds ratios (ORs) or relative risks (RRs) reported by included studies were pooled. RESULTS Fifteen studies (97,157 individuals) were included. High use of vegetarian diet {OR 0.71 [95% confidence interval (CI): 0.45, 0.97]}, prudent diet [OR 0.87 (95% CI: 0.76, 0.98)/RR 0.89 (95% CI: 0.82, 0.97)], and dairy [OR 0.66 (95% CI: -0.08, 1.39)/RR 0.58 (95% CI: 0.41, 0.75)] were associated with lower risk of knee osteoarthritis but risk was relatively higher with high use of omnivorous diet [OR 1.13 (95% CI: 0.95, 1.30)/RR 1.06 (95% CI: 0.84, 1.29) and 1.05 (0.78, 1.33)]. High intake of vitamin C [OR 0.92 (0.29, 1.56)] or E [OR 0.93 (0.64, 1.21)] did not reduce knee osteoarthritis risk, but high use of carotenoids was associated with the lower risk [OR 0.66 (0.37, 0.96)]. CONCLUSIONS Knee osteoarthritis risk is low with high use of vegetarian diet, prudent diet, and dairy, but cannt be reduced by high intakes of vitamin C/E.
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Affiliation(s)
- Chao Xu
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Shun Wang
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Weiye Ti
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Jun Yang
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Yalikun Yasen
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Miryaqup Memetsidiq
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Song-Qing Shi
- Department of Orthopaedics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People's Hospital of Zhejiang Province, Yuyao, Zhejiang, China
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A Mendelian randomization study on the role of serum parathyroid hormone and 25-hydroxyvitamin D in osteoarthritis. Osteoarthritis Cartilage 2021; 29:1282-1290. [PMID: 33975017 DOI: 10.1016/j.joca.2021.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Serum parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] have been demonstrated to be associated with pathogenesis and progression of osteoarthritis (OA). This study aimed to determine the potential causal relationship between serum PTH and 25(OH)D levels and risk of OA. DESIGN We applied the two-sample Mendelian randomization (MR) approach to estimate the causal roles of serum PTH and 25(OH)D on OA. The instrumental variables for serum PTH and 25(OH)D were derived from two large genome-wide association studies (GWAS), which included 29,155 and 79,366 individuals, respectively. Summary-level data for overall, hip and knee OA were extracted from a GWAS meta-analysis, including 455,221 individuals. All participants included in this study were from the European population. RESULTS An inverse association was observed between serum PTH levels and risk of OA (random-effects: Effect = 0.71; 95% CI: 0.54 to 0.92; fixed-effects: Effect = 0.71; 95% CI: 0.61 to 0.82). Stratified by site, serum PTH levels were found to be inversely associated with knee OA (random-effects: Effect = 0.53; 95% CI: 0.41 to 0.68; fixed-effects: Effect = 0.53; 95% CI: 0.41 to 0.68). However, there was no evidence of the causal effect of serum 25(OH)D levels on OA. CONCLUSIONS The present study indicates an inverse causal relationship between serum PTH concentrations and development of OA. Moreover, a site-specific association was also observed between serum PTH levels and knee OA. The potential mechanisms by which serum PTH affects OA need to be further investigated.
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Tudorachi NB, Totu EE, Fifere A, Ardeleanu V, Mocanu V, Mircea C, Isildak I, Smilkov K, Cărăuşu EM. The Implication of Reactive Oxygen Species and Antioxidants in Knee Osteoarthritis. Antioxidants (Basel) 2021; 10:985. [PMID: 34205576 PMCID: PMC8233827 DOI: 10.3390/antiox10060985] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
Knee osteoarthritis (KOA) is a chronic multifactorial pathology and a current and essential challenge for public health, with a negative impact on the geriatric patient's quality of life. The pathophysiology is not fully known; therefore, no specific treatment has been found to date. The increase in the number of newly diagnosed cases of KOA is worrying, and it is essential to reduce the risk factors and detect those with a protective role in this context. The destructive effects of free radicals consist of the acceleration of chondrosenescence and apoptosis. Among other risk factors, the influence of redox imbalance on the homeostasis of the osteoarticular system is highlighted. The evolution of KOA can be correlated with oxidative stress markers or antioxidant status. These factors reveal the importance of maintaining a redox balance for the joints and the whole body's health, emphasizing the importance of an individualized therapeutic approach based on antioxidant effects. This paper aims to present an updated picture of the implications of reactive oxygen species (ROS) in KOA from pathophysiological and biochemical perspectives, focusing on antioxidant systems that could establish the premises for appropriate treatment to restore the redox balance and improve the condition of patients with KOA.
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Affiliation(s)
- Nicoleta Bianca Tudorachi
- Faculty of Medicine, “Ovidius” University of Constanța, Mamaia Boulevard 124, 900527 Constanța, Romania; (N.B.T.); (V.A.)
| | - Eugenia Eftimie Totu
- Faculty of Applied Chemistry and Material Science, University Politehnica of Bucharest, 1–5 Polizu Street, 011061 Bucharest, Romania
| | - Adrian Fifere
- Centre of Advanced Research in Bionanoconjugates and Biopolymers Department, “Petru Poni” Institute of Macromolecular Chemistry, 41A Grigore Ghica Voda Alley, 700487 Iasi, Romania
| | - Valeriu Ardeleanu
- Faculty of Medicine, “Ovidius” University of Constanța, Mamaia Boulevard 124, 900527 Constanța, Romania; (N.B.T.); (V.A.)
| | - Veronica Mocanu
- Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (V.M.); (C.M.)
| | - Cornelia Mircea
- Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (V.M.); (C.M.)
| | - Ibrahim Isildak
- Faculty of Chemistry-Metallurgy, Department of Bioengineering, Yildiz Technical University, Istanbul 34220, Turkey;
| | - Katarina Smilkov
- Faculty of Medical Sciences, Division of Pharmacy, Department of Applied Pharmacy, Goce Delcev University, Krste Misirkov Street, No. 10-A, 2000 Stip, North Macedonia;
| | - Elena Mihaela Cărăuşu
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, “Nicolae Leon” Building, 13 Grigore Ghica Street, 700259 Iasi, Romania;
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Joseph GB, McCulloch CE, Nevitt MC, Neumann J, Lynch JA, Lane NE, Link TM. Associations Between Vitamins C and D Intake and Cartilage Composition and Knee Joint Morphology Over 4 Years: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2020; 72:1239-1247. [PMID: 31282125 DOI: 10.1002/acr.24021] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/02/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the cross-sectional and longitudinal associations of vitamin C and D intake with magnetic resonance imaging (MRI) measures of cartilage composition (T2) and joint structure (cartilage, meniscus, and bone marrow) using data from the Osteoarthritis Initiative (OAI) cohort. METHODS A total of 1,785 subjects with radiographic Kellgren/Lawrence knee grades 0-3 in the right knee were selected from the OAI database. Vitamins C and vitamin D intake (diet, supplements, and total) were assessed using the Block Brief 2000 Food Frequency Questionnaire at baseline. The MRI analysis protocol included 3T cartilage T2 quantification and semiquantitative joint morphology gradings (Whole-Organ Magnetic Resonance Imaging Score [WORMS]) at baseline and 4 years. Linear regression was used to assess the association between standardized baseline vitamin intake and both baseline WORMS scores and standardized cartilage T2 values. RESULTS Higher vitamin C intake was associated with lower average cartilage T2 values, medial tibia T2 values, and medial tibia WORMS scores (standardized coefficient range -0.07 to -0.05, P < 0.05). Higher vitamin D intake was associated with a lower cartilage WORMS sum score and medial femur WORMS score (standardized coefficient range -0.24 to -0.09, P < 0.05). Consistent use of vitamin D supplements of 400 IU at least once a week over 4 years was associated with significantly less worsening of cartilage, meniscus, and bone marrow abnormalities (odds ratio range 0.40-0.56, P < 0.05). CONCLUSION Supplementation with vitamin D over 4 years was associated with significantly less progression of knee joint abnormalities. Given the observational nature of this study, future longitudinal randomized controlled trials of vitamin D supplementation are warranted.
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Saffarpour S, Nasirinezhad F. Ascorbic acid eliminated pain-induced peripheral neuropathy by modulation of nitric oxide pathway in rats. ACTA ACUST UNITED AC 2019. [DOI: 10.1186/s41110-019-0098-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Ripani U, Manzarbeitia-Arroba P, Guijarro-Leo S, Urrutia-Graña J, De Masi-De Luca A. Vitamin C May Help to Reduce the Knee's Arthritic Symptoms. Outcomes Assessment of Nutriceutical Therapy. Med Arch 2019; 73:173-177. [PMID: 31404121 PMCID: PMC6643354 DOI: 10.5455/medarh.2019.73.173-177] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 04/26/2019] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Osteoarthritis (OA) is a chronic joint disease characterized by degeneration of the articular cartilage, changes in the physico-chemical properties of the synovial fluid and macroscopical modifications of the joint. Patients with Classes I and II of Knee OA can be treated with pharmacologic therapy. Vitamin C is key for both preventing inflammatory arthritis and maintaining healthy joints with OA. AIM The aim of our paper is to verify the effectiveness of the addition of vitamin c in nutriceutical drugs for the therapy of the knee arthritis in the young adult. RESULTS Group B has a lower VAS score at 6 and 12 months with p<0.05. Not statistical difference we found in KSS during all follow up. A better quality of life was founded in Group B at 12 months in group B(p<0.05) and less use of pain killers/monthly(p<0.05). CONCLUSION There is no denying that vitamin C benefits everybody, whether they have arthritis or not. Therefore, it is a good idea to maintain a healthy balance of vitamin C. Without a doubt, vitamin C benefits most people with early OA.
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Affiliation(s)
- Umberto Ripani
- Pain Therapy Center, Division of Anesthesia, Analgesia and Intensive Care, Department of Emergency, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Paloma Manzarbeitia-Arroba
- Department of Orthopedics and Traumatology, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Sandra Guijarro-Leo
- Department of Orthopedics and Traumatology, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Javier Urrutia-Graña
- Department of Orthopedics and Traumatology, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
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Shmagel A, Onizuka N, Langsetmo L, Vo T, Foley R, Ensrud K, Valen P. Low magnesium intake is associated with increased knee pain in subjects with radiographic knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2018; 26:651-658. [PMID: 29454594 DOI: 10.1016/j.joca.2018.02.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 02/04/2018] [Accepted: 02/07/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE As magnesium mediates bone and muscle metabolism, inflammation, and pain signaling, we aimed to evaluate whether magnesium intake is associated with knee pain and function in radiographic knee osteoarthritis (OA). METHODS We investigated the associations between knee pain/function metrics and magnesium intake from food and supplements in 2548 Osteoarthritis Initiative cohort participants with prevalent radiographic knee OA (Kellgren-Lawrence score ≥2). Magnesium intake was assessed by Food Frequency Questionnaire (FFQ) at baseline. WOMAC and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were reported annually with total follow up of 48 months. Analyses used linear mixed models. RESULTS Among participants with baseline radiographic knee OA the mean total magnesium intake was 309.9 mg/day (SD 132.6) for men, and 287.9 mg/day (SD 118.1) for women, with 68% of men and 44% of women below the estimated average requirement. Subjects with lower magnesium intake had worse knee OA pain and function scores, throughout the 48 months (P < 0.001). After adjustment for age, sex, race, body mass index (BMI), calorie intake, fiber intake, pain medication use, physical activity, renal insufficiency, smoking, and alcohol use, lower magnesium intake remained associated with worse pain and function outcomes (1.4 points higher WOMAC and 1.5 points lower KOOS scores for every 50 mg of daily magnesium intake, P < 0.05). Fiber intake was an effect modifier (P for interaction <0.05). The association between magnesium intake and knee pain and function scores was strongest among subjects with low fiber intake. CONCLUSION Lower magnesium intake was associated with worse pain and function in knee OA, especially among individuals with low fiber intake.
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Affiliation(s)
- A Shmagel
- Division of Rheumatic and Autoimmune Diseases, University of Minnesota, USA.
| | | | - L Langsetmo
- Minneapolis VA Center for Chronic Disease Outcomes Research, Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, USA
| | - T Vo
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, USA
| | - R Foley
- University of Minnesota, Division of Renal Diseases and Hypertension, USA
| | - K Ensrud
- University of Minnesota, Minneapolis VA Center for Chronic Disease Outcomes Research, USA
| | - P Valen
- University of Minnesota, Minneapolis VA Medical Center, USA
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