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Rockel JS, Potla P, Kapoor M. Transcriptomics and metabolomics: Challenges of studying obesity in osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100479. [PMID: 38774038 PMCID: PMC11103424 DOI: 10.1016/j.ocarto.2024.100479] [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: 03/11/2024] [Accepted: 04/30/2024] [Indexed: 05/24/2024] Open
Abstract
Objective Obesity is a leading risk factor for both the incidence and progression of osteoarthritis (OA). Omic technologies, including transcriptomics and metabolomics are capable of identifying RNA and metabolite profiles in tissues and biofluids of OA patients. The objective of this review is to highlight studies using transcriptomics and metabolomics that contribute to our understanding of OA pathology in relation to obesity. Design We conducted a targeted search of PUBMED for articles, and GEO for datasets, published up to February 13, 2024, screening for those using high-throughput transcriptomic and metabolomic techniques to study human or pre-clinical animal model tissues or biofluids related to obesity-associated OA. We describe relevant studies and discuss challenges studying obesity as a disease-related factor in OA. Results Of the 107 publications identified by our search criteria, only 15 specifically used transcriptomics or metabolomics to study joint tissues or biofluids in obesity-related OA. Specific transcriptomic and metabolomic signatures associated with obesity-related OA have been defined in select local joint tissues, biofluids and other biological material. However, considerable challenges exist in understanding contributions of obesity-associated modifications of transcriptomes and metabolomes related to OA, including sociodemographic, anthropometric, dietary and molecular redundancy-related factors. Conclusions A number of additional transcriptomic and metabolomic studies are needed to comprehensively understand how obesity affects OA incidence, progression and outcomes. Integration of transcriptome and metabolome signatures from multiple tissues and biofluids, using network-based approaches will likely help to better define putative therapeutic targets that could enable precision medicine approaches to obese OA patients.
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Affiliation(s)
- Jason S. Rockel
- Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Pratibha Potla
- Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Mohit Kapoor
- Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Department of Surgery and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Weber P, Asadikorayem M, Zenobi-Wong M. Zwitterionic Poly-Carboxybetaine Polymers Restore Lubrication of Inflamed Articular Cartilage. Adv Healthc Mater 2024:e2401623. [PMID: 39007282 DOI: 10.1002/adhm.202401623] [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: 05/02/2024] [Revised: 07/02/2024] [Indexed: 07/16/2024]
Abstract
Osteoarthritis is a degenerative joint disease that is associated with decreased synovial fluid viscosity and increased cartilage friction. Though viscosupplements are available for decades, their clinical efficacy is limited and there is ample need for more effective joint lubricants. This study first evaluates the tribological and biochemical properties of bovine articular cartilage explants after stimulation with the inflammatory cytokine interleukin-1β. This model is then used to investigate the tribological potential of carboxybetaine (CBAA)-based zwitterionic polymers of linear and bottlebrush architecture. Due to their affinity for cartilage tissue, these polymers form a highly hydrated surface layer that decreases friction under high load in the boundary lubrication regime. For linear pCBAA, these benefits are retained over several weeks and the relaxation time of cartilage explants under compression is furthermore decreased, thereby potentially boosting the weeping lubrication mechanism. Bottlebrush bb-pCBAA shows smaller benefits under boundary lubrication but is more viscous than linear pCBAA, therefore providing better lubrication under low load in the fluid-film regime and enabling a longer residence time to bind to the cartilage surface. Showing how CBAA-based polymers restore the lost lubrication mechanisms during inflammation can inspire the next steps toward more effective joint lubricants in the future.
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Affiliation(s)
- Patrick Weber
- Tissue Engineering + Biofabrication Laboratory, ETH Zurich, Otto-Stern-Weg 7, Zürich, 8093, Switzerland
| | - Maryam Asadikorayem
- Tissue Engineering + Biofabrication Laboratory, ETH Zurich, Otto-Stern-Weg 7, Zürich, 8093, Switzerland
| | - Marcy Zenobi-Wong
- Tissue Engineering + Biofabrication Laboratory, ETH Zurich, Otto-Stern-Weg 7, Zürich, 8093, Switzerland
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Ding C, Yimiti D, Sanada Y, Matsubara Y, Nakasa T, Matsubara K, Adachi N, Miyaki S. High-fat diet-induced obesity accelerates the progression of spontaneous osteoarthritis in senescence-accelerated mouse prone 8. Mod Rheumatol 2024; 34:831-840. [PMID: 37522619 DOI: 10.1093/mr/road069] [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: 05/08/2023] [Revised: 06/19/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES Ageing and obesity are major risk factors for osteoarthritis (OA), a widespread disease currently lacking efficient treatments. Senescence-accelerated mouse prone 8 (SAMP8) display early onset ageing phenotypes, including OA. This study investigates the impacts of high-fat diet (HFD)-induced obesity on OA development in SAMP8. METHODS SAMP8 at 5 weeks were fed either a normal chow diet or an HFD for 10 weeks to induce obesity. Parameters related to obesity, liver function, and lipid and glucose metabolism were analysed. At 14 weeks of age, knee joint pathology, bone mineral density, and muscle strength were assessed. Immunohistochemistry and TUNEL staining were performed to evaluate markers for cartilage degeneration and chondrocyte apoptosis. RESULTS At 14 weeks of age, HFD-induced obesity increased liver and adipose tissue inflammation in SAMP8 without further exacerbating diabetes. Histological scoring revealed aggravated cartilage, menisci deterioration, and synovitis, while no further loss of bone mineral density or muscle strength was observed. Increased chondrocyte apoptosis was detected in knee joints following HFD feeding. CONCLUSIONS Ten weeks of HFD feeding promotes spontaneous OA progression in 14-week-old SAMP8, potentially via liver damage that subsequently leads to chondrocyte apoptosis. This ageing-obese mouse model may prove valuable for further exploration of spontaneous OA pathophysiology.
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Affiliation(s)
- Chenyang Ding
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Dilimulati Yimiti
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yohei Sanada
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuki Matsubara
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoyuki Nakasa
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kiminori Matsubara
- Department of Human Life Science Education, Graduate School of Education, Hiroshima University, Higashi-Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigeru Miyaki
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
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4
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Wyatt PB, Reiter CR, Satalich JR, O'Neill CN, Vap AR. Shoulder Hemiarthroplasty Is Associated With Higher 30-Day Complication Rates Compared With Total Shoulder Arthroplasty for Glenohumeral Osteoarthritis: A Propensity Score Matched Analysis. Orthopedics 2024; 47:217-224. [PMID: 38567998 DOI: 10.3928/01477447-20240325-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
BACKGROUND Anatomical total shoulder arthroplasty (TSA) and shoulder hemiarthroplasty (HA) have both been shown to have good outcomes in patients with osteoarthritis of the glenohumeral joint. However, evidence comparing perioperative complications between these procedures in this population is heterogeneous. MATERIALS AND METHODS The American College of Surgeons National Surgical Quality Improvement Program database was queried between the years 2012 and 2021 (10 years in total) for records of patients who underwent either TSA or HA for osteoarthritis of the glenohumeral joint. Patients in each group underwent a 1:1 propensity match for demographic variables. Bivariate and multivariate analyses were performed to compare complications and risk factors between these cohorts. RESULTS A total of 4376 propensity-matched patients, with 2188 receiving TSA and 2188 receiving HA, were included in the primary analyses. The HA cohort had a higher rate of any adverse event (7.18% vs 4.8%, P=.001), death (0.69% vs 0.1%, P=.004), sepsis (0.46% vs 0.1%, P=.043), postoperative transfusion (4.62% vs 2.2%, P<.001), postoperative intubation (0.5% vs 0.1%, P=.026), and extended length of stay (23.77% vs 13.1%, P<.001). HA was found to increase the odds of developing these complications when baseline demographics were controlled. Older age (odds ratio, 1.040; 95% CI, 1.021-1.059; P<.001) and lower body mass index (odds ratio, 0.949; 95% CI, 0.923-0.975; P<.001) increased the odds of having any adverse event in the HA cohort but not in the TSA cohort. CONCLUSION Compared with TSA, HA appears to be associated with significantly higher rates of 30-day postoperative complications when performed for glenohumeral osteoarthritis. [Orthopedics. 2024;47(4):217-224.].
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Kopp W. Aging and "Age-Related" Diseases - What Is the Relation? Aging Dis 2024:AD.2024.0570. [PMID: 39012663 DOI: 10.14336/ad.2024.0570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 06/28/2024] [Indexed: 07/17/2024] Open
Abstract
The study explores the intricate relationship between aging and the development of noncommunicable diseases [NCDs], focusing on whether these diseases are inevitable consequences of aging or primarily driven by lifestyle factors. By examining epidemiological data, particularly from hunter-gatherer societies, the study highlights that many NCDs prevalent in modern populations are rare in these societies, suggesting a significant influence of lifestyle choices. It delves into the mechanisms through which poor diet, smoking, and other lifestyle factors contribute to systemic physiological imbalances, characterized by oxidative stress, insulin resistance and hyperinsulinemia, and dysregulation of the sympathetic nervous system, the renin-angiotensin-aldosterone system, and the immune system. The interplay between this pattern and individual factors such as genetic susceptibility, biological variability, epigenetic changes and the microbiome is proposed to play a crucial role in the development of a range of age-related NCDs. Modified biomolecules such as oxysterols and advanced glycation end products also contribute to their development. Specific diseases such as benign prostatic hyperplasia, Parkinson's disease, glaucoma and osteoarthritis are analyzed to illustrate these mechanisms. The study concludes that while aging contributes to the risk of NCDs, lifestyle factors play a crucial role, offering potential avenues for prevention and intervention through healthier living practices. One possible approach could be to try to restore the physiological balance, e.g. through dietary measures [e.g. Mediterranean diet, Okinawan diet or Paleolithic diet] in conjunction with [a combination of] pharmacological interventions and other lifestyle changes.
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Lavu MS, Porto JR, Hecht CJ, Kaelber DC, Sculco PK, Heckmann ND, Kamath AF. Five-Year Incidence of Progression to Osteoarthritis and Total Joint Arthroplasty in Patients Prescribed Glucagon-Like Peptide 1 Receptor Agonists. J Arthroplasty 2024:S0883-5403(24)00585-0. [PMID: 38857711 DOI: 10.1016/j.arth.2024.06.008] [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: 03/10/2024] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Research has suggested that glucagon-like peptide-1 receptor agonists (GLP-1-RAs) may have therapeutic effects on osteoarthritis of the hip and knee, in addition to managing diabetes and obesity. However, there is a lack of understanding regarding the association between GLP-1-RA use and the diagnosis of osteoarthritis (OA) of the hip and knee. METHODS A collaborative network analytics platform was queried for obese diabetic (n = 1,094,198), obese nondiabetic (n = 916,235), and nonobese diabetic (n = 157,305) patients who had an index visit between 2015 and 2017. Patients who had pre-existing hip and/or knee OA were excluded. A 1:1 propensity score matching was used to balance GLP-1-RA use in stratified cohorts for age, sex, race, body mass index, and hemoglobin A1c. The primary outcomes were rates of progression to hip OA, knee OA, major joint injections, total hip arthroplasty, and total knee arthroplasty. Cox proportional hazards models determined hazard ratios (HRs) between cohorts prescribed and not prescribed GLP-1-RAs. RESULTS All patients had a five-year follow-up. Rates of progression to hip and knee OA were higher among the GLP-1-RA users in both obese diabetic (hip HR: 1.63, 95% confidence interval [CI]: 1.46 to 1.82; knee HR: 1.52, CI: 1.41 to 1.64) and nonobese diabetic (hip HR: 1.78, CI: 1.50 to 2.10; knee HR: 1.58, CI: 1.39 to 1.80) cohorts. These diabetic cohorts received higher rates of major joint injections, though there was no difference in rates of total hip arthroplasty or total knee arthroplasty. No differences in five-year outcomes were seen when comparing obese, nondiabetic patients who were prescribed GLP-1-RAs with obese, nondiabetic patients not exposed to GLP-1-RAs. CONCLUSIONS This five-year analysis found a greater risk of progression to hip and knee OA among obese and non-obese diabetic GLP-1-RA users. Further studies should explore GLP-1-RA effects upon glucose management, weight loss, and lower extremity arthritis development. LEVEL OF EVIDENCE III, retrospective cohort study.
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Affiliation(s)
- Monish S Lavu
- Department of Orthopaedics, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Joshua R Porto
- Department of Orthopaedics, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Christian J Hecht
- Department of Orthopaedics, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - David C Kaelber
- Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio; The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio
| | - Peter K Sculco
- Department of Orthopedics, Hospital for Special Surgery, New York, New York
| | - Nathanael D Heckmann
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California
| | - Atul F Kamath
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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Taskina EA, Alekseeva LI, Kashevarova NG, Strebkova EA, Mikhaylov KM, Sharapova EP, Savushkina NM, Alekseeva OG, Raskina TA, Averkieva JV, Usova EV, Vinogradova IB, Salnikova OV, Markelova AS, Lila AM. [Relationship between hypercholesterolemia and osteoarthritis (preliminary results)]. TERAPEVT ARKH 2024; 96:471-478. [PMID: 38829808 DOI: 10.26442/00403660.2024.05.202702] [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: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/05/2024]
Abstract
AIM To evaluate the relationship of hypercholesterolemia (HCE) with clinical, instrumental, and laboratory parameters in osteoarthritis (OA) in a multicenter, cross-sectional study. MATERIALS AND METHODS The study included 183 patients aged 40-75 years, with a confirmed diagnosis of stage I-III OA (ACR) of the knee joints, who signed an informed consent. The mean age was 55.6±10.7 years (40 to 75), body mass index was 29.3±6.3 kg/m2, and disease duration was 5 [1; 10] years. For each patient, a case record form was filled out, including anthropometric indicators, medical history, clinical examination data, an assessment of knee joint pain according to VAS, WOMAC, KOOS and comorbidities. All patients underwent standard radiography and ultrasound examination of the knee joints and laboratory tests. RESULTS HCE was detected in 59% of patients. Depending on its presence or absence, patients were divided into two groups. Patients were comparable in body mass index, waist and hip measurement, and disease duration but differed significantly in age. Individuals with elevated total cholesterol levels had higher VAS pain scores, total WOMAC and its components, an overall assessment of the patient's health, a worse KOOS index, and ultrasound findings (reduced cartilage tissue). HCE patients showed high levels of cholesterol, low-density lipoproteins, triglycerides, STX-II, and COMP (p<0.05). However, after stratification by age, many initial intergroup differences became insignificant, and differences in the WOMAC pain score persisted. CONCLUSION The results of the study confirmed the high prevalence of HCE in OA patients (59%). Patients with OA and increased total cholesterol have more intense pain in the knee joints.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - A M Lila
- Nasonova Research Institute of Rheumatology
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8
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Van den Langenbergh J, Bastiaansen-Jenniskens Y, van Osch G, Runhaar J, Bierma-Zeinstra S, Soballe K, Laursen J, Liljensoe A, Kops N, Mechlenburg I, Clockaerts S. PLOD2 gene expression in infrapatellar fat pad is correlated with fat mass in obese patients with end-stage knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100469. [PMID: 38694906 PMCID: PMC11061337 DOI: 10.1016/j.ocarto.2024.100469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 04/06/2024] [Indexed: 05/04/2024] Open
Abstract
Objective To investigate associations between obesity-linked systemic factors and gene expression indicative for the inflammatory and fibrotic processes in the infrapatellar fat pad (IFP), in a population of obese patients with end-stage knee osteoarthritis (KOA). Methods We collected human IFPs from 48 patients with a mean body mass index (BMI) of 35.44 kg/m2 during total knee replacement procedures. These patients were part of a randomized controlled trial and met the criteria of having OA and a BMI of ≥30 kg/m2. Blood samples were collected to assess serum levels of glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and leptin. Total body composition was measured using dual-energy X-ray absorptiometry. Gene expressions of IL6, TNFA, COL1A1, IL1B, ASMA, PLOD2 in the IFP were analyzed. Results Univariate analysis resulted in a positive correlation between BMI and procollagen-lysine,2-oxoglutarate 5-dioxygenase 2 (PLOD2) expression (r2 = 0.13). In univariate analyses of obesity-linked systemic factors and PLOD2, significant correlations were found for lean mass (r2 = 0.20), fat mass (r2 = 0.20), serum cholesterol (r2 = 0.17), serum triglycerides (r2 = 0.19) and serum leptin (r2 = 0.10). A multiple linear regression model indicated fat mass to be a strong predictor of PLOD2 production in the IFP (r2 = 0.22, P = 0.003). Conclusion Our study demonstrates the positive association between fat mass and PLOD2 expression in the IFP of obese end-stage knee OA patients. This may indicate that within this patient population the fibrotic process in the IFP is influenced by systemic adipose tissue, next to local inflammatory processes.
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Affiliation(s)
- J. Van den Langenbergh
- KU Leuven, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, Leuven, Belgium
| | - Y.M. Bastiaansen-Jenniskens
- Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, Rotterdam, Netherlands
| | - G.J.V.M. van Osch
- Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, Rotterdam, Netherlands
- Erasmus MC, University Medical Center Rotterdam, Department of Otorhinolaryngology, Rotterdam, Netherlands
| | - J. Runhaar
- Erasmus MC, University Medical Center Rotterdam, Department of General Practice, Rotterdam, Netherlands
| | - S.M.A. Bierma-Zeinstra
- Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, Rotterdam, Netherlands
- Erasmus MC, University Medical Center Rotterdam, Department of General Practice, Rotterdam, Netherlands
| | - K. Soballe
- Aarhus University Hospital, Orthopaedic Research Unit, Aarhus, Denmark
| | - J. Laursen
- Aarhus University Hospital, Orthopaedic Research Unit, Aarhus, Denmark
| | - A. Liljensoe
- Aarhus University Hospital, Orthopaedic Research Unit, Aarhus, Denmark
| | - N. Kops
- Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, Rotterdam, Netherlands
| | - I. Mechlenburg
- Aarhus University Hospital, Orthopaedic Research Unit, Aarhus, Denmark
| | - S. Clockaerts
- KU Leuven, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, Leuven, Belgium
- H.H. Z. Lier, Orthopedic Surgery and Traumatology, Lier, Belgium
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Wei Y, Zhang T, Liu Y, Liu H, Zhou Y, Su J, Chen L, Bai L, Xia Y. Ultra-processed food consumption, genetic susceptibility, and the risk of hip/knee osteoarthritis. Clin Nutr 2024; 43:1363-1371. [PMID: 38678821 DOI: 10.1016/j.clnu.2024.04.030] [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: 03/02/2023] [Revised: 10/16/2023] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND The associations between ultra-processed food (UPF) consumption, genetic susceptibility, and the risk of osteoarthritis (OA) remain unknown. This study was to examine the effect of UPF consumption, genetic susceptibility, and their interactions on hip/knee OA. METHODS Cohort analyses included 163,987 participants from the UK Biobank. Participants' UPF consumption was derived from their 24-h dietary recall using a questionnaire. Genetic risk scores (GRSs) of 70 and 83 single nucleotide polymorphisms (SNPs) for hip and knee OA were constructed. FINDINGS After 1,461,447 person-years of follow-up, 11,540 patients developed OA. After adjustments, compared to participants in the low quartile of UPF consumption, those in the high quartile had a 10 % (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.03-1.18) increased risk of knee OA. No significant association was found between UPF consumption and hip OA. Replacing 20% of UPF diet weight with an equivalent proportion of unprocessed or minimally processed food caused a 6% (HR, 0.94; 95% CI, 0.89-0.98) decreased risk of knee OA, respectively. A significant interaction was found between UPF consumption, genetic predisposition, and the risk of knee OA (P = 0.01). Participants with lower OA-GRS scores experienced higher knee OA risks due to UPF consumption. INTERPRETATION UPF consumption was associated with a higher risk of knee OA but not hip OA, particularly in those with lower genetic susceptibility. These results highlight the importance of reducing UPF consumption to prevent knee OA.
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Affiliation(s)
- Yingliang Wei
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tingjing Zhang
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Yashu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Huiyuan Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Yuhan Zhou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Jianbang Su
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Lunhao Bai
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China.
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Adam MS, Zhuang H, Ren X, Zhang Y, Zhou P. The metabolic characteristics and changes of chondrocytes in vivo and in vitro in osteoarthritis. Front Endocrinol (Lausanne) 2024; 15:1393550. [PMID: 38854686 PMCID: PMC11162117 DOI: 10.3389/fendo.2024.1393550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024] Open
Abstract
Osteoarthritis (OA) is an intricate pathological condition that primarily affects the entire synovial joint, especially the hip, hand, and knee joints. This results in inflammation in the synovium and osteochondral injuries, ultimately causing functional limitations and joint dysfunction. The key mechanism responsible for maintaining articular cartilage function is chondrocyte metabolism, which involves energy generation through glycolysis, oxidative phosphorylation, and other metabolic pathways. Some studies have shown that chondrocytes in OA exhibit increased glycolytic activity, leading to elevated lactate production and decreased cartilage matrix synthesis. In OA cartilage, chondrocytes display alterations in mitochondrial activity, such as decreased ATP generation and increased oxidative stress, which can contribute to cartilage deterioration. Chondrocyte metabolism also involves anabolic processes for extracellular matrix substrate production and energy generation. During OA, chondrocytes undergo considerable metabolic changes in different aspects, leading to articular cartilage homeostasis deterioration. Numerous studies have been carried out to provide tangible therapies for OA by using various models in vivo and in vitro targeting chondrocyte metabolism, although there are still certain limitations. With growing evidence indicating the essential role of chondrocyte metabolism in disease etiology, this literature review explores the metabolic characteristics and changes of chondrocytes in the presence of OA, both in vivo and in vitro. To provide insight into the complex metabolic reprogramming crucial in chondrocytes during OA progression, we investigate the dynamic interaction between metabolic pathways, such as glycolysis, lipid metabolism, and mitochondrial function. In addition, this review highlights prospective future research directions for novel approaches to diagnosis and treatment. Adopting a multifaceted strategy, our review aims to offer a comprehensive understanding of the metabolic intricacies within chondrocytes in OA, with the ultimate goal of identifying therapeutic targets capable of modulating chondrocyte metabolism for the treatment of OA.
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Affiliation(s)
| | | | | | | | - Panghu Zhou
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
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11
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He Y, Jiang W, Wang W. Global burden of osteoarthritis in adults aged 30 to 44 years, 1990 to 2019: results from the Global Burden of Disease Study 2019. BMC Musculoskelet Disord 2024; 25:303. [PMID: 38641788 PMCID: PMC11027234 DOI: 10.1186/s12891-024-07442-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/15/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a common orthopedic disorder, and its incidence has been increasing among young adults in recent years. The purpose of this study is to investigate the global, regional, and national trends in OA burden and variation among individuals aged 30 to 44 from 1990 to 2019. METHODS Data on the incidence, prevalence, and years lived with disability (YLDs) related to OA were sourced from the Global Burden of Disease Study 2019 among individuals aged 30 to 44. These measures were stratified by gender, region, country, and socio-demographic index (SDI). Additionally, we analyzed YLDs attributable to risk factors. RESULTS In 2019, there were a total of 32,971,701 cases of OA among individuals aged 30 to 44 years worldwide, with an additional 7,794,008 new incident cases reported. OA of the knee was the primary contributor to both incidence and prevalence rates over the past three decades. From 1990 to 2019, both males and females in countries with high SDI and high-middle SDI showed upward trends in age-standardized incidence, prevalence, and YLDs rates. In 2019, the United States of America had the highest age-standardized incidence, prevalence, and YLDs rates. Elevated body-mass index (BMI) was found to be the most prevalent risk factor for osteoarthritis-related YLDs. Age-standardized YLDs rates were positively associated with SDI. CONCLUSIONS OA remains a significant disease burden on individuals aged 30 to 44, with modifiable risk factors such as unhealthy lifestyle and obesity representing key targets for future interventions aimed at reducing the impact of this condition on younger generations.
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Affiliation(s)
- Yixiang He
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Wenkai Jiang
- The Second Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Wenji Wang
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, China.
- Department of orthopedics, the First Hospital of Lanzhou university, Lanzhou, 730000, Gansu, China.
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12
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Wilhelmsen A, Stephens FB, Bennett AJ, Karagounis LG, Jones SW, Tsintzas K. Skeletal muscle myostatin mRNA expression is upregulated in aged human adults with excess adiposity but is not associated with insulin resistance and ageing. GeroScience 2024; 46:2033-2049. [PMID: 37801203 PMCID: PMC10828472 DOI: 10.1007/s11357-023-00956-6] [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: 06/19/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023] Open
Abstract
Myostatin negatively regulates skeletal muscle growth and appears upregulated in human obesity and associated with insulin resistance. However, observations are confounded by ageing, and the mechanisms responsible are unknown. The aim of this study was to delineate between the effects of excess adiposity, insulin resistance and ageing on myostatin mRNA expression in human skeletal muscle and to investigate causative factors using in vitro models. An in vivo cross-sectional analysis of human skeletal muscle was undertaken to isolate effects of excess adiposity and ageing per se on myostatin expression. In vitro studies employed human primary myotubes to investigate the potential involvement of cross-talk between subcutaneous adipose tissue (SAT) and skeletal muscle, and lipid-induced insulin resistance. Skeletal muscle myostatin mRNA expression was greater in aged adults with excess adiposity than age-matched adults with normal adiposity (2.0-fold higher; P < 0.05) and occurred concurrently with altered expression of genes involved in the maintenance of muscle mass but did not differ between younger and aged adults with normal adiposity. Neither chronic exposure to obese SAT secretome nor acute elevation of fatty acid availability (which induced insulin resistance) replicated the obesity-mediated upregulation of myostatin mRNA expression in vitro. In conclusion, skeletal muscle myostatin mRNA expression is uniquely upregulated in aged adults with excess adiposity and insulin resistance but not by ageing alone. This does not appear to be mediated by the SAT secretome or by lipid-induced insulin resistance. Thus, factors intrinsic to skeletal muscle may be responsible for the obesity-mediated upregulation of myostatin, and future work to establish causality is required.
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Affiliation(s)
- Andrew Wilhelmsen
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | | | - Andrew J Bennett
- School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Leonidas G Karagounis
- Mary MacKillop Institute for Health Research (MMIHR), Melbourne, Australian Catholic University, Melbourne, Australia
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Simon W Jones
- Institute of Inflammation and Ageing, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Queen Elizabeth Hospital, The University of Birmingham, Birmingham, UK
| | - Kostas Tsintzas
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
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13
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Alrayes MS, Altawili MA, Alsuabie SM, Sindi AW, Alharbi KM, Alsalhi KM, Al Alawi RM, Ali ID, Nasser AN, Alabdulrahim JM, Alkhaldi MH, Alhudhaif HM, Alotaibi SA. Surgical Interventions for the Management of Obesity-Related Joint Pain: A Narrative Review. Cureus 2024; 16:e59082. [PMID: 38800150 PMCID: PMC11128294 DOI: 10.7759/cureus.59082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
Obesity-related joint pain is a common and debilitating condition that significantly impacts the quality of life, primarily due to the excess weight straining the joints. This results in inflammation and degeneration, which can cause pain, stiffness, and difficulty moving. We aimed to comprehensively review the literature discussing surgical interventions for obesity-related joint pain. We searched across databases (PubMed, Scopus, and Cochrane Library) to identify studies published between 2000 and 2023 that assessed surgical interventions for obesity-related joint pain. This review highlights the complex interplay of mechanical, inflammatory, and metabolic factors contributing to joint pain in obese individuals, highlighting both surgical and non-surgical interventions. Non-surgical interventions include weight loss, exercise, physical therapy, and medications. Surgical interventions include bariatric surgery and joint replacement surgery. Bariatric surgery significantly reduces body weight and improves the quality of life outcomes; however, multiple studies have found no improvement or worsening of joint pain post-surgery. Total joint arthroplasty has demonstrated good improvement in pain and function outcomes based on recent meta-analyses, although risks of complications are higher in obese patients. The treatment choice for obesity-related joint pain depends on the individual patient's circumstances. Non-surgical interventions are usually the first line of treatment. However, if these interventions are not effective, surgical interventions may be an option.
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Affiliation(s)
| | | | | | - Ahmad W Sindi
- General Practice, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Kawkab M Alharbi
- Surgery, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | | | | | | | - Alrashed N Nasser
- General Practice, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | | | - Hamad M Alhudhaif
- General Practice, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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14
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Godziuk K, Hawker GA. Obesity and body mass index: Past and future considerations in osteoarthritis research. Osteoarthritis Cartilage 2024; 32:452-459. [PMID: 38354848 DOI: 10.1016/j.joca.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 02/16/2024]
Abstract
Obesity is an important topic for the osteoarthritis (OA) scientific community. However, the predominant use of body mass index (BMI) to define obesity in OA research is associated with uncertainties and limitations. These include an inability to discern fat and muscle mass, account for sex-differences in fat distribution, or identify adiposity-related health impairments. A focus on BMI in OA research may influence weight bias in clinical practice and impact disparities in access to effective OA treatments. To ensure that our understanding and approaches to improve health outcomes for individuals with or at risk for OA continues to advance in the next decade, future research will need to consider alternative measures beyond BMI for obesity identification and align with evolving obesity science. OA researchers must be aware of issues associated with weight stigma and work to minimize negative generalizations based on BMI.
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Affiliation(s)
- Kristine Godziuk
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
| | - Gillian A Hawker
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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15
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Karjalainen K, Tanska P, Collins KH, Herzog W, Korhonen RK, Moo EK. Independent and combined effects of obesity and traumatic joint injury to the structure and composition of rat knee cartilage. Connect Tissue Res 2024; 65:117-132. [PMID: 38530304 DOI: 10.1080/03008207.2024.2310838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 01/22/2024] [Indexed: 03/27/2024]
Abstract
Osteoarthritis (OA) is a multifactorial joint disease characterized by articular cartilage degradation. Risk factors for OA include joint trauma, obesity, and inflammation, each of which can affect joint health independently, but their interaction and the associated consequences of such interaction were largely unexplored. Here, we studied compositional and structural alterations in knee joint cartilages of Sprague-Dawley rats exposed to two OA risk factors: joint injury and diet-induced obesity. Joint injury was imposed by surgical transection of anterior cruciate ligaments (ACLx), and obesity was induced by a high fat/high sucrose diet. Depth-dependent proteoglycan (PG) content and collagen structural network of cartilage were measured from histological sections collected previously in Collins et al.. (2015). We found that ACLx primarily affected the superficial cartilages. Compositionally, ACLx led to reduced PG content in lean animals, but increased PG content in obese rats. Structurally, ACLx caused disorganization of collagenous network in both lean and obese animals through increased collagen orientation in the superficial tissues and a change in the degree of fibrous alignment. However, the cartilage degradation attributed to joint injury and obesity was not necessarily additive when the two risk factors were present simultaneously, particularly for PG content and collagen orientation in the superficial tissues. Interestingly, sham surgeries caused a through-thickness disorganization of collagen network in lean and obese animals. We conclude that the interactions of multiple OA risk factors are complex and their combined effects cannot be understood by superposition principle. Further research is required to elucidate the interactive mechanism between OA subtypes.
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Affiliation(s)
- Kalle Karjalainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Kelsey H Collins
- Laboratory of Musculoskeletal Crosstalk, Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Eng Kuan Moo
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Department of Mechanical and Aerospace Engineering, Carleton University, Ottawa, Canada
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16
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Herrero-Beaumont G, Castro-Dominguez F, Migliore A, Naredo E, Largo R, Reginster JY. Systemic osteoarthritis: the difficulty of categorically naming a continuous condition. Aging Clin Exp Res 2024; 36:45. [PMID: 38376694 PMCID: PMC10879223 DOI: 10.1007/s40520-024-02714-w] [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: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/21/2024]
Abstract
Osteoarthritis (OA) is a disease with systemic implications that go beyond joint problems. Its pathogenic mechanisms involve a variety of systemic conditions that contribute to joint damage. These include metabolic dysfunction, chronic low-grade inflammation, neuroplastic pain, and the influence of the central nervous system in the development of neuropathic pain. Besides, OA can negatively affect other aspects of health, such as quality of life, reduced physical activity, social isolation, depression, and anxiety. OA can be considered a complex system in which pathological interactions involve not only obesity and metabolic dysfunction, but also fragility syndrome, sarcopenia, neurological complications, and systemic energy redistribution. Complex systems are composed of multiple interacting and dynamic parts and exhibit emergent properties that cannot be fully explained by examining their individual components. Chronic low-grade inflammation is characteristic of OA, occurring both in the affected joint, and systemically, mainly due to adipose tissue inflammation in obese patients. Obesity is a key factor in the progression of OA, so primary treatment should focus on its control, while maintaining muscle health. The chronic inflammation could lead to changes in energy distribution among the affected joint tissues. Therefore, OA should be approached as a systemic disease, considering individual patient factors, such as genetics, inflammatory response, and lifestyle. Medical care should be more holistic and personalized. Consideration of a name change, such as "systemic OA", could help to move away from the perception of a disease focused only on the joints.
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Affiliation(s)
| | | | - Alberto Migliore
- Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Esperanza Naredo
- Bone and Joint Research Unit, Rheumatology Dept, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Raquel Largo
- Bone and Joint Research Unit, Rheumatology Dept, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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17
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Li Q, Tang X, Li W. Potential diagnostic markers and biological mechanism for osteoarthritis with obesity based on bioinformatics analysis. PLoS One 2023; 18:e0296033. [PMID: 38127891 PMCID: PMC10735003 DOI: 10.1371/journal.pone.0296033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Numerous observational studies have shown that obesity (OB) is a significant risk factor in the occurrence and progression of osteoarthritis (OA), but the underlying molecular mechanism between them remains unclear. The study aimed to identify the key genes and pathogeneses for OA with OB. We obtained two OA and two OB datasets from the gene expression omnibus (GEO) database. First, the identification of differentially expressed genes (DEGs), weighted gene co-expression network analysis (WGCNA), and machine learning algorithms were used to identify key genes for diagnosing OA with OB, and then the nomogram and receiver operating characteristic (ROC) curve were conducted to assess the diagnostic value of key genes. Second, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to explore the pathogenesis of OA with OB. Third, CIBERSORT was created to investigate immunocyte dysregulation in OA and OB. In this study, two genes (SOD2, ZNF24) were finally identified as key genes for OA with OB. These two key genes had high diagnostic values via nomogram and ROC curve calculation. Additionally, functional analysis emphasized that oxidative stress and inflammation response were shared pathogenesis of OB and AD. Finally, in OA and OB, immune infiltration analysis showed that SOD2 closely correlated to M2 macrophages, regulatory T cells, and CD8 T cells, and ZNF24 correlated to regulatory T cells. Overall, our findings might be new biomarkers or potential therapeutic targets for OA and OB comorbidity.
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Affiliation(s)
- Qiu Li
- Department of Cardiovascular, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430077, China
| | - Xijie Tang
- Department of Orthopedics, Wuhan Third Hospital, School of Medicine, Wuhan University of Science and Technology, Wuhan, 430061, China
| | - Weihua Li
- Department of Cardiovascular, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430077, China
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18
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Shumnalieva R, Kotov G, Ermencheva P, Monov S. Pathogenic Mechanisms and Therapeutic Approaches in Obesity-Related Knee Osteoarthritis. Biomedicines 2023; 12:9. [PMID: 38275369 PMCID: PMC10812969 DOI: 10.3390/biomedicines12010009] [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: 11/23/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
The knee is the joint most frequently involved in osteoarthritis, a common joint disorder in the adult population that is associated with significant chronic joint pain, reduced mobility and quality of life. Recent studies have established an association between obesity and the development of knee osteoarthritis that goes beyond the increased mechanical load on the knees as weight-bearing joints. This link is based on the maintenance of a chronic low-grade inflammation, altered secretion of adipokines by the adipose tissue and development of sarcopenia. Major adipokines involved in the pathogenesis of obesity-related knee osteoarthritis include adiponectin, which appears to have a protective effect, as well as leptin, resistin and visfatin, which are associated with higher pain scores and more severe structural damage. Joint pain in knee osteoarthritis may be both nociceptive and neuropathic and is the result of complex mechanisms driven by nerve growth factor, calcitonin gene-related peptide and pro-inflammatory cytokines. The role of endogenous cannabinoids and gut microbiota in common mechanisms between obesity and knee pain has recently been studied. The aim of the present review is to highlight major pathogenic mechanisms in obesity-related knee osteoarthritis with special attention on pain and to comment on possible therapeutic approaches.
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Affiliation(s)
- Russka Shumnalieva
- Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
| | - Georgi Kotov
- Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
| | - Plamena Ermencheva
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
| | - Simeon Monov
- Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
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19
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Lim YZ, Wang Y, Urquhart DM, Estee MM, Wluka AE, Heritier S, Cicuttini FM. Metformin for knee osteoarthritis with obesity: study protocol for a randomised, double-blind, placebo-controlled trial. BMJ Open 2023; 13:e079489. [PMID: 38070903 PMCID: PMC10729261 DOI: 10.1136/bmjopen-2023-079489] [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] [Received: 09/02/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Over half of the populations with knee osteoarthritis (OA) have obesity. These individuals have many other shared metabolic risk factors. Metformin is a safe, inexpensive, well-tolerated drug that has pleiotropic effects, including structural protection, anti-inflammatory and analgesic effects in OA, specifically the knee. The aim of this randomised, double-blind, placebo-controlled trial is to determine whether metformin reduces knee pain over 6 months in individuals with symptomatic knee OA who are overweight or obese. METHODS AND ANALYSIS One hundred and two participants with symptomatic knee OA and overweight or obesity will be recruited from the community in Melbourne, Australia, and randomly allocated in a 1:1 ratio to receive either metformin 2 g or identical placebo daily for 6 months. The primary outcome is reduction of knee pain [assessed by 100 mm Visual Analogue Scale (VAS)] at 6 months. The secondary outcomes are OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) responder criteria [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function and participant's global assessment (VAS)] at 6 months; change in knee pain, stiffness, function using WOMAC at 6 months and quality of life at 6 months. Adverse events will be recorded. The primary analysis will be by intention to treat, including all participants in their randomised groups. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Alfred Hospital Ethics Committee (708/20) and Monash University Human Research Ethics Committee (28498). Written informed consent will be obtained from all the participants. The findings will be disseminated through peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12621000710820 .
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Affiliation(s)
- Yuan Z Lim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Donna M Urquhart
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Mahnuma Mahfuz Estee
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Anita E Wluka
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Stephane Heritier
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
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Wei G, Lu K, Umar M, Zhu Z, Lu WW, Speakman JR, Chen Y, Tong L, Chen D. Risk of metabolic abnormalities in osteoarthritis: a new perspective to understand its pathological mechanisms. Bone Res 2023; 11:63. [PMID: 38052778 PMCID: PMC10698167 DOI: 10.1038/s41413-023-00301-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
Although aging has traditionally been viewed as the most important risk factor for osteoarthritis (OA), an increasing amount of epidemiological evidence has highlighted the association between metabolic abnormalities and OA, particularly in younger individuals. Metabolic abnormalities, such as obesity and type II diabetes, are strongly linked to OA, and they affect both weight-bearing and non-weight-bearing joints, thus suggesting that the pathogenesis of OA is more complicated than the mechanical stress induced by overweight. This review aims to explore the recent advances in research on the relationship between metabolic abnormalities and OA risk, including the impact of abnormal glucose and lipid metabolism, the potential pathogenesis and targeted therapeutic strategies.
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Affiliation(s)
- Guizheng Wei
- Department of Bone and Joint Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Ke Lu
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Muhammad Umar
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Zhenglin Zhu
- Department of Orthopedic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - William W Lu
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - John R Speakman
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yan Chen
- Department of Bone and Joint Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
| | - Liping Tong
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Di Chen
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
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21
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Pujol N, Lang E, Abitan A. Evolution of body mass index and complications rate in severely or morbidly obese patients undergoing total knee arthroplasty. Orthop Traumatol Surg Res 2023; 109:103704. [PMID: 37832867 DOI: 10.1016/j.otsr.2023.103704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION Associations between obesity and knee osteoarthritis or complications after total knee arthroplasty (TKA) are well established. The procedure can significantly improve knee function, favoring weight loss, despite the risk of surgical complications. The main objective of the present study was to assess change in body mass index (BMI) after TKA in patients with severe or morbid obesity (BMI≥35kg/m2). The secondary endpoint was the rate of surgical revision. The hypotheses were that there is no significant change in BMI after TKA and that there is a significant rate of revision. METHODS This retrospective descriptive study was conducted for the period June 2009 to December 2019. Thirty-three patients (48 knees) were included: 27 women, 6 men; mean age, 66.5 years (range, 55-80). Preoperatively, 11 patients had BMI 35-39.9kg/m2 and 22 BMI≥40 (including 11 with BMI≥45kg/m2). The preoperative axis was in varus for 35 patients (73%, including 54%≥10°) and in valgus for 13 (27% including 33%≥10°). Radiological and clinical evaluation was carried out at 3 months and 1 year postoperatively. At≥2 years, change in BMI and EQ5D functional score were established by telephone survey; >5% change in BMI was considered significant. RESULTS Mean follow-up was 6.9±2.3 years (range, 2.9-10.5). Twenty-five patients (38 knees) were included for analysis. Mean postoperative BMI was 41±5kg/m2, with a mean decrease of 1.2±3.6kg/m2. At the last follow-up, BMI had increased in 8 patients (32%), including 3 by >5% (12%), and decreased in 16 (64%), including 7 by >5% (28%). The higher the baseline BMI, the greater the decrease: for BMI [35-39.9], -0.81 (range, -6.8; +4.3); for BMI [40-44.5],-1 (range, -9; +5.22); and for BMI>45, -1.54 (range, -3.97; +1.3). EQ5D averaged 0.75 at last follow-up. The higher the preoperative BMI, the more satisfactory the postoperative EQ5D: EQ5D for BMI [35-39.9]=0.71 (range, 0.36; 1); for BMI [40-44.5]=0.75 (range, 0.45; 1); and for BMI>45=0.80 (range, 0.48; 1). Four early surgical site infections (10.5%) and 2 isolated changes of the tibial component for early loosening (5.2%) required surgical revision. CONCLUSION Patients with severe or morbid obesity had a low tendency to lose weight after TKA, but this does not appear to us to be clinically relevant: the functional results were good. Nevertheless, this series showed a significant rate of revision (15%). TKA was feasible in patients with BMI≥35kg/m2, but requires appropriate patient information. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Nicolas Pujol
- Service de chirurgie orthopédique et traumatologie, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
| | - Elena Lang
- Service de chirurgie orthopédique et traumatologie, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France
| | - Alexandre Abitan
- Service de chirurgie orthopédique et traumatologie, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France
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Yang Y, Zhao Z, Wang Y, Gao Y, Sun H, Liu W. Impact of wound complications in obese versus non-obese patients undergoing total hip arthroplasty: A meta-analysis. Int Wound J 2023; 20:4200-4207. [PMID: 37518969 PMCID: PMC10681413 DOI: 10.1111/iwj.14318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023] Open
Abstract
This meta-analysis examined the post-operative wound effect of both obese and non-obese in total hip arthroplasty (THA) patients. To gather as complete an overview as possible, the researchers took advantage of 4 databases-PubMed, Embase, Cochrane Library and Web of Science-to conduct a critical assessment. Following the development of inclusion and exclusion criteria, the researchers evaluated the quality of each document. A total of 9 related trials were conducted to determine the 95% CI (CI) and OR using a fixed-effect model. The final meta-analyses were conducted with RevMan 5.3. Our findings indicate that there is no statistically significant benefit in terms of post-operative wound complications among obese and non-obese patients. Obese subjects had a significantly higher risk of injury than those without obesity (OR, 1.43; 95% CI, 1.04, 1.95, p = 0.03); obesity was also associated with a significantly higher risk of operative site infection than in non-obese subjects (OR, 1.96; 95% CI, 1.76, 2.18, p < 0.0001); and after surgery, there was also a significant increase in the risk of post-operative wound infections among obese subjects than in non-obese subjects (OR, 1.57; 95% CI, 1.34, 1.84, p < 0.0001). However, due to the small size of the cohort study in this meta-study, caution is required in the analysis. More randomized, controlled studies will be needed to validate these results.
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Affiliation(s)
- Yufei Yang
- The Second Affiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
| | | | - Yong Wang
- Inner Mongolia Medical UniversityHohhotChina
| | - Yuhui Gao
- Inner Mongolia Medical UniversityHohhotChina
| | - Hongyan Sun
- Inner Mongolia Medical UniversityHohhotChina
| | - Wanlin Liu
- The Second Affiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
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23
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Rastogi S, Pandey P, Kumar S, Verma A, R C. 'Obesity and arthritis' as the morbid duo: Designing and experimenting a novel strategy for weight reduction at a secondary care ayurveda -arthritis center. J Ayurveda Integr Med 2023; 14:100722. [PMID: 37244779 PMCID: PMC10692377 DOI: 10.1016/j.jaim.2023.100722] [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: 04/05/2022] [Revised: 04/15/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023] Open
Abstract
Obesity has been a critical confounding factor in arthritis. Its impacts are seemingly more apparent in conditions like knee osteoarthritis but it affects the net outcome in almost every type of arthritis. Reduction of weight is the obvious first advice by a treating physician in such cases. In the absence of a clear roadmap however to reach the goal, It remains an unmet advise for most arthritis patients. Obesity combined with arthritis, becomes a morbid combination where addition of weight adds to intensity of arthritis and arthritis induced limitation of movements adds to the weight. Weight reduction is much tougher in arthritis due to the physical limitations. Noticing this gap of knowledge between desired and achieved, Ayurveda -arthritis treatment and advanced research center at Lucknow has designed a strategic plan as a real help to such people and executed it through the activities focusing upon educating the obese arthritis patients for causes and concerns of obesity in general and individualized management plan through an interactive workshop. A workshop of its own kind was conducted on 24 April 2022. 28 obese arthritics as participants had offered to understand the real need and feasibility of doing these strategically focused activities aiming at weight reduction. This has come up as a new opportunity of help to the obese arthritis patients by empowering them with practical knowledge and tools to reduce weight suiting to their individual capacities and needs. The feedback of the participants provided at the end of the workshop was highly encouraging and has shown that strategically focused activities to bridge the gaps in clinical practice are highly desired and useful.
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Affiliation(s)
- Sanjeev Rastogi
- Ayurveda - Arthritis Treatment and Advanced Research Center (A-ATARC), State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow, 226003, India.
| | - Preeti Pandey
- Ayurveda - Arthritis Treatment and Advanced Research Center (A-ATARC), State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow, 226003, India
| | - Sumit Kumar
- Ayurveda - Arthritis Treatment and Advanced Research Center (A-ATARC), State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow, 226003, India
| | - Ankita Verma
- Ayurveda - Arthritis Treatment and Advanced Research Center (A-ATARC), State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow, 226003, India
| | - Chinmayi R
- Ayurveda - Arthritis Treatment and Advanced Research Center (A-ATARC), State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow, 226003, India
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24
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Condemi S, Panuel M, Chaumoitre K, Belcastro MG, Pietrobelli A, Voisin JL. A pathological Neandertal thumb phalanx from Moula-Guercy (France). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 42:14-17. [PMID: 37354658 DOI: 10.1016/j.ijpp.2023.06.002] [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: 11/13/2022] [Revised: 06/17/2023] [Accepted: 06/18/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE To discuss a Neandertal pathological adult first pollical proximal phalanx (I2-104) from the Baume de Moula-Guercy (Ardèche, France) and evaluate the possible causes of this pathology. METHODS Macroscopic analyses of external features, as well as CT imaging, were used in the analysis RESULTS: The presence of asymmetric eburnation on the distal epiphysis associated with an osteophyte on the palmar surface, as well as the absence of periosteal bone reaction visible on CT images, is consistent with osteoarthritis. CONCLUSION Osteoarthritis (OA) can have different origins and the cause is difficult to identify. The pathology of the Moula-Guercy I2-104 phalanx may be due to a genetic predisposition for OA known in Neandertals and associated with short limb bones. The OA could have been aggravated by the age of this individual and by an inflammatory reaction caused by repeated movements and intense vibrations provoked by high-frequency knapping or by other use of the hands SIGNIFICANCE: The I2-104 phalanx is the first Neandertal pollical phalanx known to display OA, although joints of this bone are frequently affected by this pathology in modern humans. Thus, greater insight into the presence and consequences of Neandertal behaviors is offered LIMITATION: It is impossible to give a definitive conclusion on the cause(s) of the OA in this case. SUGGESTIONS FOR FURTHER RESEARCH More data is needed concerning OA within Neandertals and its relationship with behavior and genetics.
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Affiliation(s)
- Silvana Condemi
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France.
| | - Michel Panuel
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
| | - Kathia Chaumoitre
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
| | - Maria Giovanna Belcastro
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Alma Mater Studiorum Università di Bologna, Via Selmi 3, Bologna, Italy
| | - Annalisa Pietrobelli
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Alma Mater Studiorum Università di Bologna, Via Selmi 3, Bologna, Italy
| | - Jean-Luc Voisin
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France.
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25
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Chabronova A, van den Akker G, Housmans BAC, Caron MMJ, Cremers A, Surtel DAM, Peffers MJ, van Rhijn LW, Marchand V, Motorin Y, Welting TJM. Depletion of SNORA33 Abolishes ψ of 28S-U4966 and Affects the Ribosome Translational Apparatus. Int J Mol Sci 2023; 24:12578. [PMID: 37628759 PMCID: PMC10454564 DOI: 10.3390/ijms241612578] [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: 07/05/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Eukaryotic ribosomes are complex molecular nanomachines translating genetic information from mRNAs into proteins. There is natural heterogeneity in ribosome composition. The pseudouridylation (ψ) of ribosomal RNAs (rRNAs) is one of the key sources of ribosome heterogeneity. Nevertheless, the functional consequences of ψ-based ribosome heterogeneity and its relevance for human disease are yet to be understood. Using HydraPsiSeq and a chronic disease model of non-osteoarthritic primary human articular chondrocytes exposed to osteoarthritic synovial fluid, we demonstrated that the disease microenvironment is capable of instigating site-specific changes in rRNA ψ profiles. To investigate one of the identified differential rRNA ψ sites (28S-ψ4966), we generated SNORA22 and SNORA33 KO SW1353 cell pools using LentiCRISPRv2/Cas9 and evaluated the ribosome translational capacity by 35S-Met/Cys incorporation, assessed the mode of translation initiation and ribosomal fidelity using dual luciferase reporters, and assessed cellular and ribosomal proteomes by LC-MS/MS. We uncovered that the depletion of SNORA33, but not SNORA22, reduced 28S-ψ4966 levels. The resulting loss of 28S-ψ4966 affected ribosomal protein composition and function and led to specific changes in the cellular proteome. Overall, our pioneering findings demonstrate that cells dynamically respond to disease-relevant changes in their environment by altering their rRNA pseudouridylation profiles, with consequences for ribosome function and the cellular proteome relevant to human disease.
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Affiliation(s)
- Alzbeta Chabronova
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Guus van den Akker
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Bas A C Housmans
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Marjolein M J Caron
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Andy Cremers
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Don A M Surtel
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Mandy J Peffers
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L8 7TX, UK
| | - Lodewijk W van Rhijn
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Virginie Marchand
- UAR2008 IBSLor CNRS-INSERM-Université de Lorraine, F54000 Nancy, France
| | - Yuri Motorin
- UAR2008 IBSLor CNRS-INSERM-Université de Lorraine, F54000 Nancy, France
- UMR7365 IMOPA, CNRS-Université de Lorraine, F54000 Nancy, France
| | - Tim J M Welting
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 HX Maastricht, The Netherlands
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University Medical Center+ (MUMC+), 6229 HX Maastricht, The Netherlands
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26
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Cavallo C, Boffa A, Salerno M, Merli G, Grigolo B, Filardo G. Adipose Tissue-Derived Products May Present Inflammatory Properties That Affect Chondrocytes and Synoviocytes from Patients with Knee Osteoarthritis. Int J Mol Sci 2023; 24:12401. [PMID: 37569775 PMCID: PMC10418602 DOI: 10.3390/ijms241512401] [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: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Adipose tissue-derived cell-based injectable therapies have been demonstrated to have disease-modifying effects on joint tissues in preclinical studies on animal osteoarthritis (OA) models, but clinical results are heterogeneous and not always satisfactory. The aim of this study was to investigate the influence of adipose tissue properties on the therapeutic effects of the adipose-derived product in an in vitro OA setting. Micro-fragmented adipose tissue (MF-AT) samples were obtained from 21 OA patients (mean age 51.7 ± 11.8 years, mean BMI 25.7 ± 4.1 kg/m2). The analysis of the MF-AT supernatant was performed to analyze the release of inflammatory factors. The effects of MF-AT inflammatory factors were investigated on chondrocytes and synoviocytes gene expression levels. Patients' characteristics were analyzed to explore their influence on MF-AT inflammatory molecules and on the MF-AT effects on the gene expression of chondrocytes and synoviocytes. The study results demonstrated that adipose tissue-derived products may present inflammatory properties that influence the therapeutic potential for OA treatment, with products with a higher pro-inflammatory profile stimulating a higher expression of genes related to a more inflamed and catabolic phenotype. A higher pro-inflammatory cytokine pattern and a higher pro-inflammatory effect were found in adipose tissue-derived products obtained from OA patients with higher BMI.
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Affiliation(s)
- Carola Cavallo
- Laboratorio RAMSES, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (C.C.); (B.G.)
| | - Angelo Boffa
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Manuela Salerno
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.M.); (G.F.)
| | - Giulia Merli
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.M.); (G.F.)
| | - Brunella Grigolo
- Laboratorio RAMSES, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (C.C.); (B.G.)
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.M.); (G.F.)
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27
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Yu D, Huang X, Mamas MA, Wilkie R. Persistent high prevalence of modifiable cardiovascular risk factors among patients with osteoarthritis in the UK in 1992-2017. RMD Open 2023; 9:e003298. [PMID: 37648396 PMCID: PMC10471862 DOI: 10.1136/rmdopen-2023-003298] [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: 05/09/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES To compare the annual and period prevalence of modifiable cardiovascular risk factors (MCVRFs) between populations with and without osteoarthritis (OA) in the UK over 25 years. METHODS 215 190 patients aged 35 years and over from the UK Clinical Practice Research Datalink GOLD database who were newly diagnosed OA between 1992 and 2017, as well as 1:1 age-matched, sex-matched, practice-matched and index year-matched non-OA individuals, were incorporated. MCVRFs including smoking, hypertension, type 2 diabetes, obesity and dyslipidaemia were defined by Read codes and clinical measurements. The annual and period prevalence and prevalence rate ratios (PRRs) of individual and clustering (≥1, ≥2 and ≥3) MCVRFs were estimated by Poisson regression with multiple imputations for missing values. RESULTS The annual prevalence of MCVRFs increased in the population with OA between 1992 and 2017 and was consistently higher in the population with OA compared with the population without OA between 2004 and 2017. Trends towards increased or stable annual PRRs for individuals and clustering of MCVRFs were observed. A 26-year period prevalence of single and clustering MCVRFs was significantly higher in individuals with OA compared with non-OA individuals. Period PRRs were higher in Southern England, women and increased with age for most MCVRFs except for obesity, which has the higher PRR in the youngest age group. CONCLUSIONS A consistently higher long-term prevalence of MCVRFs was observed in individuals with OA compared to those without OA. The higher prevalence of obesity in the youngest age group with OA highlights the need for public health strategies. Further research to understand MCVRF management in OA populations is necessary.
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Affiliation(s)
- Dahai Yu
- Department of Nephrology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Xiaoyang Huang
- Shenzhen Ellen-Sven Precision Medicine Institute, Shenzhen, Guangdong, China
| | - Mamas A Mamas
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Ross Wilkie
- School of Medicine, Keele University, Keele, Staffordshire, UK
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28
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Visco V, Izzo C, Bonadies D, Di Feo F, Caliendo G, Loria F, Mancusi C, Chivasso P, Di Pietro P, Virtuoso N, Carrizzo A, Vecchione C, Ciccarelli M. Interventions to Address Cardiovascular Risk in Obese Patients: Many Hands Make Light Work. J Cardiovasc Dev Dis 2023; 10:327. [PMID: 37623340 PMCID: PMC10455377 DOI: 10.3390/jcdd10080327] [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: 05/29/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Obesity is a growing public health epidemic worldwide and is implicated in slowing improved life expectancy and increasing cardiovascular (CV) risk; indeed, several obesity-related mechanisms drive structural, functional, humoral, and hemodynamic heart alterations. On the other hand, obesity may indirectly cause CV disease, mediated through different obesity-associated comorbidities. Diet and physical activity are key points in preventing CV disease and reducing CV risk; however, these strategies alone are not always sufficient, so other approaches, such as pharmacological treatments and bariatric surgery, must support them. Moreover, these strategies are associated with improved CV risk factors and effectively reduce the incidence of death and CV events such as myocardial infarction and stroke; consequently, an individualized care plan with a multidisciplinary approach is recommended. More precisely, this review explores several interventions (diet, physical activity, pharmacological and surgical treatments) to address CV risk in obese patients and emphasizes the importance of adherence to treatments.
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Affiliation(s)
- Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Carmine Izzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Davide Bonadies
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Federica Di Feo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Giuseppe Caliendo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Francesco Loria
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Costantino Mancusi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80138 Naples, Italy;
| | - Pierpaolo Chivasso
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, 84131 Salerno, Italy;
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Nicola Virtuoso
- Cardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy;
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
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29
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Shumnalieva R, Kotov G, Monov S. Obesity-Related Knee Osteoarthritis-Current Concepts. Life (Basel) 2023; 13:1650. [PMID: 37629507 PMCID: PMC10456094 DOI: 10.3390/life13081650] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
The knee is the joint most frequently involved in osteoarthritis and represents a significant contributor to patient morbidity and impaired functional status. Major risk factors include genetics, age, sex, mechanical load and obesity/metabolic syndrome. Recent studies highlighted the role of obesity and metabolic syndrome in the pathogenesis of knee osteoarthritis not simply through increased mechanical loading but the systemic effects of obesity-induced inflammation. The current concept of knee osteoarthritis is that of a 'whole joint disease', which highlights the involvement not only of articular cartilage but also the synovium, subchondral bone, ligaments and muscles. Obesity and metabolic syndrome are associated with higher levels of pro-inflammatory cytokines, increased production of adipokines with both protective and destructive effects on articular cartilage, an up-regulation of proteolytic enzymes such as matrix metalloproteinases and aggrecanases and an increase in free fatty acids and reactive oxygen species induced by dyslipidemia. These findings underscore that the adequate management of knee osteoarthritis needs to include an optimization of body weight and a beneficial mobility regimen. The possible introduction of pharmacological therapy targeting specific molecules involved in the pathogenesis of obesity-related osteoarthritis will likely also be considered in future therapeutic strategies, including personalized treatment approaches.
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Affiliation(s)
| | - Georgi Kotov
- Clinic of Rheumatology, Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
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30
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Truong AP, Wall CJ, Stoney JD, Graves SE, Lorimer MF, de Steiger RN. Obesity is associated with an increased risk of undergoing hip replacement in Australia. ANZ J Surg 2023; 93:1901-1906. [PMID: 37248204 DOI: 10.1111/ans.18543] [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: 12/15/2022] [Revised: 05/14/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Obesity is a known risk factor for the development of hip osteoarthritis. The aim of this study was to investigate whether obesity is associated with the risk of undergoing total hip replacement (THR) in Australia. METHODS A cohort study was conducted comparing data from the Australian Bureau of Statistics and the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) from 2017 to 2018. Body mass index (BMI) data for patients undergoing primary total hip replacement and resurfacing for osteoarthritis were obtained from the AOANJRR. The distribution of THR patients by BMI category was compared to the general population, in age and sex sub-groups. RESULTS During the study period, 32 495 primary THR were performed for osteoarthritis in Australia. Compared to the general population, there was a higher prevalence of Class I, II and III obesity in patients undergoing THR in both sexes aged 35-74 years. Class III obese females and males aged 55-64 years were 2.9 and 1.7 times more likely to undergo THR, respectively (P < 0.001). Class III obese females and males underwent THR on average 5.7 and 7.0 years younger than their normal weight counterparts, respectively. CONCLUSION Obese Australians are at increased risk of undergoing THR, and at a younger age.
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Affiliation(s)
- Anthony P Truong
- Department of Orthopaedics, Toowoomba Hospital, Darling Downs Health, Toowoomba, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Christopher J Wall
- Department of Orthopaedics, Toowoomba Hospital, Darling Downs Health, Toowoomba, Queensland, Australia
- School of Medicine, Rural Clinical School, University of Queensland, Brisbane, Queensland, Australia
| | - James D Stoney
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, Victoria, Australia
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia
| | - Stephen E Graves
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia
| | - Michelle F Lorimer
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Richard N de Steiger
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia
- Department of Surgery, Epworth Healthcare, The University of Melbourne, Melbourne, Victoria, Australia
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31
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Koppold DA, Kandil FI, Güttler O, Müller A, Steckhan N, Meiß S, Breinlinger C, Nelle E, Hartmann AM, Jeitler M, Hanslian E, Fischer JM, Michalsen A, Kessler CS. Effects of Prolonged Fasting during Inpatient Multimodal Treatment on Pain and Functional Parameters in Knee and Hip Osteoarthritis: A Prospective Exploratory Observational Study. Nutrients 2023; 15:2695. [PMID: 37375597 DOI: 10.3390/nu15122695] [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: 04/25/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Preliminary clinical data suggest that pain reduction through fasting may be effective for different diagnoses. This uncontrolled observational clinical study examined the effects of prolonged modified fasting on pain and functional parameters in hip and knee osteoarthritis. Patients admitted to the inpatient department of Internal Medicine and Nature-based Therapies of the Immanuel Hospital Berlin between February 2018 and December 2020 answered questionnaires at the beginning and end of inpatient treatment, as well as at 3, 6, and 12 months after discharge. Additionally, selected blood and anthropometric parameters, as well as subjective pain ratings, were routinely assessed during the inpatient stay. Fasting was the only common intervention for all patients, being performed as part of a multimodal integrative treatment program, with a daily caloric intake of <600 kcal for 7.7 ± 1.7 days. N = 125 consecutive patients were included. The results revealed an amelioration of overall symptomatology (WOMAC Index score: -14.8 ± 13.31; p < 0.001; d = 0.78) and pain alleviation (NRS Pain: -2.7 ± 1.98, p < 0.001, d = 1.48). Pain medication was reduced, stopped, or replaced by herbal remedies in 36% of patients. Improvements were also observed in secondary outcome parameters, including increased quality of life (WHO-5: +4.5 ± 4.94, p < 0.001, d = 0.94), reduced anxiety (HADS-A: -2.1 ± 2.91, p < 0001, d = 0.55) and depression (HADS-D: -2.3 ± 3.01, p < 0.001, d = 0.65), and decreases in body weight (-3.6 kg ± 1.65, p < 0.001, d = 0.21) and blood pressure (systolic: -6.2 ± 15.93, p < 0.001, d = 0.43; diastolic: -3.7 ± 10.55, p < 0.001, d = 0.43). The results suggest that patients with osteoarthritis of the lower extremities may benefit from prolonged fasting as part of a multimodal integrative treatment to improve quality of life, pain, and disease-specific functional parameters. Confirmatory randomized controlled trials are warranted to further investigate these hypotheses.
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Affiliation(s)
- Daniela A Koppold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany
- Department of Pediatrics, Division of Oncology and Hematology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Farid I Kandil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Pediatrics, Division of Oncology and Hematology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Oliver Güttler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Anna Müller
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- State Institute of Forensic Medicine Berlin, 10559 Berlin, Germany
| | - Nico Steckhan
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Connected Healthcare, Hasso Plattner Institute, University of Potsdam, 14482 Potsdam, Germany
| | - Sara Meiß
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Carolin Breinlinger
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany
| | - Esther Nelle
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Anika M Hartmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany
| | - Etienne Hanslian
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Jan Moritz Fischer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany
| | - Christian S Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal Medicine and Nature-Based Therapies, Immanuel Hospital Berlin, 14109 Berlin, Germany
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32
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Gambari L, Cellamare A, Grassi F, Grigolo B, Panciera A, Ruffilli A, Faldini C, Desando G. Targeting the Inflammatory Hallmarks of Obesity-Associated Osteoarthritis: Towards Nutraceutical-Oriented Preventive and Complementary Therapeutic Strategies Based on n-3 Polyunsaturated Fatty Acids. Int J Mol Sci 2023; 24:ijms24119340. [PMID: 37298291 DOI: 10.3390/ijms24119340] [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: 03/15/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity (Ob), which has dramatically increased in the last decade, is one of the main risk factors that contribute to the incidence and progression of osteoarthritis (OA). Targeting the characteristics of obesity-associated osteoarthritis (ObOA) may offer new chances for precision medicine strategies in this patient cohort. First, this review outlines how the medical perspective of ObOA has shifted from a focus on biomechanics to the significant contribution of inflammation, mainly mediated by changes in the adipose tissue metabolism through the release of adipokines and the modification of fatty acid (FA) compositions in joint tissues. Preclinical and clinical studies on n-3 polyunsaturated FAs (PUFAs) are critically reviewed to outline the strengths and weaknesses of n-3 PUFAs' role in alleviating inflammatory, catabolic and painful processes. Emphasis is placed on potential preventive and therapeutic nutritional strategies based on n-3 PUFAs, with a focus on ObOA patients who could specifically benefit from reformulating the dietary composition of FAs towards a protective phenotype. Finally, tissue engineering approaches that involve the delivery of n-3 PUFAs directly into the joint are explored to address the perspectives and current limitations, such as safety and stability issues, for implementing preventive and therapeutic strategies based on dietary compounds in ObOA patients.
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Affiliation(s)
- Laura Gambari
- Laboratorio Ramses, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Antonella Cellamare
- Laboratorio Ramses, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Francesco Grassi
- Laboratorio Ramses, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Brunella Grigolo
- Laboratorio Ramses, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Alessandro Panciera
- 1st Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy
| | - Alberto Ruffilli
- 1st Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy
| | - Cesare Faldini
- 1st Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy
| | - Giovanna Desando
- Laboratorio Ramses, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy
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33
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Sobieh BH, El-Mesallamy HO, Kassem DH. Beyond mechanical loading: The metabolic contribution of obesity in osteoarthritis unveils novel therapeutic targets. Heliyon 2023; 9:e15700. [PMID: 37180899 PMCID: PMC10172930 DOI: 10.1016/j.heliyon.2023.e15700] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/16/2023] Open
Abstract
Osteoarthritis (OA) is a prevalent progressive disease that frequently coexists with obesity. For several decades, OA was thought to be the result of ageing and mechanical stress on cartilage. Researchers' perspective has been greatly transformed when cumulative findings emphasized the role of adipose tissue in the diseases. Nowadays, the metabolic effect of obesity on cartilage tissue has become an integral part of obesity research; hoping to discover a disease-modifying drug for OA. Recently, several adipokines have been reported to be associated with OA. Particularly, metrnl (meteorin-like) and retinol-binding protein 4 (RBP4) have been recognized as emerging adipokines that can mediate OA pathogenesis. Accordingly, in this review, we will summarize the latest findings concerned with the metabolic contribution of obesity in OA pathogenesis, with particular emphasis on dyslipidemia, insulin resistance and adipokines. Additionally, we will discuss the most recent adipokines that have been reported to play a role in this context. Careful consideration of these molecular mechanisms interrelated with obesity and OA will undoubtedly unveil new avenues for OA treatment.
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Affiliation(s)
- Basma H. Sobieh
- Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Hala O. El-Mesallamy
- Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
- Faculty of Pharmacy, Sinai University, Sinai, Egypt
| | - Dina H. Kassem
- Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
- Corresponding author. Associate Professor of Biochemistry Department of Biochemistry, Faculty of Pharmacy, Ain Shams University, street of African Union Organization, 11566, Cairo, Egypt.
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34
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Merola C, Caioni G, Cimini A, Perugini M, Benedetti E. Sodium valproate exposure influences the expression of pparg in the zebrafish model. Birth Defects Res 2023; 115:658-667. [PMID: 36786327 DOI: 10.1002/bdr2.2159] [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: 09/15/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 02/15/2023]
Abstract
Valproic acid (VPA) is an anti-epileptic drug used alone or in combination with other medications to treat seizures, mania, and bipolar disorder. VPA recognized as a teratogenic chemical can cause severe birth defects mainly affecting the brain and spinal cord when administered during pregnancy. However, the potential mechanisms of developmental toxicity are still less studied, and in the present study, the influence of VPA exposure was evaluated on zebrafish early-life stages. Zebrafish were exposed to two sublethal concentrations of sodium valproate (SV) (0.06 mM and 0.15 mM) from 24 hours post-fertilization (hpf) to 96 hpf and the SV teratogenic potential was investigated through morphometric analysis of zebrafish larvae combined with the evaluation of cartilage profile. Moreover, the effect of SV on the transcription level of pparg was also performed. The results of the study showed the teratogenic potential of SV, which disrupts the morphometric signature of the head and body. The marked distortion of cartilage structures was paralleled to a malformation of telencephalon and optic tectum in both concentrations suggesting a high teratogen effect of SV on the brain. These data were further confirmed by the increased expression of pparg in the zebrafish head. Overall, the present study confirms the teratogenic activity of SV in the zebrafish model and, for the first time, points out the potential protective role of pparg in the SV dose-dependent toxicity.
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Affiliation(s)
- Carmine Merola
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | - Giulia Caioni
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Annamaria Cimini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Monia Perugini
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | - Elisabetta Benedetti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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35
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Infrared Thermography in Symptomatic Knee Osteoarthritis: Joint Temperature Differs Based on Patient and Pain Characteristics. J Clin Med 2023; 12:jcm12062319. [PMID: 36983319 PMCID: PMC10055129 DOI: 10.3390/jcm12062319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
The aim of this study was to evaluate osteoarthritis (OA) patients with infrared thermography to investigate imaging patterns as well as demographic and clinical characteristics that influence knee inflammation. Forty patients with one-sided symptomatic knee OA were included and evaluated through knee-specific PROMs and the PainDETECT Questionnaire for neuropathic pain evaluation. Thermograms were captured using a thermographic camera FLIR-T1020 and temperatures were extracted using the software ResearchIR for the overall knee and the five ROIs: medial, lateral, medial patella, lateral patella, and suprapatellar. The mean temperature of the total knee was 31.9 ± 1.6 °C. It negatively correlated with age (rho = −0.380, p = 0.016) and positively correlated with BMI (rho = 0.421, p = 0.007) and the IKDC objective score (tau = 0.294, p = 0.016). Men had higher temperatures in the knee medial, lateral, and suprapatellar areas (p = 0.017, p = 0.019, p = 0.025, respectively). Patients with neuropathic pain had a lower temperature of the medial knee area (31.5 ± 1.0 vs. 32.3 ± 1.1, p = 0.042), with the total knee negatively correlating with PainDETECT (p = 0.045). This study demonstrated that the skin temperature of OA symptomatic knees is influenced by demographic and clinical characteristics of patients, with higher joint temperatures in younger male patients with higher BMI and worst objective knee scores and lower temperatures in patients affected by neuropathic pain.
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36
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Association of general and central obesity, and their changes with risk of knee osteoarthritis: a nationwide population-based cohort study. Sci Rep 2023; 13:3796. [PMID: 36882508 PMCID: PMC9992488 DOI: 10.1038/s41598-023-30727-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
In this study, we aimed to evaluate the association between general and central obesity, and their changes with risk of knee osteoarthritis (OA) using retrospective cohort data collected from the Korean National Health Insurance Service. We studied 1,139,463 people aged 50 and over who received a health examination in 2009. To evaluate the association between general and/or central obesity and knee OA risk, a Cox proportional hazard models were used. Additionally, we investigate knee OA risk according to the change in obesity status over 2 years for subjects who had undergone health examinations for 2 consecutive years. General obesity without central obesity (HR 1.281, 95% CI 1.270-1.292) and central obesity without general obesity (HR 1.167, 95% CI 1.150-1.184) were associated with increased knee OA risk than the comparison group. Individuals with both general with central obesity had the highest risk (HR 1.418, 95% CI 1.406-1.429). This association was more pronounced in women and younger age group. Remarkably, the remission of general or central obesity over two years was associated with decreased knee OA risk (HR 0.884; 95% CI 0.867-0.902; HR 0.900; 95% CI 0.884-0.916, respectively). The present study found that both general and central obesity were associated with increased risk of knee OA and the risk was highest when the two types of obesity were accompanied. Changes in obesity status have been confirmed to alter the risk of knee OA.
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37
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Guarino A, Farinelli L, Iacono V, Cozzolino A, Natali S, Zorzi C, Mariconda M. Long-Term Survival and Predictors of Failure of Opening Wedge High Tibial Osteotomy. Orthop Surg 2023; 15:1002-1007. [PMID: 36782306 PMCID: PMC10102285 DOI: 10.1111/os.13674] [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: 10/14/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE High tibial valgus osteotomy (HTO) is a widely accepted procedure indicated for varus knee with symptomatic osteoarthritis of the medial compartment. However, there is a lack of studies evaluating long term results of this procedure. The primary aim of this study was to evaluate the long-term survival of opening wedge high tibial osteotomy (HTO) for isolated osteoarthritis in the medial compartment of the knee. The secondary objective was to identify independent predictors of conversion to total knee arthroplasty (TKA). METHODS This is a long term retrospective study of 296 cases of open wedge HTOs performed at a single center (level of evidence IV) between January 2005 and August 2015. Opening wedge medial HTO was always performed after diagnostic arthroscopy. Eighty-three percent of the population (233 patients, 247 procedures) was followed up at a mean 11.6 years (6-17) by telephone interview, to evaluate the possible conversion to TKA. Mean age at the index operation was 42.8 years (range 15-70) and most patients were male (70%). Associated procedures (e.g., platelet rich plasma supplementation, microfractures, meniscectomy, etc.) were carried out at the time of the HTO in 80 (32%) cases. Survival of HTO and its association with age, sex, body mass index, smoking habit, preoperative severity of varus deformity, cartilage status at surgery, and associated procedures were evaluated. Kaplan-Meier and Cox regression analyses were performed. RESULTS Thirty-three of the 247 HTOs (13.4%) were converted to knee replacement, with 86.6% of the original procedures surviving at a mean 12-year follow-up. Kaplan-Meier survival estimates at 17 years for HTO were 75.5% (95% confidence interval [CI] 66.7-84.3). There was significant difference (P < 0.001) in the 17-year survival rate between obese (55.5%; 95% CI 35.3-75.6) and non-obese (79.7%; 95% CI 70.1-89.2) patients. The determinants of conversion to knee arthroplasty detected at multivariate Cox regression analysis were body mass index, severity of cartilage degeneration in the medial compartment (Outerbridge grade), and age. CONCLUSION The long-term survival of open wedge HTO for osteoarthritis in the medial compartment of the knee is satisfactory. The risk of conversion to TKA is significantly increased in obese patients. Advanced age and severity of pre-existing cartilage damage may also contribute to the risk of conversion to TKA.
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Affiliation(s)
- Amedeo Guarino
- Department of Public Health, Section of Orthopaedics, Federico II University, Naples, Italy
| | - Luca Farinelli
- Orthopaedic Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Venanzio Iacono
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore-Don Calabria in Negrar (VE), Negrar di Valpolicella VR, Italy
| | - Andrea Cozzolino
- Department of Public Health, Section of Orthopaedics, Federico II University, Naples, Italy
| | - Simone Natali
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore-Don Calabria in Negrar (VE), Negrar di Valpolicella VR, Italy
| | - Claudio Zorzi
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore-Don Calabria in Negrar (VE), Negrar di Valpolicella VR, Italy
| | - Massimo Mariconda
- Department of Public Health, Section of Orthopaedics, Federico II University, Naples, Italy
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38
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Zeng J, Franklin DK, Das A, Hirani V. The effects of dietary patterns and food groups on symptomatic osteoarthritis: A systematic review. Nutr Diet 2023; 80:21-43. [PMID: 36278278 PMCID: PMC10092134 DOI: 10.1111/1747-0080.12781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/28/2022]
Abstract
AIM To systematically review current literature to determine the association between symptomatic osteoarthritis and dietary patterns, diet quality and food groups in adults aged ≥45 years. METHODS The review was registered on PROSPERO (CRD42021270891). Cochrane Central Library, Cumulative Index of Nursing and Allied Health Literature, Embase, Medline and Web of Science databases were searched. A total of 3816 records were identified. Eligible articles involved populations aged ≥45 years with symptomatic osteoarthritis, assessing dietary patterns, diet quality or food groups, with pain in joints as outcomes. The Joanna Briggs Institute Critical Appraisal Checklists were used for quality assessment. Grading of Recommendations, Assessment, Development and Evaluation was used to assess the certainty of evidence. RESULTS Six cohort studies were included. The Prudent dietary pattern and the Mediterranean dietary pattern reduced the progression of osteoarthritis symptoms. The Western dietary pattern increased symptomatic osteoarthritis progression. Increased total fibre consumption reduced symptomatic osteoarthritis progression and pain worsening, but the effects of fibre from each food group were inconclusive. Diet with high inflammatory potential increased risk of new onset symptomatic osteoarthritis, but the effects of overall diet quality were inconclusive. CONCLUSIONS The Prudent dietary pattern showed the highest protection on symptomatic osteoarthritis in adults aged 45 years and over. The body of evidence is limited, suggesting that further research is needed to corroborate the estimated effect at a high certainty of evidence, and to incorporate previously unstudied dietary patterns and food groups. Identifying the most beneficial dietary pattern may inform future guidelines for reducing symptomatic osteoarthritis in middle aged and older adults.
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Affiliation(s)
- Jiayu Zeng
- Discipline of Nutrition and Dietetics, School of Nursing and Midwifery, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniella Kate Franklin
- Discipline of Nutrition and Dietetics, School of Nursing and Midwifery, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Arpita Das
- Discipline of Nutrition and Dietetics, School of Nursing and Midwifery, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Vasant Hirani
- Discipline of Nutrition and Dietetics, School of Nursing and Midwifery, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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39
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Maxwell CV, Shirley R, O'Higgins AC, Rosser ML, O'Brien P, Hod M, O'Reilly SL, Medina VP, Smith GN, Hanson MA, Adam S, Ma RC, Kapur A, McIntyre HD, Jacobsson B, Poon LC, Bergman L, Regan L, Algurjia E, McAuliffe FM. Management of obesity across women's life course: FIGO Best Practice Advice. Int J Gynaecol Obstet 2023; 160 Suppl 1:35-49. [PMID: 36635081 PMCID: PMC10107516 DOI: 10.1002/ijgo.14549] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obesity is a chronic, progressive, relapsing, and treatable multifactorial, neurobehavioral disease. According to the World Health Organization, obesity affects 15% of women and has long-term effects on women's health. The focus of care in patients with obesity should be on optimizing health outcomes rather than on weight loss. Appropriate and common language, considering cultural sensitivity and trauma-informed care, is needed to discuss obesity. Pregnancy is a time of significant physiological change. Pre-, ante-, and postpartum clinical encounters provide opportunities for health optimization for parents with obesity in terms of, but not limited to, fertility and breastfeeding. Pre-existing conditions may also be identified and managed. Beyond pregnancy, women with obesity are at an increased risk for gastrointestinal and liver diseases, impaired kidney function, obstructive sleep apnea, and venous thromboembolism. Gynecological and reproductive health of women living with obesity cannot be dismissed, with accommodations needed for preventive health screenings and consideration of increased risk for gynecologic malignancies. Mental wellness, specifically depression, should be screened and managed appropriately. Obesity is a complex condition and is increasing in prevalence with failure of public health interventions to achieve significant decrease. Future research efforts should focus on interprofessional care and discovering effective interventions for health optimization.
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Affiliation(s)
- Cynthia V Maxwell
- Maternal Fetal Medicine; Sinai Health and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rachelle Shirley
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Amy C O'Higgins
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian, New York, New York, USA
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of HealthUniversidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Esraa Algurjia
- The World Association of Trainees in Obstetrics & Gynecology, Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Silisteanu AE, Antonescu OR, Racheriu M. The role of the therapeutic physical exercise and the complex recovery treatment for the patients with chronic degenerative diseases during the COVID-19 pandemic. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract: Background: Osteoarthritis is one of the most common causes of pain and musculoskeletal disability and mainly affects the middle-aged and the elderly. The condition is chronic and disabling, it diminishes the patients' quality of life. Purpose. The study had the purpose of pointing out a possible connection between physical ac-tivity and the reduction of pain accompanied by the increased functional capacity in patients with chronic degenerative diseases during the COVID-19 pandemic. Material and method: The study was conducted on an outpatient basis for a period of 6 months on a number of 40 patients diagnosed with osteoarthritis. The evaluation of the pa-tients was made at the beginning of the treatment and at its end (after 4 weeks), as well as at the control after 12 weeks. Results: The study included a number of 40 patients over 45 years old, divided into 2 study groups: in group L1-knee osteoarthritis and in group L2 -hip osteoarthritis. The therapeutic physical exercise reduced pain and stiff-ness, and it also improved the functional capacity. Conclusions: Therapeutic physical exercise has an important role in the reduction of pain and disability, as well as in the increase in the quality of life, if it is done properly.
Keywords: osteoarthritis, therapeutic physical exercise, pain, pandemic COVID-19
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Affiliation(s)
- Andrei Emanuel Silisteanu
- Healthcare Management, Lucian Blaga University of Sibiu, Faculty of Medicine /FPACS-Cluj Napoca, Romania
| | | | - Mihaela Racheriu
- Lucian Blaga University of Sibiu, Faculty of Medicine,Sibiu, Romania
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Lopez-Jimenez F, Almahmeed W, Bays H, Cuevas A, Di Angelantonio E, le Roux CW, Sattar N, Sun MC, Wittert G, Pinto FJ, Wilding JPH. Obesity and cardiovascular disease: mechanistic insights and management strategies. A joint position paper by the World Heart Federation and World Obesity Federation. Eur J Prev Cardiol 2022; 29:2218-2237. [PMID: 36007112 DOI: 10.1093/eurjpc/zwac187] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023]
Abstract
The ongoing obesity epidemic represents a global public health crisis that contributes to poor health outcomes, reduced quality of life, and >2.8 million deaths each year. Obesity is relapsing, progressive, and heterogeneous. It is considered a chronic disease by the World Obesity Federation (WOF) and a chronic condition by the World Heart Federation (WHF). People living with overweight/obesity are at greater risk for cardiovascular (CV) morbidity and mortality. Increased adiposity (body fat), particularly visceral/abdominal fat, is linked to CV risk and CV disease (CVD) via multiple direct and indirect pathophysiological mechanisms. The development of CVD is driven, in part, by obesity-related metabolic, endocrinologic, immunologic, structural, humoral, haemodynamic, and functional alterations. The complex multifaceted nature of these mechanisms can be challenging to understand and address in clinical practice. People living with obesity and CVD often have concurrent chronic physical or psychological disorders (multimorbidity) requiring multidisciplinary care pathways and polypharmacy. Evidence indicates that intentional weight loss (particularly when substantial) lowers CVD risk among people with overweight/obesity. Long-term weight loss and maintenance require ongoing commitment from both the individual and those responsible for their care. This position paper, developed by the WOF and the WHF, aims to improve understanding of the direct and indirect links between overweight/obesity and CVD, the key controversies in this area and evidence relating to cardiometabolic outcomes with available weight management options. Finally, an action plan for clinicians provides recommendations to help in identifying and addressing the risks of obesity-related CVD (recognizing resource and support variances between countries).
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Affiliation(s)
| | - Wael Almahmeed
- Department of Cardiology, Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Harold Bays
- Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, USA
| | - Ada Cuevas
- Center for Advanced Metabolic Medicine and Nutrition (CAMMYN), School of Medicine University Finis Terrae, Santiago, Chile
| | - Emanuele Di Angelantonio
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Science Centre, Human Technopole, Milan, Italy
| | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marie Chan Sun
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Mauritius, Mauritius
| | - Gary Wittert
- Freemasons Centre for Male Health and Wellbeing, School of Medicine, University of Adelaide, Adelaide, Australia
| | - Fausto J Pinto
- Cardiology Department, Centro Hospitalar Universitário Lisboa Norte, CAML, CCUL, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Office of the President, World Heart Federation, Geneva, Switzerland
| | - John P H Wilding
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Clinical Sciences Centre, Aintree University Hospital, Liverpool, UK
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Chang AH, Lee JJ, Almagor O, Chmiel JS, Hayes KW, Moisio KC, Sharma L. Knee Confidence Trajectories Over Eight Years and Factors Associated With Poor Trajectories in Individuals With or at Risk for Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2022; 74:1857-1865. [PMID: 33973405 PMCID: PMC10266298 DOI: 10.1002/acr.24629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/01/2021] [Accepted: 04/20/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify distinct trajectories of lack of knee confidence over an 8-year follow-up period and to examine baseline factors associated with poor trajectories in individuals with or at risk for knee osteoarthritis (OA). METHODS The Osteoarthritis Initiative is a prospective cohort study of individuals with or at high risk for knee OA. Confidence in the knees was assessed within the Knee Injury and Osteoarthritis Outcome Score instrument querying how much the individual is troubled by lack of confidence in his/her knee(s), rated as not-at-all (score = 0), mildly (score = 1), moderately (score = 2), severely (score = 3), and extremely (score = 4) troubled, reported annually from baseline to 96 months. Lack of knee confidence was defined as a score of ≥2. We used latent class models to identify subgroups that share similar underlying knee confidence trajectories over an 8-year period and multivariable multinomial logistic regression models to examine baseline factors associated with poor trajectories. RESULTS Among 4,515 participants (mean ± SD age 61.2 ± 9.2 years, mean ± SD BMI 28.6 ± 4.8 kg/m2 ; 2,640 [58.5%] women), 4 distinct knee confidence trajectories were identified: persistently good (65.6%); declining (9.1%); poor, improving (13.9%); and persistently poor (11.4%). Baseline predictors associated with persistently poor confidence (reference: persistently good) were younger age, male sex, higher body mass index (BMI), depressive symptoms, more advanced radiographic disease, worse knee pain, weaker knee extensors, history of knee injury and surgery, and reported hip and/or ankle pain. CONCLUSION Findings suggest the dynamic nature of self-reported knee confidence and that addressing modifiable factors (e.g., BMI, knee strength, depressive symptoms, and lower extremity pain) may improve its long-term course.
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Affiliation(s)
- Alison H Chang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jungwha Julia Lee
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Orit Almagor
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joan S Chmiel
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen W Hayes
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kirsten C Moisio
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leena Sharma
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Witkam R, Gwinnutt JM, Selby DA, Cooper R, Humphreys JH, Verstappen SMM. Does body mass index mediate the relationship between socioeconomic position and incident osteoarthritis? Semin Arthritis Rheum 2022; 56:152063. [DOI: 10.1016/j.semarthrit.2022.152063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
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Aggarwal VA, Sambandam SN, Wukich DK. The impact of obesity on total knee arthroplasty outcomes: A retrospective matched cohort study. J Clin Orthop Trauma 2022; 33:101987. [PMID: 36089991 PMCID: PMC9449637 DOI: 10.1016/j.jcot.2022.101987] [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: 06/08/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 10/15/2022] Open
Abstract
Background Total Knee Arthroplasty (TKA) is a common orthopaedic surgery to treat advanced knee arthritis. Post-operative complications can be affected by obesity, defined as a body mass index of 30 kg/m2 or higher. We examine the rates of specific complications, revision rates, and costs of care following TKA and compare them between multifactor matched obese and non-obese patients. We hypothesize these outcomes will be worse in obese patients than in non-obese patients. Methods This retrospective study of the PearlDiver database queries for patients who underwent TKA under Current Procedural Terminology (CPT) and International Statistical Classification of Diseases (ICD-9) codes between January 2011 and January 2020. Patients were matched based on age, gender, and comorbidity indices, and various complications, revision rates, and costs were compared between the matched obese and non-obese patient groups. Results Obesity was associated with higher rates of surgical complications, such as wound complications, surgical site infections, need for revision, and higher total cost of care one year after TKA, and medical complications such as, acute kidney injury, deep vein thrombosis, urinary tract infection, and narcotics use, but significantly lower rates of anemia, arrhythmia, cardiac arrest, pneumonia, and transfusion. Obese patients also experienced significantly lower drug costs of care. Conclusion Outcomes were not definitively worse in obese patients when compared to matched non-obese patients. Nevertheless, understanding the complications that can arise following TKA will assist in educating patients about potential risks from surgery and guide surgeons in caring for their patients as obesity is predicted to continue increasing in prevalence. As such, future studies should examine underlying mechanisms that cause these complications to develop potential therapies.
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Affiliation(s)
| | - Senthil N Sambandam
- University of Texas Southwestern, Staff Orthopedic Surgeon, Dallas VAMC, Dallas, TX, USA
| | - Dane K Wukich
- Department of Orthopaedics, University of Texas Southwestern, Dallas, TX, USA
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Zhao K, Nie L, Chin GMJ, Ye X, Sun P. Association between fat mass and obesity-related variant and osteoarthritis risk: Integrated meta-analysis with bioinformatics. Front Med (Lausanne) 2022; 9:1024750. [PMID: 36213660 PMCID: PMC9537627 DOI: 10.3389/fmed.2022.1024750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022] Open
Abstract
Objective The association of fat mass and obesity-related (FTO) gene with osteoarthritis (OA) risk has been investigated in multiple genome-wide association studies but showed inconsistent results. Our study aimed to assess FTO expression in different OA sequencing datasets and to meta-analyze whether FTO polymorphism was associated with the risk of osteoarthritis. Method Gene expression profiles were obtained from ArrayExpress, Gene Expression Omnibus (GEO), and BioProject databases. Three electronic databases including PubMed and EMBASE were systematically retrieved to identify articles exploring the association between FTO polymorphisms and OA risk published before September 2022. Summary odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were calculated to perform the result. Stata software was utilized to conduct analyses on predetermined ethnicity and gender subgroups and sensitivity. Results FTO gene was differentially expressed in the datasets from the UK. This systematic review and meta-analysis encompasses eight studies that revealed a significant association between FTO polymorphisms and OA risk [OR 1.07, 95% CI (1.03, 1.11), P < 0.001] in the overall population. In subgroup analysis, a marked association was observed in European Caucasian [OR 1.08, 95% CI (1.04–1.12), P < 0.001] and North American Caucasian with the Asian subgroups [OR 0.98, 95% CI (0.83–1. 6), P = 0.83] as an exception. Among the studies, four of them demonstrated attenuation in their OA risk after body mass index (BMI) adjustment in Caucasian populations. Conclusion FTO significant differential expression was associated with the increased risk of OA in Caucasian populations. Nevertheless, the causality between FTO polymorphisms and OA risk remains largely elusive. Hence, further studies with larger sample size are necessary to validate whether FTO gene polymorphism contributes to OA susceptibility.
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Affiliation(s)
- Kun Zhao
- Department of Rehabilitation Medicine, Center for Rehabilitation Medicine, Rehabilitation and Sports Medicine Research Institute of Zhejiang Province, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Liuyan Nie
- Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Grace Min Jun Chin
- Zhejiang University-University of Edinburgh Institute, Zhejiang University, Hangzhou, China
| | - Xiangming Ye
- Department of Rehabilitation Medicine, Center for Rehabilitation Medicine, Rehabilitation and Sports Medicine Research Institute of Zhejiang Province, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Peng Sun
- Department of Rehabilitation Medicine, Center for Rehabilitation Medicine, Rehabilitation and Sports Medicine Research Institute of Zhejiang Province, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
- *Correspondence: Peng Sun,
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Pomilio AB, Szewczuk NA, Duchowicz PR. Dietary anthocyanins balance immune signs in osteoarthritis and obesity - update of human in vitro studies and clinical trials. Crit Rev Food Sci Nutr 2022; 64:2634-2672. [PMID: 36148839 DOI: 10.1080/10408398.2022.2124948] [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] [Indexed: 11/03/2022]
Abstract
Anthocyanins are known to change ligand-receptor bindings, cell membrane permeability, and intracellular signaling pathways. The beneficial effects of dietary anthocyanins have been chronologically demonstrated in interventional and observational studies, including fourteen human chondrocyte studies and related cell culture assays, nineteen human clinical trials in osteoarthritis patients, seven in vivo obesity assays, nineteen in vitro assays in preadipocytes and related cells, and twenty-two clinical trials in overweight/obese subjects, which are critically discussed in this update. Strawberries, cherries, berries, pomegranate, tropical fruits, rosehip, purple rice, purple corn, red beans, and black soybean, together with cyanidin, delphinidin, malvidin, peonidin, some 3-O-glycosides, metabolites, and acylated anthocyanins from a potato cultivar have shown the best outcomes. The set of these five key tests and clinical trials, taken together, contributes to the understanding of the underlying mechanisms and pathways involved. Furthermore, this set shows the value of anthocyanins in counteracting the progression of osteoarthritis/obesity. The interplay between the inflammation of osteoarthritis and obesity, and the subsequent regulation/immunomodulation was performed through isolated and food anthocyanins. The antioxidant, anti-inflammatory, and immunomodulatory properties of anthocyanins explain the findings of the studies analyzed. However, further interventional studies should be conducted to finally establish the appropriate doses for anthocyanin supplementation, dose-response, and length of consumption, to include dietary recommendations for osteoarthritis/obese patients for preventive and management purposes.
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Affiliation(s)
- Alicia B Pomilio
- Laboratorio de Química y Bioquímica Estructural, CONICET, Área Hematología, Departamento de Bioquímica Clínica, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nicolas A Szewczuk
- Laboratorio de QSAR (Quantitative Structure-Activity Relationships), Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), CONICET, Departamento de Química, Universidad Nacional de La Plata (UNLP), Plata, Argentina
| | - Pablo R Duchowicz
- Laboratorio de QSAR (Quantitative Structure-Activity Relationships), Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), CONICET, Departamento de Química, Universidad Nacional de La Plata (UNLP), Plata, Argentina
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Reichardt A, Passmore SR, Toth A, Olin G. Utilization of chiropractic services in patients with osteoarthritis and spine pain at a publicly funded healthcare facility in Canada: A retrospective study. J Back Musculoskelet Rehabil 2022; 35:1075-1084. [PMID: 35253731 DOI: 10.3233/bmr-210192] [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: 02/04/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is one of the most prevalent and disabling musculoskeletal diseases worldwide. There is preliminary evidence from experimental studies and consensus documents that chiropractic management may alleviate spine and/or extremity OA related pain in the short term. OBJECTIVE This research explores the potential relationship of a pragmatic course of care, including soft tissue therapy, spinal manipulation, and other treatments commonly delivered by chiropractors, to spine and extremity pain in patients with OA. METHODS A retrospective analysis of prospectively collected data from the chiropractic program at a publicly funded healthcare facility was conducted. The primary outcome measures for patients diagnosed with spine and/or extremity OA (n= 76) were numeric pain scores of each spinal and extremity region at baseline and discharge, and a change score was determined. RESULTS Statistically significant improvements that exceed a clinically meaningful difference in pain numeric rating scale scores were demonstrated by point change reductions from baseline to discharge visits. Change scores exceeding a minimally clinically important difference of "2-points" were present in the sacroiliac (-2.91), extremity (-2.84), cervical (-2.73), thoracic (-2.61), and lumbar (-2.59) regions. CONCLUSION Patients diagnosed with OA in a socioeconomically disadvantaged community demonstrated reductions in mean pain scores in both a clinically meaningful and statistically significant manner concurrent with a course of chiropractic care.
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Affiliation(s)
- Amber Reichardt
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Steven R Passmore
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada.,Research Department, New York Chiropractic College, Seneca Falls, NY, USA
| | - Audrey Toth
- Chiropractic Program, Mount Carmel Clinic, Winnipeg, MB, Canada
| | - Gerald Olin
- Manitoba Chiropractors Association, Winnipeg, MB, Canada
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Icariin represses the inflammatory responses and survival of rheumatoid arthritis fibroblast-like synoviocytes by regulating the TRIB1/TLR2/NF-kB pathway. Int Immunopharmacol 2022; 110:108991. [DOI: 10.1016/j.intimp.2022.108991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 06/06/2022] [Accepted: 06/20/2022] [Indexed: 11/19/2022]
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Li D, Ruan G, Zhang Y, Zhao Y, Zhu Z, Ou Q, Huang H, Chen J, Han W, Tang S, Li J, Wang L, Chen T, Bai X, Cai D, Ding C. Metformin attenuates osteoarthritis by targeting chondrocytes, synovial macrophages and adipocytes. Rheumatology (Oxford) 2022; 62:1652-1661. [PMID: 35984286 DOI: 10.1093/rheumatology/keac467] [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: 02/12/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the therapeutic effect and mechanism of metformin on knee osteoarthritis (OA) in normal diet (ND) mice or high-fat diet (HFD)-induced obese mice. METHODS Destabilization of the medial meniscus surgery was performed in ND mice or HFD mice, and metformin was administrated in drinking water or not. The changes of OA joint structure, infiltration and polarization of synovial macrophages and circulating and local levels of leptin and adiponectin were evaluated. In vitro, the effects of metformin on chondrocytes and macrophages, and of conditioned mediums derived from mouse abdominal fat on murine chondrogenic cell line ATDC5 and murine macrophage cell line RAW264.7, were detected. RESULTS Metformin showed protective effects on OA, characterized by reductions on OARSI score (2.00, 95% CI [1.15-2.86] for ND mice and 3.17, 95% CI [2.37-3.96] for HFD mice) and synovitis score (1.17, 95% CI [0.27-2.06] for ND mice and 2.50, 95% CI [1.49-3.51] for HFD mice) after 10 weeks of treatment, and the effects were more significant in HFD mice than in ND mice. Mechanistically, in addition to decreasing apoptosis and matrix-degrading enzymes expression in chondrocytes as well as infiltration and pro-inflammatory differentiation of synovial macrophages, metformin reduced leptin secretion by adipose tissue in HFD mice. CONCLUSIONS Metformin protects against knee OA which could be through reducing apoptosis and catabolism of chondrocytes, and suppressing infiltration and pro-inflammatory polarization of synovial macrophages. For obese mice, metformin has a greater protective effect in knee OA additionally through reducing leptin secretion from adipose tissue.
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Affiliation(s)
- Delong Li
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Department of Orthopedics, Academy of Orthopedics Guangdong Province, Orthopedic Hospital of Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Guangfeng Ruan
- Clinical Research Centre, Guangzhou First People's Hospital, Guangzhou, 510180, China
| | - Yan Zhang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Yang Zhao
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Qianhua Ou
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Hong Huang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Jieli Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Weiyu Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Su'an Tang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Jia Li
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Liang Wang
- Department of Orthopedics, Academy of Orthopedics Guangdong Province, Orthopedic Hospital of Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Tianyu Chen
- Department of Orthopedics, Academy of Orthopedics Guangdong Province, Orthopedic Hospital of Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Xiaochun Bai
- Department of Orthopedics, Academy of Orthopedics Guangdong Province, Orthopedic Hospital of Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.,Key Laboratory of Mental Health of the Ministry of Education, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Daozhang Cai
- Department of Orthopedics, Academy of Orthopedics Guangdong Province, Orthopedic Hospital of Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000, Australia
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Aggarwal VA, Sambandam S, Wukich D. The Impact of Obesity on Total Hip Arthroplasty Outcomes: A Retrospective Matched Cohort Study. Cureus 2022; 14:e27450. [PMID: 36060384 PMCID: PMC9420459 DOI: 10.7759/cureus.27450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/11/2022] Open
Abstract
Aim Previous research has shown that obesity is associated with worse postoperative outcomes. We aim to determine how rates of specific complications after total hip arthroplasty (THA) align with obesity status. We hypothesize that obese patients would have higher rates of complications and cost and thus have worse outcomes than non-obese patients. Methods Data were collected from a large commercial insurance database between 2011 and 2020. Patients underwent a hip replacement under current procedural terminology (CPT) and International Statistical Classification of Diseases (ICD-9/ICD-10) codes. Obese (defined as having a BMI of 30 kg/m2 or higher) and non-obese patients were matched on age, gender, Charlson Comorbidity Index (CCI), and Elixhauser Comorbidity Index (ECI). Standardized complications and costs in one year were compared using unequal variance t-tests. Results Under CPT codes, 61,462 obese (45% male) and 61,462 non-obese patients (45% male) underwent a hip replacement. Obese patients had significantly higher rates of surgical site infection (SSI) (OR=1.193, p=0.0001), deep vein thrombosis (DVT) (OR=1.275, p=0.001), wound complication (OR=1.736, p<0.0001), hematoma (OR=1.242, p=0.0001), pulmonary embolism (OR=1.141, p=0.0355), UTI (OR=1.065, p=0.0016), and opioid prescriptions (OR=1.17, p<0.0001), and significantly lower rates of arrhythmia (OR=0.907, p<0.0001), congestive heart failure (CHF) (OR=0.863, p<0.0001), cardiac arrest (OR=0.637 p<0.0001), pneumonia (OR=0.795, p<0.0001), and transfusion (OR=0.777, p<0.0001). Furthermore, obese patients were significantly more likely to undergo revision within 10 years (OR=1.172, p<0.0001). Under ICD codes, 31,922 obese (45% male) and 31,922 non-obese patients (45% male) were included. Obese patients did not have a significant difference in total cost or drug cost. Conclusions Obese patients had significantly higher rates of infection, venous thromboembolic event, wound complication, hematoma, and opioid prescriptions but significantly lower rates of cardiac issues, pneumonia, and transfusion, after hip replacement. Additionally, there was no significant difference in total or drug cost. Therefore, this study did not support our hypothesis that obese patients have worse outcomes than non-obese patients, as there neither was a clear significant increase in complication rates nor a significant increase in costs. However, further research should be done to better understand the complex relationship between obesity and postoperative outcomes.
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