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Lee DY, Bahar ME, Kim CW, Seo MS, Song MG, Song SY, Kim SY, Kim DR, Kim DH. Autophagy in Osteoarthritis: A Double-Edged Sword in Cartilage Aging and Mechanical Stress Response: A Systematic Review. J Clin Med 2024; 13:3005. [PMID: 38792546 PMCID: PMC11122125 DOI: 10.3390/jcm13103005] [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: 04/08/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Although osteoarthritis (OA) development is epidemiologically multifactorial, a primary underlying mechanism is still under debate. Understanding the pathophysiology of OA remains challenging. Recently, experts have focused on autophagy as a contributor to OA development. Method: To better understand the pathogenesis of OA, we survey the literature on the role of autophagy and the molecular mechanisms of OA development. To identify relevant studies, we used controlled vocabulary and free text keywords to search the MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and SCOPUS database. Thirty-one studies were included for data extraction and systematic review. Among these studies, twenty-five studies investigated the effects of autophagy in aging and OA chondrocytes, six studies examined the effects of autophagy in normal human chondrocytes, and only one study investigated the effects of mechanical stress-induced autophagy on the development of OA in normal chondrocytes. Results: The studies suggest that autophagy activation prevents OA by exerting cell-protective effects in normal human chondrocytes. However, in aging and osteoarthritis (OA) chondrocytes, the role of autophagy is intricate, as certain studies indicate that stimulating autophagy in these cells can have a cytotoxic effect, while others propose that it may have a protective (cytoprotective) effect against damage or degeneration. Conclusions: Mechanical stress-induced autophagy is also thought to be involved in the development of OA, but further research is required to identify the precise mechanism. Thus, autophagy contributions should be interpreted with caution in aging and the types of OA cartilage.
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Affiliation(s)
- Dong-Yeong Lee
- Department of Orthopaedic Surgery, Barun Hospital, Jinju 52725, Republic of Korea;
| | - Md Entaz Bahar
- Department of Biochemistry and Convergence Medical Sciences, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea; (M.E.B.); (M.-S.S.)
| | - Chang-Won Kim
- Department of Orthopaedic Surgery, Institute of Medical Science, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea; (C.-W.K.); (S.-Y.S.); (S.-Y.K.)
| | - Min-Seok Seo
- Department of Biochemistry and Convergence Medical Sciences, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea; (M.E.B.); (M.-S.S.)
| | - Myung-Geun Song
- Department of Orthopaedic Surgery, Inha University Hospital, Incheon 22212, Republic of Korea;
| | - Sang-Youn Song
- Department of Orthopaedic Surgery, Institute of Medical Science, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea; (C.-W.K.); (S.-Y.S.); (S.-Y.K.)
| | - Soung-Yon Kim
- Department of Orthopaedic Surgery, Institute of Medical Science, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea; (C.-W.K.); (S.-Y.S.); (S.-Y.K.)
| | - Deok-Ryong Kim
- Department of Biochemistry and Convergence Medical Sciences, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea; (M.E.B.); (M.-S.S.)
| | - Dong-Hee Kim
- Department of Orthopaedic Surgery, Institute of Medical Science, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea; (C.-W.K.); (S.-Y.S.); (S.-Y.K.)
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Park HB, Gwark JY, Jung J. Associations of normal fasting glucose levels and of insulin resistance with degenerative rotator cuff tear : Normoglycemia and rotator cuff tear. BMC Musculoskelet Disord 2023; 24:973. [PMID: 38102571 PMCID: PMC10724963 DOI: 10.1186/s12891-023-06899-5] [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: 05/10/2023] [Accepted: 09/20/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The upper normoglycemic range has been proposed as a risk factor for degenerative rotator cuff tendon tear (RCT), and insulin resistance has been suggested as a risk factor for tendinopathy. However, no research has established their association with degenerative RCT in the general population. This study aimed to determine whether fasting glucose levels and insulin resistance are risk factors for degenerative RCT in the normoglycemic population and identify the risk range for fasting glucose. METHODS This study included 418 normoglycemic participants from a rural cohort. Participants completed questionnaires, physical exams, blood tests, and MRI evaluations of both shoulders. Insulin resistance was assessed using a triglyceride/high-density-lipoprotein (TG/HDL) ≥ 3.5. Logistic regression analysis was used to determine the association between fasting glucose level, TG/HDL ≥ 3.5, and other factors and degenerative RCT. The study calculated the areas under the receiver operating characteristic curve (AUC) to determine the more appropriate predicting value between the scale and categorical values of fasting glucose levels, and compared the AUCs using the DeLong method. RESULTS In the multivariable analyses, both scale and categorical values of fasting glucose levels, and TG/HDL ≥ 3.5 were significantly associated with degenerative RCT. Fasting glucose levels ≥ 90.5 mg/dL (OR: 3.87, 95% CI: 2.10-7.06) in scale value and 90-99 mg/dL (OR: 4.13, 95% CI: 2.87-8.12) in categorical value were significantly associated with degenerative RCT (P < .001). The AUC of the scale value of fasting glucose levels ≥ 90.5 mg/dL was 0.68. The AUC of the categorical value of fasting glucose levels of 90-99 mg/dL was 0.70. Because of the significantly larger AUC of the categorical value of fasting glucose levels of 90-99 mg/dL, those fasting glucose levels were determined to be independently associated with degenerative RCT (P < .001). CONCLUSIONS High fasting glucose levels within the normal range may link to increase insulin resistance and risk of degenerative RCT. Normoglycemic levels of 90-99 mg/dL and insulin resistance may be risk factors for degenerative RCT. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Hyung Bin Park
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro Seongsan- gu, Changwon, 51472, Republic of Korea.
- Gyeongsang institute of medical sciences, Gyeongsang national university, Jinju, Republic of Korea.
| | - Ji-Yong Gwark
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro Seongsan- gu, Changwon, 51472, Republic of Korea
- Gyeongsang institute of medical sciences, Gyeongsang national university, Jinju, Republic of Korea
| | - Jaehoon Jung
- Division of Endocrinology, Department of Internal Medicine, School of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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Wagan AA, Surahyo P, Bhutto AQ, Asghar A. Osteoarthritis knee and modifiable cardiovascular risk factors: play in tandem. Pak J Med Sci 2023; 39:1711-1716. [PMID: 37936722 PMCID: PMC10626073 DOI: 10.12669/pjms.39.6.7596] [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: 01/24/2023] [Revised: 07/31/2023] [Accepted: 08/18/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To know the frequency of modifiable cardiovascular risk factors in knee osteoarthritis patients. Method Cross sectional study was done at Department of Rheumatology Indus Medical College, Tando Mohammad Khan from March 25, 2022 to November 24, 2022. Total 246 Osteoarthritis of knee cases with (Kellgren-Lawrence grad-II and above) on x-ray, were selected after demographic details, blood pressure, body mass index and physical examination was done, 5ml of venous blood was drawn by phlebotomist, sent for fasting blood sugar, serum lipids analysis and Framingham 10years risk score was calculated afterward for each participant. Results In this study males (126) and females (120). Overall (78%) had risk factors, Patients having one CVD risk factor were (22.8%), two risk factors in (21.1%), three in (21.5%), four (9.8%) and five factors in (1.6%) while frequency of modifiable cardiovascular risk shows obesity (45.5%) hypertension (40.2%) intermediate to high risk of framingham score (40%) diabetes mellitus (25%), smoking (17%), high low density lipoproteins (8.1%). In males obesity(54.2%), hypertension (47.5% ) and (45.8%) were on medication, diabetes mellitus(31.7%), smoker(31%), high risk FRS(39.2%), K-L grade-IV(58.4%) and in females: obesity (42%), hypertension (43.7%) and (40.5%) were on medication, diabetes mellitus in (19%), smoking (4%), high risk FRS (13.5%), K-L Grade-4 (42%), significant association of diabetes mellitus, smoking, FRS and K-L grades with gender (p<0.05). Conclusion In OA knee there is high prevalence of modifiable cardiovascular risk factors and together these imposes a major health risk for future cardiac events and disability.
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Affiliation(s)
- Abrar Ahmed Wagan
- Abrar Ahmed Wagan, MBBS, FCPS, FCPS, FACR Associate Professor of Rheumatology Indus Medical College, Tando Mohammad Khan
| | - Paras Surahyo
- Paras Surahyo, MBBS, FCPS Assistant Professor, Department of Radiology, Bilawal Medical College, Jamshoro, Pakistan
| | - Abdul Qadir Bhutto
- Abdul Qadir Bhutto, MBBS, MD Assistant Professor, Department of Cardiology Pir Abdul Qadir Shah Jilani Medical College Gambat
| | - Ammad Asghar
- Ammad Asghar, MBBS, FCPS, FCPS Assistant Professor of Medicine, Department of Medicine Sahiwal Medical College Sahiwal
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Sampath SJP, Venkatesan V, Ghosh S, Kotikalapudi N. Obesity, Metabolic Syndrome, and Osteoarthritis-An Updated Review. Curr Obes Rep 2023; 12:308-331. [PMID: 37578613 DOI: 10.1007/s13679-023-00520-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE OF REVIEW Metabolic syndrome (MetS), also called the 'deadly quartet' comprising obesity, diabetes, dyslipidemia, and hypertension, has been ascertained to have a causal role in the pathogenesis of osteoarthritis (OA). This review is aimed at discussing the current knowledge on the contribution of metabolic syndrome and its various components to OA pathogenesis and progression. RECENT FINDINGS Lately, an increased association identified between the various components of metabolic syndrome (obesity, diabetes, dyslipidemia, and hypertension) with OA has led to the identification of the 'metabolic phenotype' of OA. These metabolic perturbations alongside low-grade systemic inflammation have been identified to inflict detrimental effects upon multiple tissues of the joint including cartilage, bone, and synovium leading to complete joint failure in OA. Recent epidemiological and clinical findings affirm that adipokines significantly contribute to inflammation, tissue degradation, and OA pathogenesis mediated through multiple signaling pathways. OA is no longer perceived as just a 'wear and tear' disease and the involvement of the metabolic components in OA pathogenesis adds up to the complexity of the disease. Given the global surge in obesity and its allied metabolic perturbations, this review aims to throw light on the current knowledge on the pathophysiology of MetS-associated OA and the need to address MetS in the context of metabolic OA management. Better regulation of the constituent factors of MetS could be profitable in preventing MetS-associated OA. The identification of key roles for several metabolic regulators in OA pathogenesis has also opened up newer avenues in the recognition and development of novel therapeutic agents.
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Affiliation(s)
- Samuel Joshua Pragasam Sampath
- Department of Biotechnology, Faculty of Science & Humanities, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu District, Tamil Nadu, 603203, India.
- Molecular Biology Division, Indian Council of Medical Research - National Institute of Nutrition, Hyderabad, Telangana, 500007, India.
| | | | - Sudip Ghosh
- Molecular Biology Division, Indian Council of Medical Research - National Institute of Nutrition, Hyderabad, Telangana, 500007, India
| | - Nagasuryaprasad Kotikalapudi
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, MA, 02115, USA
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Arra M, Abu-Amer Y. Cross-talk of inflammation and chondrocyte intracellular metabolism in osteoarthritis. Osteoarthritis Cartilage 2023; 31:1012-1021. [PMID: 37094761 DOI: 10.1016/j.joca.2023.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/26/2023]
Abstract
Osteoarthritis is a disease that impacts millions around the world, leading to significant financial and medical burden for patients and the healthcare system. However, no effective biomarkers or disease modifying therapeutics exist for the early identification and management of the disease. Inflammation drives chondrocytes to express extracellular matrix (ECM) degrading enzymes and interruption of this pathway is a viable target to prevent degradation of cartilage. It has been demonstrated that inflammation can alter the intracellular metabolism of chondrocytes, a process known as metabolic reprogramming. This metabolic reprogramming is critical for cartilage breakdown by shifting chondrocytes to an ECM-catabolic state and likely as a potential therapeutic target for osteoarthritis. Metabolic modulators hold the potential to reduce chondrocyte inflammatory responses and protect cartilage. In this narrative review, we explore some of the existing examples of interactions between metabolism and inflammatory pathways in chondrocytes. We summarize the impact of inflammatory stimulation on various metabolic pathways and describe several examples by which targeting of metabolism is able to modulate ECM-degrading activity of chondrocytes to protect against cartilage damage.
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Affiliation(s)
- M Arra
- Department of Orthopedic Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Y Abu-Amer
- Department of Orthopedic Surgery, Washington University School of Medicine, Saint Louis, MO, USA; Department of Cell Biology & Physiology, Washington University School of Medicine, Saint Louis, MO, USA; Shriners Hospital for Children, Saint Louis, MO, USA.
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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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Cheng KY, Strotmeyer ES, Kado DM, Schousboe JT, Schenk S, Nevitt M, Lane NE, Hughes‐Austin JM. The Association of Metabolic Syndrome and Obesity With Clinical Hip Osteoarthritis in the Study of Osteoporotic Fractures and the Osteoporotic Fractures in Men Study Cohorts. ACR Open Rheumatol 2023; 5:115-123. [PMID: 36694301 PMCID: PMC10010487 DOI: 10.1002/acr2.11518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Metabolic dysregulation frequently co-occurs with obesity, which has been shown to be a risk factor for lower extremity osteoarthritis (OA). We evaluated the association between metabolic syndrome (MetS), alone and in combination with obesity, and hip OA. METHODS In two parallel cross-sectional analyses, we studied 403 women from the Study of Osteoporotic Fractures (SOF) and 2354 men from the Osteoporotic Fractures in Men (MrOS) study. We used multivariable logistic regression to evaluate associations of obesity (body mass index ≥30 kg/m2 ) and/or MetS (three of five National Cholesterol Education Program Adult Treatment Panel III criteria) with clinical hip OA, defined as a modified Croft score of 2 or more or total hip replacement, and pain or limited range of motion. Our analysis adjusted for demographics. RESULTS Approximately 3.5% of SOF women and 5.4% of MrOS men had clinical hip OA. Among women, obesity was not associated with hip OA, yet those with MetS had a 365% higher odds of hip OA (95% CI: 1.37-15.83). Among men, those who had obesity had a 115% higher odds of hip OA (95% CI: 1.39-3.32), yet MetS was not associated with hip OA. There was no interaction between MetS, obesity, and hip OA in either women or men. CONCLUSION In women, but not in men, MetS was associated with hip OA. In men, but not in women, obesity was associated with hip OA. These findings suggest that mechanical effects of obesity may predominate in the pathogenesis of hip OA in men, whereas metabolic effects predominate in women.
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Affiliation(s)
| | | | - Deborah M. Kado
- Stanford University, Stanford, and Geriatric Research Education and Clinical CenterPalo AltoCalifornia
| | - John T. Schousboe
- Park Nicollet Clinic and Health Partners InstituteBloomingtonMinnesota
| | - Simon Schenk
- University of California San DiegoLa JollaCalifornia
| | - Michael Nevitt
- University of CaliforniaSan FranciscoSan Francisco, California
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Jansen NEJ, Molendijk E, Schiphof D, van Meurs JBJ, Oei EHG, van Middelkoop M, Bierma-Zeinstra SMA. Metabolic syndrome and the progression of knee osteoarthritis on MRI. Osteoarthritis Cartilage 2023; 31:647-655. [PMID: 36801367 DOI: 10.1016/j.joca.2023.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/23/2023] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Metabolic osteoarthritis (OA) is one of the proposed clinical phenotypes defined by the existence of metabolic syndrome (MetS). This study aimed to (1) investigate whether MetS and its components are associated with progression of knee OA magnetic resonance imaging (MRI) features, and (2) to evaluate the interaction of MetS with menopause and progression of MRI features. METHOD 682 women from the Rotterdam Study who participated in a sub-study with knee MRI data available and 5-year follow-up were included. Tibiofemoral (TF) and patellofemoral (PF) OA features were assessed with the MRI Osteoarthritis Knee Score. MetS was quantified by the MetS severity Z-score. Generalized estimating equations were used to evaluate associations between MetS and menopausal transition and progression of MRI features. RESULTS MetS severity at baseline was associated with progression of osteophytes in all compartments, bone marrow lesions (BMLs) in the PF compartment, and cartilage defects in the medial TF compartment. Waist circumference was associated with progression of osteophytes in all compartments and cartilage defects in the medial TF compartment. High-density lipoprotein (HDL)-cholesterol levels were associated with progression of osteophytes in the medial and lateral TF compartment and glucose levels with osteophytes in the PF and medial TF compartment. No interactions were found between MetS with menopausal transition and MRI features. CONCLUSION Women with higher MetS severity at baseline showed progression of osteophytes, BMLs, and cartilage defects, indicating more structural knee OA progression after 5 years. Further studies are required to understand whether targeting MetS components may prevent the progression of structural knee OA in women.
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Affiliation(s)
- N E J Jansen
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - E Molendijk
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - D Schiphof
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - J B J van Meurs
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - E H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - M van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - S M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Orthopaedics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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Knee Osteoarthritis-How Close Are We to Disease-Modifying Treatment: Emphasis on Metabolic Type Knee Osteoarthritis. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010140. [PMID: 36676089 PMCID: PMC9866724 DOI: 10.3390/life13010140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023]
Abstract
Osteoarthritis (OA) is a whole-joint disease that affects cartilage, bone, and synovium as well as ligaments, menisci, and muscles [...].
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10
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Goel S, Kamath SU, Annappa R, Krishnamurthy SL, Jain M, Thakkar S, Damsas L, Banerjee S, Divakar PM. Cross-sectional assessment of cardiovascular risk factors in patients with knee osteoarthritis. F1000Res 2022; 10:508. [PMID: 35265321 DOI: 10.12688/f1000research.27744.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Osteoarthritis (OA) and cardiovascular disease (CVD) are prevalent in India. However, there is dearth of literature among Indians studying the relationship between the two. This study was carried out to assess various cardiovascular (CV) risk factors in patients with knee OA with an objective to investigate their association, screening and management. Methods: In total, 225 patients were included in this cross-sectional study. Participants were diagnosed with knee OA on the basis of the Kellgren and Lawrence (K-L) classification of their radiograph. Participants were also assessed for CV risk factors (age, body mass index, systolic blood pressure, diabetes mellitus, total cholesterol, high-density lipoprotein, smoking) with the help of the Joint British Society QRisk3 calculator (JBS3) a comprehensive risk score calculator as well as a screening tool, which produces three more variables, namely 10-years risk of developing CVD, physiological heart age and life expectancy. Chi Square, Fishers exact test and one-way ANOVA tests were used to compare the categorical and quantitative variables, respectively. Pearson's correlation coefficient was used to assess the relationship between CV risk factors and knee OA. Multiple regression analysis was done to adjust the multiple con-founders and determine their significance. Results: Patients with severe knee OA had a statistically significantly higher prevalence of CV risk factors (p<0.05). Grade 4 knee OA patients were found to have a mean JBS3 risk of 38%, heart age of 82 years and life expectancy of 77 years as compared to grade 2 patients who had a mean JBS3 risk of 11%, heart age of 63 years and life expectancy of 82 years. Conclusions: Our study concluded that there is a strong positive correlation between knee OA and CVD, with CV risk score being directly proportional to the severity of OA.
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Affiliation(s)
- Sagar Goel
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Surendra Umesh Kamath
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Rajendra Annappa
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Sunil Lakshmipura Krishnamurthy
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Manesh Jain
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Samarth Thakkar
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Lulu Damsas
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Sayak Banerjee
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Prajwal Madapura Divakar
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
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Ningrum DNA, Kung WM, Tzeng IS, Yuan SP, Wu CC, Huang CY, Muhtar MS, Nguyen PA, Li JYC, Wang YC. A Deep Learning Model to Predict Knee Osteoarthritis Based on Nonimage Longitudinal Medical Record. J Multidiscip Healthc 2021; 14:2477-2485. [PMID: 34539180 PMCID: PMC8445097 DOI: 10.2147/jmdh.s325179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/27/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To develop deep learning model (Deep-KOA) that can predict the risk of knee osteoarthritis (KOA) within the next year by using the previous three years nonimage-based electronic medical record (EMR) data. PATIENTS AND METHODS We randomly selected information of two million patients from the Taiwan National Health Insurance Research Database (NHIRD) from January 1, 1999 to December 31, 2013. During the study period, 132,594 patients were diagnosed with KOA, while 1,068,464 patients without KOA were chosen randomly as control. We constructed a feature matrix by using the three-year history of sequential diagnoses, drug prescriptions, age, and sex. Deep learning methods of convolutional neural network (CNN) and artificial neural network (ANN) were used together to develop a risk prediction model. We used the area under the receiver operating characteristic (AUROC), sensitivity, specificity, and precision to evaluate the performance of Deep-KOA. Then, we explored the important features using stepwise feature selection. RESULTS This study included 132,594 KOA patients, 83,111 females (62.68%), 49,483 males (37.32%), mean age 64.2 years, and 1,068,464 non-KOA patients, 545,902 females (51.09%), 522,562 males (48.91%), mean age 51.00 years. The Deep-KOA achieved an overall AUROC, sensitivity, specificity, and precision of 0.97, 0.89, 0.93, and 0.80 respectively. The discriminative analysis of Deep-KOA showed important features from several diseases such as disorders of the eye and adnexa, acute respiratory infection, other metabolic and immunity disorders, and diseases of the musculoskeletal and connective tissue. Age and sex were not found as the most discriminative features, with AUROC of 0.9593 (-0.76% loss) and 0.9644 (-0.25% loss) respectively. Whereas medications including antacid, cough suppressant, and expectorants were identified as discriminative features. CONCLUSION Deep-KOA was developed to predict the risk of KOA within one year earlier, which may provide clues for clinical decision support systems to target patients with high risk of KOA to get precision prevention program.
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Affiliation(s)
- Dina Nur Anggraini Ningrum
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
- Public Health Department, Faculty of Sport Science, Universitas Negeri Semarang, Semarang City, Indonesia
| | - Woon-Man Kung
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - I-Shiang Tzeng
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Department of Statistics, National Taipei University, Taipei, Taiwan
| | - Sheng-Po Yuan
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Otorhinolaryngology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Chu-Ya Huang
- Taiwan College of Healthcare Executives, Taipei, Taiwan
| | - Muhammad Solihuddin Muhtar
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Phung-Anh Nguyen
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan
| | - Jack Yu-Chuan Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yao-Chin Wang
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Emergency Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
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12
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Kluzek S, Rubin KH, Sanchez-Santos M, O'Hanlon MS, Andersen M, Glintborg D, Abrahamsen B. Accelerated osteoarthritis in women with polycystic ovary syndrome: a prospective nationwide registry-based cohort study. Arthritis Res Ther 2021; 23:225. [PMID: 34461982 PMCID: PMC8406767 DOI: 10.1186/s13075-021-02604-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is the most common form of arthritis with multiple risk factors implicated including female sex and obesity. Metabolic dysregulation associated with obesity leading to metabolic syndrome is a proposed component of that association. Polycystic ovary syndrome (PCOS) commonly affects women of reproductive age and these women are at higher risk of developing metabolic syndrome and thus likely to represent a high-risk group for early OA development. There are no published studies exploring the epidemiology of knee, hip and hand OA in women diagnosed with PCOS. STUDY AIM To assess the prevalence and incidence of knee, hip and hand osteoarthritis (OA) in women with polycystic ovary syndrome (PCOS) when compared with age-matched controls. METHODS Prospective Danish national registry-based cohort study. The prevalence of OA in 2015 and incidence rates of OA over 11.1 years were calculated and compared in more than 75,000 Danish women with either a documented diagnosis of PCOS ± hirsutism (during the period of 1995 to 2012) or age-matched females without those diagnoses randomly drawn from the same population register. RESULTS In 2015, the prevalence of hospital treated knee, hip and hand OA was 5.2% in women with PCOS diagnosis. It was 73% higher than that seen in age-matched controls. Significantly higher incidence rates were observed in the PCOS cohort compared with the age-matched controls during the follow-up period (up to 20 years), with the following hazard ratios (HR): 1.9 (95% CI 1.7 to 2.1) for knee, 1.8 (95% CI 1.3-2.4) for hand and 1.3 (95% CI 1.1 to 1.6) for hip OA. After excluding women with obesity, similar associations were observed for knee and hand OA. However, risk of developing hip OA was no longer significant. CONCLUSIONS In this large prospective study, women with PCOS diagnosis had higher prevalence and accelerated onset of OA of both weight and non-weight bearing joints, when compared with age-matched controls. Further studies are needed to understand the relative effect of metabolic and hormonal changes linked with PCOS and their role in promoting development of OA.
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Affiliation(s)
- Stefan Kluzek
- Academic Department of Orthopaedics, Trauma and Sports Medicine, Versus Arthritis - Centre for Sport, Exercise and Osteoarthritis Research, Faculty of Medicine and Health Sciences, University of Nottingham, Queens Medical Centre, Nottingham, NG7 2UH, UK.
| | | | | | | | | | | | - Bo Abrahamsen
- Holbæk Hospital and University of Southern Denmark, Odense, Denmark
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13
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Goel S, Kamath SU, Annappa R, Krishnamurthy SL, Jain M, Thakkar S, Damsas L, Banerjee S, Divakar PM. Cross-sectional assessment of cardiovascular risk factors in patients with knee osteoarthritis. F1000Res 2021; 10:508. [PMID: 35265321 PMCID: PMC8866909 DOI: 10.12688/f1000research.27744.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 12/01/2023] Open
Abstract
Background: Osteoarthritis (OA) and cardiovascular disease (CVD) are prevalent in India. However, there is dearth of literature among Indians studying the relationship between the two. This study was carried out to assess various cardiovascular (CV) risk factors in patients with knee OA with an objective to investigate their association, screening and management. Methods: In total, 225 patients were included in this cross-sectional study. Participants were diagnosed with knee OA on the basis of the Kellgren and Lawrence (K-L) classification of their radiograph. Participants were also assessed for CV risk factors (age, body mass index, systolic blood pressure, diabetes mellitus, total cholesterol, high-density lipoprotein, smoking) with the help of the Joint British Society QRisk3 calculator (JBS3) a comprehensive risk score calculator as well as a screening tool, which produces three more variables, namely 10-years risk of developing CVD, physiological heart age and life expectancy. Chi Square, Fishers exact test and one-way ANOVA tests were used to compare the categorical and quantitative variables, respectively. Pearson's correlation coefficient was used to assess the relationship between CV risk factors and knee OA. Multiple regression analysis was done to adjust the multiple con-founders and determine their significance. Results: Patients with severe knee OA had a statistically significantly higher prevalence of CV risk factors (p<0.05). Grade 4 knee OA patients were found to have a mean JBS3 risk of 38%, heart age of 82 years and life expectancy of 77 years as compared to grade 2 patients who had a mean JBS3 risk of 11%, heart age of 63 years and life expectancy of 82 years. Conclusions: Our study concluded that there is a strong positive correlation between knee OA and CVD, with CV risk score being directly proportional to the severity of OA.
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Affiliation(s)
- Sagar Goel
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Surendra Umesh Kamath
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Rajendra Annappa
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Sunil Lakshmipura Krishnamurthy
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Manesh Jain
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Samarth Thakkar
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Lulu Damsas
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Sayak Banerjee
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
| | - Prajwal Madapura Divakar
- Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal Academy Of Higher Education, Manipal, Karnataka, 576104, India
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14
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Roemer FW, Guermazi A, Hannon MJ, Fujii T, Omoumi P, Hunter DJ, Eckstein F, Kwoh CK. Presence of MRI-defined inflammation particularly in overweight and obese women increases risk of radiographic knee osteoarthritis: the POMA Study. Arthritis Care Res (Hoboken) 2021; 74:1391-1398. [PMID: 33527736 PMCID: PMC8326300 DOI: 10.1002/acr.24568] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/28/2020] [Accepted: 01/28/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Aims were to assess 1.) whether odds for incident radiographic osteoarthritis (ROA) differ between men and women in regard to body mass index (BMI) and inflammatory magnetic resonance imaging (MRI) markers one and two years prior and 2.) whether presence of inflammation on MRI differs between normal-weight, and overweight/obese persons that develop ROA up to four years prior. METHODS We studied 355 knees from the Osteoarthritis Initiative study that developed incident ROA and 355 matched controls. MRIs were read for effusion-synovitis and Hoffa-synovitis for up to four consecutive annual time points. Subjects were classified as normal-weight (BMI < 25), overweight (BMI ≥25/<30) or obese (BMI ≥30). Conditional logistic regression was used to assess odds of incident ROA for effusion-synovitis and Hoffa-synovitis at one and two years prior ROA incidence (i.e. "P-1" and "P-2") considering BMI category. Bivariate logistic regression was used to assess odds of inflammation for cases only. RESULTS 178 (25.1%) participants were normal-weight, 283 (39.9%) overweight and 249 (35.1%) obese. At P-2 being overweight with Hoffa-synovitis (OR 3.26, 95%CI 1.39,7.65) or effusion-synovitis (3.56, 95%CI 1.45,8.75) was associated with greater odds of incident ROA in women. For those with incident ROA there were no increased odds of synovitis in the overweight/obese subgroup for most time points but increased odds for effusion-synovitis were observed at P-2 (OR 2.21, 95%CI 1.11,4.43). CONCLUSIONS Presence of inflammatory markers seems to play a role especially in overweight women while obese women have increased odds for ROA also in the absence of these markers.
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Affiliation(s)
- Frank W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rdfloor, 820 Harrison Avenue, Boston, MA, 02118, USA.,Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg & Universitätsklinikum Erlangen, Erlangen, Germany, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rdfloor, 820 Harrison Avenue, Boston, MA, 02118, USA.,Department of Radiology, VA Boston Healthcare System, 1400 VFW Parkway, Suite 1B105, West Roxbury, MA, 02132, USA
| | - Michael J Hannon
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, S700 Biomedical Science Tower, 3500 Terrace Street, Pittsburgh, PA, 15261, USA.,Pinney Associates, 201 N Craig Street # 320, Pittsburgh, PA, 15213, USA
| | - Tomoko Fujii
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, S700 Biomedical Science Tower, 3500 Terrace Street, Pittsburgh, PA, 15261, USA.,Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Pacific Hwy, St. Leonards, NSW, 2065, Australia
| | - Felix Eckstein
- Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nürnberg, Strubergasse 21, 5020, Salzburg, Austria.,Ludwig Boltzmann Inst. for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg, Strubergasse 21, 5020, Salzburg, Austria.,Chondrometrics GmbH, Ulrichshöglerstr. 21, 83404, Ainring, Germany
| | - C Kent Kwoh
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, S700 Biomedical Science Tower, 3500 Terrace Street, Pittsburgh, PA, 15261, USA.,University of Arizona Arthritis Center & Division of Rheumatology, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
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15
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Metabolic syndrome and the incidence of knee osteoarthritis: A meta-analysis of prospective cohort studies. PLoS One 2020; 15:e0243576. [PMID: 33362213 PMCID: PMC7757818 DOI: 10.1371/journal.pone.0243576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/23/2020] [Indexed: 01/01/2023] Open
Abstract
Background Cross-sectional studies suggest an association between metabolic syndrome (MetS) and knee osteoarthritis (KOA). We performed a meta-analysis to evaluate whether MetS is an independent risk factor for KOA. Methods Prospective cohort studies evaluating the association between MetS and KOA in general population were retrieved from PubMed and Embase. Only studies with multivariate analyses were included. Data were pooled with a random-effect model, which is considered to incorporate heterogeneity among the included studies. Results Five studies including 94,965 participants were included, with 18,990 people with MetS (20.0%). With a mean follow-up duration of 14.5 years, 2,447 KOA cases occurred. Pooled results showed that MetS was not significant associated with an increased risk of KOA after controlling of factors including body mass index (adjusted risk ratio [RR]: 1.06, 95% CI: 0.92~1.23, p = 0.40; I2 = 33%). Subgroup analysis showed that MetS was independently associated with an increased risk of severe KOA that needed total knee arthroplasty (RR = 1.16, 95% CI: 1.03~1.30, p = 0.02), but not total symptomatic KOA (RR = 0.84, 95% CI: 0.65~1.08, p = 0.18). Stratified analyses suggested that MetS was independently associated with an increased risk of KOA in women (RR = 1.23, 95% CI: 1.03~1.47, p = 0.02), but not in men (RR = 0.90, 95% CI: 0.70~1.14, p = 0.37). Conclusions Current evidence from prospective cohort studies did not support MetS was an independent risk factor of overall KOA in general population. However, MetS may be associated with an increased risk of severe KOA in general population, or overall KOA risk in women.
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16
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Liu X, Li M, Zhang B, Zhang N, Feng Q. A landscape of circulating long non-coding RNA (lncRNA) expression profile and the predictive value of candidate lncRNAs for disease risk of knee osteoarthritis. J Clin Lab Anal 2020; 34:e23423. [PMID: 32557900 PMCID: PMC7521218 DOI: 10.1002/jcla.23423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 02/13/2020] [Accepted: 02/22/2020] [Indexed: 12/15/2022] Open
Abstract
Background This study aimed to investigate the plasma long non‐coding RNA (lncRNA) expression profile in knee osteoarthritis (KOA) patients and the value of candidate lncRNAs for predicting KOA risk. Methods Plasma was obtained for RNA sequencing (RNA‐seq) in eight KOA patients and eight healthy controls (Ctrls). Ten candidate lncRNAs were then selected from the differentially expressed (DE) lncRNAs according to the rank of absolute value of Log2 (fold change). Afterward, RT‐qPCR was used to examine 10 candidate lncRNAs expressions in plasma of 100 KOA patients and 100 Ctrls. Results In eight KOA patients and eight Ctrls, principal component analysis and heatmap plots disclosed that lncRNA and mRNA expression profile could distinguish KOA patients from Ctrls. Then Volcano plot identified 418 upregulated lncRNAs, 347 downregulated lncRNAs, 521 upregulated mRNAs, and 333 downregulated mRNAs in KOA patients compared to Ctrls. Next, enrichment analyses revealed that DE lncRNAs were mainly enriched in biological processes, molecular functions, and signaling pathways related to inflammation and bone formation. In 100 KOA patients and 100 Ctrls, eight candidate lncRNAs were dysregulated in KOA patients compared to Ctrls, including lncRNA ABCF2P2, lncRNA RP13‐16H11.7, lncRNA CTC‐340A15.2, lncRNA RP4‐735C1.6, lncRNA RP11‐293G6‐B.8, lncRNA RP11‐1246C19.1, lncRNA RP11‐303E16.6, and lncRNA RP5‐882C2.2. Receiver operating characteristic curve analysis revealed that these eight candidate lncRNAs presented with values for predicting KOA risk. Furthermore, multivariate logistic regression elucidated that six candidate lncRNAs could independently predict KOA risk. Conclusion We disclosed a landscape of circulating lncRNA expression profile in KOA patients, and discovered several specific lncRNAs which could assist in KOA management.
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Affiliation(s)
- Xuanyi Liu
- The Fourth Department of Orthopedics, Cangzhou People's Hospital, Cangzhou, China
| | - Mian Li
- The Fourth Department of Orthopedics, Cangzhou People's Hospital, Cangzhou, China
| | - Bingyao Zhang
- The Graduate School of Chengde Medical University, Chengde, China
| | - Ning Zhang
- The Graduate School of Chengde Medical University, Chengde, China
| | - Qing Feng
- The Fourth Department of Orthopedics, Cangzhou People's Hospital, Cangzhou, China
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17
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Gratal P, Lamuedra A, Medina JP, Bermejo-Álvarez I, Largo R, Herrero-Beaumont G, Mediero A. Purinergic System Signaling in Metainflammation-Associated Osteoarthritis. Front Med (Lausanne) 2020; 7:506. [PMID: 32984382 PMCID: PMC7485330 DOI: 10.3389/fmed.2020.00506] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/22/2020] [Indexed: 12/18/2022] Open
Abstract
Inflammation triggered by metabolic imbalance, also called metainflammation, is low-grade inflammation caused by the components involved in metabolic syndrome (MetS), including central obesity and impaired glucose tolerance. This phenomenon is mainly due to excess nutrients and energy, and it contributes to the pathogenesis of osteoarthritis (OA). OA is characterized by the progressive degeneration of articular cartilage, which suffers erosion and progressively becomes thinner. Purinergic signaling is involved in several physiological and pathological processes, such as cell proliferation in development and tissue regeneration, neurotransmission and inflammation. Adenosine and ATP receptors, and other members of the signaling pathway, such as AMP-activated protein kinase (AMPK), are involved in obesity, type 2 diabetes (T2D) and OA progression. In this review, we focus on purinergic regulation in osteoarthritic cartilage and how different components of MetS, such as obesity and T2D, modulate the purinergic system in OA. In that regard, we describe the critical role in this disease of receptors, such as adenosine A2A receptor (A2AR) and ATP P2X7 receptor. Finally, we also assess how nucleotides regulate the inflammasome in OA.
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Affiliation(s)
- Paula Gratal
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Ana Lamuedra
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Juan Pablo Medina
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | | | - Raquel Largo
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | | | - Aránzazu Mediero
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
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18
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Yeh YT, Liang CC, Chang CL, Hsu CY, Li PC. Increased risk of knee osteoarthritis in patients using oral N-acetylcysteine: a nationwide cohort study. BMC Musculoskelet Disord 2020; 21:531. [PMID: 32778089 PMCID: PMC7418329 DOI: 10.1186/s12891-020-03562-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/03/2020] [Indexed: 12/20/2022] Open
Abstract
Background Knee osteoarthritis (OA) is known to be a progressive degenerative disorder; however, recent evidence suggests that inflammatory mediators contribute to cartilage degradation. Studies have reported that N-acetylcysteine (NAC) had a promising effect on the reduction of the synthesis of proinflammatory and structural mediators by synovial cells. Given the lack of relevant clinical trials, we conducted this study to determine the relationship between NAC use and risk of knee OA. Methods We designed a retrospective cohort study from 2000 to 2013. Patients who received oral NAC over 28 days within 1 year after the first prescription were defined as the case group, whereas those without NAC use were considered as candidates of the control group. We adopted 1:4 propensity-score matching by age, sex, index year, and comorbidities to obtain the control group. The primary outcome was a new diagnosis of knee OA during the follow-up period. Results Our study sample comprised 12,928 people who used NAC and 51,715 NAC nonusers. NAC users had a significantly higher incidence of osteoarthritis (adjusted hazard ratio: 1.42, P < .001) than did NAC nonusers. Also, in analyses stratified by age group and sex, all subgroups exhibited a significantly higher incidence of knee osteoarthritis (P < .0001) among NAC users than among NAC nonusers. The use of oral NAC was associated with nearly four-fold increased the risk of knee OA in the young age group. Conclusions Long-term use of oral NAC is associated with a higher risk of knee OA.
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Affiliation(s)
- Ying-Ting Yeh
- Department of Physical Medicine and Rehabilitation Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chung-Chao Liang
- Department of Physical Medicine and Rehabilitation Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chia-Ling Chang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Pei-Chen Li
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
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19
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Liu SY, Zhu WT, Chen BW, Chen YH, Ni GX. Bidirectional association between metabolic syndrome and osteoarthritis: a meta-analysis of observational studies. Diabetol Metab Syndr 2020; 12:38. [PMID: 32399062 PMCID: PMC7204053 DOI: 10.1186/s13098-020-00547-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Emerging observational studies suggest an association between metabolic syndrome (MetS) and osteoarthritis (OA). This meta-analysis was conducted to examine whether or not there is a bidirectional relationship between MetS and OA. METHODS The PubMed and Embase databases were searched from their inception to October 2019. We selected studies according to predefined criteria. Random effects were selected to calculate two sets of pooled risk estimates: MetS predicting OA and OA predicting MetS. RESULTS A total of seven cross-sectional studies and four cohort studies met the criteria for MetS predicting the onset of OA. Another six cross-sectional studies and one cohort study met the criteria for OA predicting the onset of MetS. The pooled odds risk (OR) for OA incidences associated with baseline MetS was 1.45 (95% CI 1.27-1.66). The OR for MetS incidences associated with baseline OA was 1.90 (95% CI 1.11-3.27). In an overall analysis, we found that MetS was associated with prevalent OA in both cross-sectional studies (OR = 1.32, 95% CI 1.21-1.44) and cohort studies (OR = 1.76, 95% CI 1.29-2.42). No indication of heterogeneity was found in the cross-sectional studies (p = 0.395, I2 = 4.8%), whereas substantial heterogeneity was detected in the cohort studies (p = 0.000, I2 = 79.3%). CONCLUSION Meta-analysis indicated a bidirectional association between MetS and OA. We advise that patients with MetS should monitor their OA status early and carefully, and vice versa.
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Affiliation(s)
- Sheng-Yao Liu
- Department of Orthopeadics, The Second Affilicated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen-Ting Zhu
- Department of Pharmacy, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bin-Wei Chen
- Department of Orthopeadics, The Second Affilicated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuan-Hong Chen
- Department of Orthopeadics, The Second Affilicated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guo-Xin Ni
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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20
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Pan F, Tian J, Mattap SM, Cicuttini F, Jones G. Association between metabolic syndrome and knee structural change on MRI. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez266] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Abstract
Objective
To examine the association of metabolic syndrome (MetS) and its components with knee cartilage volume loss and bone marrow lesion (BML) change.
Methods
Longitudinal data on 435 participants from a population-based cohort study were analysed. Blood pressure, glucose, triglycerides and high-density lipoprotein (HDL) were collected. MetS was defined based on the National Cholesterol Education Program–Adult Treatment Panel III criteria. MRI of the right knee was performed to measure cartilage volume and BML. Radiographic knee OA was assessed by X-ray and graded using the Altman atlas for osteophytes and joint space narrowing.
Results
Thirty-two percent of participants had MetS and 60% had radiographic knee OA. In multivariable analysis, the following were independently associated with medial tibial cartilage volume loss: MetS, β = −0.30%; central obesity, β = −0.26%; and low HDL, β = −0.25% per annum. MetS, hypertriglyceridaemia and low HDL were also associated with higher risk of BML size increase in the medial compartment (MetS: relative risk 1.72, 95% CI 1.22, 2.43; hypertriglyceridaemia: relative risk 1.43, 95% CI 1.01, 2.02; low HDL: relative risk 1.67, 95% CI 1.18, 2.36). After further adjustment for central obesity or BMI, MetS and low HDL remained statistically significant for medial tibial cartilage volume loss and BML size increase. The number of components of MetS correlated with greater cartilage volume loss and BML size increase (both P for trend <0.05). There were no statistically significant associations in the lateral compartment.
Conclusion
MetS and low HDL are associated with medial compartment cartilage volume loss and BML size increase, suggesting that targeting these factors has the potential to prevent or slow knee structural change.
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Affiliation(s)
- Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania
| | - Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania
| | - Siti Maisarah Mattap
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Victoria, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania
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21
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Park S, Choi NK. The relationships of blood lead level, body mass index, and osteoarthritis in postmenopausal women. Maturitas 2019; 125:85-90. [DOI: 10.1016/j.maturitas.2019.04.215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/11/2019] [Indexed: 01/20/2023]
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22
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Vascular cell adhesion molecule 1 in patients with severe osteoarthritis of the hip : A prospective cross-sectional study. Wien Klin Wochenschr 2019; 131:369-373. [PMID: 31037360 PMCID: PMC6702185 DOI: 10.1007/s00508-019-1497-2] [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: 04/24/2018] [Accepted: 04/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Osteoarthritis (OA) of the hip is a frequent and debilitating joint disease. Only few clinical risk factors for hip OA are established and clinically applicable biomarkers to identify patients at risk are still lacking. The glycoprotein vascular cell adhesion molecule 1 (VCAM-1) is expressed by chondrocytes and synovial tissue and was a predictive marker for development of severe large joint OA in a previous study. OBJECTIVE It was tested whether increased serum levels of VCAM-1 are prevalent in patients with severe OA of the hips. METHODS In this prospective, multicenter, cross-sectional study, risk factors of severe hip OA were investigated in patients scheduled for hip joint arthroplasty and 100 patients were randomly selected for validation of VCAM-1 as a potential biomarker for hip OA. Serum samples were analyzed by an enzyme-linked immunosorbent assay and compared with a sex and age-matched control cohort. RESULTS The groups were similar in age, gender ratio and prevalence of diabetes. Serum concentrations of VCAM-1 were 8% higher in OA patients compared to controls, without reaching statistical significance (818 ng ml-1, 95% confidence interval, CI 746-891 ng ml-1 versus 759 ng m-1, 95% CI 711-807 ng ml-1; P = 0.4839). CONCLUSION The results of this study show that serum concentrations of VCAM-1 cannot distinguish patients with severe hip OA from age and sex-matched controls.
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Sanchez-Santos MT, Judge A, Gulati M, Spector TD, Hart DJ, Newton JL, Arden NK, Kluzek S. Association of metabolic syndrome with knee and hand osteoarthritis: A community-based study of women. Semin Arthritis Rheum 2019; 48:791-798. [DOI: 10.1016/j.semarthrit.2018.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/28/2018] [Accepted: 07/23/2018] [Indexed: 01/03/2023]
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Sun AR, Wu X, Liu B, Chen Y, Armitage CW, Kollipara A, Crawford R, Beagley KW, Mao X, Xiao Y, Prasadam I. Pro-resolving lipid mediator ameliorates obesity induced osteoarthritis by regulating synovial macrophage polarisation. Sci Rep 2019; 9:426. [PMID: 30674985 PMCID: PMC6344566 DOI: 10.1038/s41598-018-36909-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/18/2018] [Indexed: 12/17/2022] Open
Abstract
Non-resolved persistent macrophage-mediated synovial inflammation is considered as one of the main drivers of both the establishment and progression of obesity-associated osteoarthritis (OA). Herein, we used clodronate-loaded liposomes (CL) to locally deplete macrophages in the synovial joints to examine the role of macrophages in the progression of obesity-induced OA. Furthermore, resolvin D1 (RvD1), a unique family of pro-resolving lipid mediator derived from the omega-3 polyunsaturated fatty acid, have shown marked potency in changing the pro-inflammatory behaviour of the macrophages. We sought to determine whether RvD1 administration ameliorates obesity-induced OA by resolving macrophage-mediated synovitis. Therapeutic properties of RvD1 and macrophage depletion (CL) were tested for its ability to slow post-traumatic OA (PTOA) in obese mice models. PTOA was induced in C57Bl/6 mice fed with high-fat diet (HFD) by surgically destabilising the meniscus. Firstly, CL treatment showed beneficial effects in reducing synovitis and cartilage destruction in obese mice with PTOA. In vitro treatment with RvD1 decreased the levels of pro-inflammatory markers in CD14+ human macrophages. Furthermore, intra-articular treatment with RvD1 diminishes the progression of OA in the knee joint from mice as follows: (a) decreases macrophages infiltration in synovium, (b) reduces the number of pro-inflammatory macrophages in synovium and (c) improves the severity of synovitis and cartilage degradation. Thus, our results provide new evidence for the potential targeting of macrophages in the treatment of obesity-induced OA.
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Affiliation(s)
- Antonia Rujia Sun
- Institute of Health and Biomedical Innovation, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, 4059, Australia
| | - Xiaoxin Wu
- Department of Orthopaedic Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| | - Bohao Liu
- Department of Orthopaedic Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yang Chen
- Department of Orthopaedic Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| | - Charles W Armitage
- Institute of Health and Biomedical Innovation, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Avinash Kollipara
- Institute of Health and Biomedical Innovation, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia.,Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Ross Crawford
- Institute of Health and Biomedical Innovation, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, 4059, Australia.,The Prince Charles Hospital, Orthopedic Department, Brisbane, Australia
| | - Kenneth W Beagley
- Institute of Health and Biomedical Innovation, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Xinzhan Mao
- Department of Orthopaedic Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, 4059, Australia.,Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Indira Prasadam
- Institute of Health and Biomedical Innovation, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, 4059, Australia. .,Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, Queensland, Australia.
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Arellano Perez Vertti RD, Aguilar Muñiz LS, Morán Martínez J, González Galarza FF, Arguello Astorga R. Cartilage Oligomeric Matrix Protein Levels in Type 2 Diabetes Associated with Primary Knee Osteoarthritis Patients. Genet Test Mol Biomarkers 2018; 23:16-22. [PMID: 30526057 DOI: 10.1089/gtmb.2018.0184] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIMS (1) To evaluate the association between type 2 diabetes mellitus (T2D) and primary knee osteoarthritis (KOA); and (2) to compare synovial fluid (SF) cartilage oligomeric matrix protein (COMP) concentrations and glycemic control parameters in patients with T2D, with and without primary KOA. METHODS A total of 231 individuals were included in this study. Primary KOA was confirmed according to the criteria established by the American College of Rheumatology. The presence of T2D was determined by medical history. In addition, fasting plasma glucose and glycated hemoglobin were analyzed to confirm diabetic and nondiabetic status. RESULTS Our results showed an association between T2D and primary KOA after covariate adjustments (OR = 3.755, p = 0.000024, 95% CI: 2.033-6.934). In addition, SF COMP levels were significantly higher in T2D groups with and without primary KOA (p = 0.00035; p = 0.001 respectively) when compared to nonT2D controls. CONCLUSION This study suggests a strong association between T2D and primary KOA; in addition, the presence of T2D may have an influence in SF COMP levels in subjects with and without primary KOA. The glycemic control parameters and duration of diabetes may be useful as an indirect indicator of SF COMP levels to prevent the effects of chronic exposure to hyperglycemia and subsequent damage to the articular cartilage.
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Affiliation(s)
- Ruben Daniel Arellano Perez Vertti
- 1 Facultad de Medicina Torreon, Universidad Autonoma de Coahuila , Torreon, Mexico .,2 Instituto de Ciencia y Medicina Genómica , Torreon, Mexico
| | | | | | - Faviel Francisco González Galarza
- 1 Facultad de Medicina Torreon, Universidad Autonoma de Coahuila , Torreon, Mexico .,2 Instituto de Ciencia y Medicina Genómica , Torreon, Mexico
| | - Rafael Arguello Astorga
- 1 Facultad de Medicina Torreon, Universidad Autonoma de Coahuila , Torreon, Mexico .,2 Instituto de Ciencia y Medicina Genómica , Torreon, Mexico
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Ha GC, Yoon JR, Yoo CG, Kang SJ, Ko KJ. Effects of 12-week aquatic exercise on cardiorespiratory fitness, knee isokinetic function, and Western Ontario and McMaster University osteoarthritis index in patients with knee osteoarthritis women. J Exerc Rehabil 2018; 14:870-876. [PMID: 30443535 PMCID: PMC6222165 DOI: 10.12965/jer.1836308.154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 08/14/2018] [Indexed: 01/08/2023] Open
Abstract
The purpose of this study is to investigate the risk factors of metabolic syndrome, cardiorespiratory fitness, knee isokinetic function, and osteoarthritis index inpatients with knee osteoarthritis women. Subjects were divided into the exercise group (n=9, aged 60.89±5.06), and the control groups (n=8, aged 61.25±1.91). Aquatic exercise was performed for 12 weeks, 3 times a week, 60 min a day. The changes of metabolic syndrome risk factors, cardiorespiratory fitness, knee isokinetic function, and WOMAC index (Western Ontario and McMaster University osteoarthritis index) were measured and analyzed at pre- and postexercise program for verifying exercise effectiveness. As a result, fasting blood glucose (P<0.05), glycosylated hemoglobin (P<0.01), and triglyceride (P<0.05) were significantly decreased in the risk factors of metabolic syndrome. The maximum oxygen uptake in cardiorespiratory fitness was not significantly different. The left and right extensor muscles of knee isokinetic function increased significantly (P<0.01, P<0.01, respectively). There was no significant difference in flexor muscles. Osteoarthritis index was significantly improved in stiffness (P<0.01) and physical function (P<0.05). In conclusion, aquatic exercise can be regarded as an effective exercise program for managing metabolic syndrome risk factors, increasing muscle function, and improving osteoarthritis index in patients with osteoarthritis of the knee.
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Affiliation(s)
- Gi-Chul Ha
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Jae-Ryang Yoon
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Cheol-Gyu Yoo
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Seol-Jung Kang
- Department of Physical Education, Changwon National University, Changwon, Korea
| | - Kwang-Jun Ko
- Department of Sports Medicine, National Fitness Center, Seoul, Korea
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Abstract
PURPOSE OF REVIEW Osteoarthritis, the most common joint disease, is associated with substantial medical costs, lost productivity, and reduced quality of life. However, available pharmaceutical treatments have limitations in terms of efficacy and long-term safety. RECENT FINDINGS In vitro evidence suggests that some natural products may possess anti-inflammatory and anti-oxidative properties and may inhibit the release of key osteoarthritis-related cytokines. There is, therefore, ongoing interest in identifying natural products that safely promote joint health and treat osteoarthritis. Numerous plant extracts, including curcumin, Boswellia extract, and pycnogenol, have shown effect sizes (ES) for reducing pain and functional disability larger than those observed with analgesics and products such as glucosamine and chondroitin. The ES for methylsulfonylmethane and avocado/soybean unsaponifiables are also considered to be clinically relevant. Data from a small number of studies using natural products for treating osteoarthritis are promising but require confirmation in further well-designed clinical trials.
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Park HB, Gwark JY, Im JH, Jung J, Na JB, Yoon CH. Factors Associated with Atraumatic Posterosuperior Rotator Cuff Tears. J Bone Joint Surg Am 2018; 100:1397-1405. [PMID: 30106821 PMCID: PMC6133217 DOI: 10.2106/jbjs.16.01592] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Certain metabolic factors have been proposed as risk factors for a posterosuperior rotator cuff tear. Although metabolic syndrome is of increasing concern in industrialized societies, little information exists regarding its association with posterosuperior rotator cuff tears. The purpose of this study was to determine the risk factors for an atraumatic posterosuperior rotator cuff tear, including metabolic factors and metabolic syndrome. METHODS This study involved 634 subjects (634 shoulders) drawn from a cohort of rural residents. Posterosuperior rotator cuff tear diagnoses were based on magnetic resonance imaging (MRI) findings. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for various demographic, physical, and social factors, including age, sex, dominant-side involvement, body mass index (BMI), and participation in manual labor; the comorbidities of diabetes, hypertension, dyslipidemia, thyroid dysfunction, ipsilateral carpal tunnel syndrome, and metabolic syndrome; and the serum metabolic parameters of serum lipid profile, glycosylated hemoglobin A1c, and level of thyroid hormone. Two multivariable analyses were performed: the first excluded metabolic syndrome while including diabetes, hypertension, BMI, and hypo-high-density lipoproteinemia (hypo-HDLemia), and the second included metabolic syndrome while excluding the formerly included variables. RESULTS Age, BMI, waist circumference, dominant-side involvement, manual labor, diabetes, hypertension, metabolic syndrome, ipsilateral carpel tunnel syndrome, HDL (high-density lipoprotein), and hypo-HDLemia were significantly associated with posterosuperior rotator cuff tears in univariate analyses (p ≤ 0.035). In the first multivariable analysis, age (OR. 1.86 [95% CI, 1.47 to 2.35]), BMI (OR, 1.09 [95% CI, 1.02 to 1.18]), dominant-side involvement (OR, 2.04 [95% CI, 1.38 to 3.01]), manual labor (OR, 9.48 [95% CI, 5.13 to 17.51]), diabetes (OR, 3.38 [95% CI, 1.98 to 5.77]), and hypo-HDLemia (OR, 2.07 [95% CI, 1.30 to 3.29]) were significantly associated with posterosuperior rotator cuff tears (p ≤ 0.019). In the second multivariable analysis, age (OR, 1.85 [95% CI, 1.48 to 2.31]), dominant-side involvement (OR, 1.83 [95% CI, 1.26 to 2.67]), manual labor (OR, 7.71 [95% CI, 4.33 to 13.73]), and metabolic syndrome (OR, 1.98 [95% CI, 1.35 to 2.91]) were significantly associated with posterosuperior rotator cuff tears (p ≤ 0.002). CONCLUSIONS The metabolic factors of diabetes, BMI, hypo-HDLemia, and metabolic syndrome were significant independent factors associated with the development of posterosuperior rotator cuff tears. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Hyung Bin Park
- Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea,E-mail address for H.B. Park:
| | - Ji-Yong Gwark
- Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jin-Hyung Im
- Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jaehoon Jung
- Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jae-Boem Na
- Departments of Radiology (J.-B.N.) and Rehabilitation Medicine (C.H.Y.), Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Chul Ho Yoon
- Departments of Radiology (J.-B.N.) and Rehabilitation Medicine (C.H.Y.), Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
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Association between the severity of symptomatic knee osteoarthritis and cumulative metabolic factors. Aging Clin Exp Res 2018; 30:481-488. [PMID: 28762210 DOI: 10.1007/s40520-017-0808-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/25/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The association between cumulative metabolic syndrome (MS) factors and knee osteoarthritis (KOA) has been highlighted over the past two decades. AIMS To clarify the relationship between cumulative MS factors and symptomatic KOA. METHODS A cross-sectional survey involving 119 women aged 45-88 years who were scheduled to undergo knee surgery was conducted. They were stratified into tertiles of symptoms as assessed by the Japanese Orthopedic Association score for KOA. Multinomial logistic regressions were performed using the severity of symptomatic KOA as the dependent variable and each MS factor or the cumulative MS factors as the independent variables. RESULTS Logistic regression analyses were performed with the upper tertile of stratified symptoms of subjects used as the reference group. After adjustment for confounders, KOA patients who had two (p = 0.004) or three or more (p < 0.0001) MS factors were significantly more likely to have severe symptoms compared to those who had no MS factors. MS factors excluding obesity were similarly analyzed. Even after additional adjustment for body mass index (BMI), KOA patients who had two or more (p = 0.005) MS factors were significantly more likely to have severe symptoms. CONCLUSION Among KOA female patients diagnosed using radiographic definition, the severity of symptomatic KOA was significantly associated with hypertension, dyslipidemia, and the number of MS factors after adjustment for age, BMI, strength of the knee extensor, and Kellgren-Lawrence grade. The severity of radiographic KOA was not associated with any MS factor or cumulative MS factors.
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Brady SRE, Mousa A, Naderpoor N, de Courten MPJ, Cicuttini F, de Courten B. Adipsin Concentrations Are Associated with Back Pain Independently of Adiposity in Overweight or Obese Adults. Front Physiol 2018; 9:93. [PMID: 29483883 PMCID: PMC5816231 DOI: 10.3389/fphys.2018.00093] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/29/2018] [Indexed: 01/07/2023] Open
Abstract
Objective: To compare cardiometabolic risk factors including cytokine and adipokine concentrations between individuals with and without back pain. Methods: In 62 overweight/obese adults (BMI ≥ 25 kg/m2; 23F/39M), we collected data on: self-reported back pain; anthropometry [BMI, waist circumference, body composition (dual energy X-ray absorptiometry-DEXA)]; metabolic parameters [fasting glucose; insulin sensitivity (hyperinsulinaemic-euglycaemic clamps)]; cardiovascular parameters (blood pressure, lipids); serum inflammation markers [high-sensitivity C-reactive protein (hsCRP; immunoturbidimetric-assay), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-10 (multiplex-assay)]; and adipokines [leptin, adipsin, resistin, and adiponectin (multiplex-assay)]. Results: Participants who reported having back pain in the past month (n = 24; 39%) had higher BMI (mean ± SD = 33.8 ± 6.3 vs. 30.2 ± 4.1 kg/m2, p = 0.008), fat-mass (39.9 ± 12.3 vs. 33.9 ± 9.8%, p = 0.04), and waist circumference (109.6 ± 16.8 vs. 101.0 ± 9.3 cm, p = 0.01) compared to those without back pain (n = 38; 61%). No differences were observed in cardiometabolic parameters, inflammatory markers, or adiponectin or resistin concentrations. Those reporting back pain had higher adipsin concentrations compared to those without back pain [median (IQR) = 744 (472-2,804) vs. 721 (515-867) ng/ml, p = 0.03], with a trend for higher leptin [5.5 (1.5-24.3) vs. 2.3 (1.5-6.7) ng/ml, p = 0.05], both of which persisted after adjustment for age and sex. Adipsin remained associated with back pain independently of adiposity (BMI, waist, fat-mass, or total %body fat; all p ≤ 0.03). Conclusions: Greater obesity, and higher adipsin and leptin concentrations were observed in those who reported back pain in the past month compared to those without back pain, and adipsin was associated with back pain independently of adiposity. Larger studies are needed to determine if adipsin could be a novel therapeutic target for prevention and/or treatment of back pain.
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Affiliation(s)
- Sharmayne R. E. Brady
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | | | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
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Yerima A, Adelowo O. Knee osteoarthritis and associated cardio-metabolic clusters in a tertiary hospital in Nigeria. Clin Rheumatol 2017; 36:2541-2548. [DOI: 10.1007/s10067-017-3816-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/23/2017] [Accepted: 08/31/2017] [Indexed: 12/11/2022]
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