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Binvignat M, Sellam J, Berenbaum F, Felson DT. The role of obesity and adipose tissue dysfunction in osteoarthritis pain. Nat Rev Rheumatol 2024; 20:565-584. [PMID: 39112603 DOI: 10.1038/s41584-024-01143-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2024] [Indexed: 08/29/2024]
Abstract
Obesity has a pivotal and multifaceted role in pain associated with osteoarthritis (OA), extending beyond the mechanistic influence of BMI. It exerts its effects both directly and indirectly through various modifiable risk factors associated with OA-related pain. Adipose tissue dysfunction is highly involved in OA-related pain through local and systemic inflammation, immune dysfunction, and the production of pro-inflammatory cytokines and adipokines. Adipose tissue dysfunction is intricately connected with metabolic syndrome, which independently exerts specific effects on OA-related pain, distinct from its association with BMI. The interplay among obesity, adipose tissue dysfunction and metabolic syndrome influences OA-related pain through diverse pain mechanisms, including nociceptive pain, peripheral sensitization and central sensitization. These complex interactions contribute to the heightened pain experience observed in individuals with OA and obesity. In addition, pain management strategies are less efficient in individuals with obesity. Importantly, therapeutic interventions targeting obesity and metabolic syndrome hold promise in managing OA-related pain. A deeper understanding of the intricate relationship between obesity, metabolic syndrome and OA-related pain is crucial and could have important implications for improving pain management and developing innovative therapeutic options in OA.
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Affiliation(s)
- Marie Binvignat
- Department of Rheumatology, Sorbonne University, AP-HP Saint-Antoine hospital, Paris, France
- Sorbonne University, INSERM UMRS_938, Centre de Recherche Saint-Antoine (CRSA), Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
- Sorbonne University, INSERM UMRS_959, I3 Lab Immunology Immunopathology Immunotherapy, Paris, France
| | - Jérémie Sellam
- Department of Rheumatology, Sorbonne University, AP-HP Saint-Antoine hospital, Paris, France.
- Sorbonne University, INSERM UMRS_938, Centre de Recherche Saint-Antoine (CRSA), Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France.
| | - Francis Berenbaum
- Department of Rheumatology, Sorbonne University, AP-HP Saint-Antoine hospital, Paris, France
- Sorbonne University, INSERM UMRS_938, Centre de Recherche Saint-Antoine (CRSA), Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
| | - David T Felson
- Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, MA, USA
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Li H, Cui Y, Wang J, Zhang W, Chen Y, Zhao J. Identification and validation of biomarkers related to lipid metabolism in osteoarthritis based on machine learning algorithms. Lipids Health Dis 2024; 23:111. [PMID: 38637751 PMCID: PMC11025229 DOI: 10.1186/s12944-024-02073-5] [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: 01/29/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Osteoarthritis and lipid metabolism are strongly associated, although the precise targets and regulatory mechanisms are unknown. METHODS Osteoarthritis gene expression profiles were acquired from the GEO database, while lipid metabolism-related genes (LMRGs) were sourced from the MigSB database. An intersection was conducted between these datasets to extract gene expression for subsequent differential analysis. Following this, functional analyses were performed on the differentially expressed genes (DEGs). Subsequently, machine learning was applied to identify hub genes associated with lipid metabolism in osteoarthritis. Immune-infiltration analysis was performed using CIBERSORT, and external datasets were employed to validate the expression of these hub genes. RESULTS Nine DEGs associated with lipid metabolism in osteoarthritis were identified. UGCG and ESYT1, which are hub genes involved in lipid metabolism in osteoarthritis, were identified through the utilization of three machine learning algorithms. Analysis of the validation dataset revealed downregulation of UGCG in the experimental group compared to the normal group and upregulation of ESYT1 in the experimental group compared to the normal group. CONCLUSIONS UGCG and ESYT1 were considered as hub LMRGs in the development of osteoarthritis, which were regarded as candidate diagnostic markers. The effects are worth expected in the early diagnosis and treatment of osteoarthritis.
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Affiliation(s)
- Hang Li
- Wuxi Medical Center, Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, Jiangsu, 214023, China
| | - Yubao Cui
- Clinical Research Center, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, 214023, Jiangsu, China
| | - Jian Wang
- Wuxi Medical Center, Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, Jiangsu, 214023, China
| | - Wei Zhang
- Wuxi Medical Center, Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, Jiangsu, 214023, China
| | - Yuhao Chen
- Wuxi Medical Center, Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, Jiangsu, 214023, China
| | - Jijun Zhao
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, Jiangsu, 214023, China.
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Eymard F, Aron-Wisnewsky J. Osteoarthritis in patients with obesity: The bariatric surgery impacts on its evolution. Joint Bone Spine 2024; 91:105639. [PMID: 37734439 DOI: 10.1016/j.jbspin.2023.105639] [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: 07/13/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 09/23/2023]
Abstract
Obesity is one of the main modifiable risk factors for osteoarthritis (OA). Moreover, obesity is associated with greater pain intensity and functional limitation, but also with a significantly lower responder rate to intra-articular treatments. Consequently, an arthroplasty is indicated earlier and more frequently in patients with obesity. However, pain and functional symptoms improve slightly less after arthroplasty in patients with obesity, who display higher incidence of early and late complications following prosthetic surgery. Bariatric surgery (BS) has increased worldwide and is efficient to induce major and sustainable weight-loss. Importantly, BS significantly reduces pain and functional limitation in patients with symptomatic knee OA. Biomarkers analysis also revealed a decrease in catabolic factors and an increase in anabolic one after BS suggesting a structural protective effect in knee OA. Nevertheless, the impact of BS prior to arthroplasty remains unclear. BS seems to decrease short- and mid-term complications such as infections or thrombosis. However, BS does not appear to modify long-term complications rate, and may even increase it, especially revisions and infections. Although few studies have compared the symptomatic and functional outcomes of joint replacement with or without BS, these are not significantly improved by prior BS. Despite these heterogeneous results, medico-economic studies found that BS prior to arthroplasty was cost-effective. To conclude, BS could significantly reduce the symptoms of OA and potentially slow its progression, but appears more disappointing in preventing long-term complications of arthroplasties and improving their functional results.
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Affiliation(s)
- Florent Eymard
- Department of Rheumatology, Henri-Mondor University Hospital, Assistance publique-Hôpitaux de Paris, AP-HP, 1, rue Gustave-Eiffel, 94000 Créteil, France.
| | - Judith Aron-Wisnewsky
- Department of Nutrition, Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, AP-HP, 75013 Paris, France; Sorbonne université, Inserm, Nutrition and Obesity: Systemic Approaches, NutriOmics, 75013 Paris, France
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Deng C, Presle N, Pizard A, Guillaume C, Bianchi A, Kempf H. Beneficial Impact of Eicosapentaenoic Acid on the Adverse Effects Induced by Palmitate and Hyperglycemia on Healthy Rat Chondrocyte. Int J Mol Sci 2024; 25:1810. [PMID: 38339087 PMCID: PMC10855847 DOI: 10.3390/ijms25031810] [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: 12/05/2023] [Revised: 01/18/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Osteoarthritis (OA) is the most prevalent form of arthritis and a major cause of pain and disability. The pathology of OA involves the whole joint in an inflammatory and degenerative process, especially in articular cartilage. OA may be divided into distinguishable phenotypes including one associated with the metabolic syndrome (MetS) of which dyslipidemia and hyperglycemia have been individually linked to OA. Since their combined role in OA pathogenesis remains to be elucidated, we investigated the chondrocyte response to these metabolic stresses, and determined whether a n-3 polyunsaturated fatty acid (PUFA), i.e., eicosapentaenoic acid (EPA), may preserve chondrocyte functions. Rat chondrocytes were cultured with palmitic acid (PA) and/or EPA in normal or high glucose conditions. The expression of genes encoding proteins found in cartilage matrix (type 2 collagen and aggrecan) or involved in degenerative (metalloproteinases, MMPs) or in inflammatory (cyclooxygenase-2, COX-2 and microsomal prostaglandin E synthase, mPGES) processes was analyzed by qPCR. Prostaglandin E2 (PGE2) release was also evaluated by an enzyme-linked immunosorbent assay. Our data indicated that PA dose-dependently up-regulated the mRNA expression of MMP-3 and -13. PA also induced the expression of COX-2 and mPGES and promoted the synthesis of PGE2. Glucose at high concentrations further increased the chondrocyte response to PA. Interestingly, EPA suppressed the inflammatory effects of PA and glucose, and strongly reduced MMP-13 expression. Among the free fatty acid receptors (FFARs), FFAR4 partly mediated the EPA effects and the activation of FFAR1 markedly reduced the inflammatory effects of PA in high glucose conditions. Our findings demonstrate that dyslipidemia associated with hyperglycemia may contribute to OA pathogenesis and explains why an excess of saturated fatty acids and a low level in n-3 PUFAs may disrupt cartilage homeostasis.
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Affiliation(s)
- Chaohua Deng
- UMR 7365 CNRS-Université de Lorraine, Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Biopôle de l’Université de Lorraine, 54500 Vandoeuvre-les-Nancy, France; (C.D.); (N.P.); (C.G.); (H.K.)
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Nathalie Presle
- UMR 7365 CNRS-Université de Lorraine, Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Biopôle de l’Université de Lorraine, 54500 Vandoeuvre-les-Nancy, France; (C.D.); (N.P.); (C.G.); (H.K.)
| | - Anne Pizard
- INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est-Créteil (UPEC), 94010 Créteil, France;
| | - Cécile Guillaume
- UMR 7365 CNRS-Université de Lorraine, Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Biopôle de l’Université de Lorraine, 54500 Vandoeuvre-les-Nancy, France; (C.D.); (N.P.); (C.G.); (H.K.)
| | - Arnaud Bianchi
- UMR 7365 CNRS-Université de Lorraine, Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Biopôle de l’Université de Lorraine, 54500 Vandoeuvre-les-Nancy, France; (C.D.); (N.P.); (C.G.); (H.K.)
| | - Hervé Kempf
- UMR 7365 CNRS-Université de Lorraine, Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Biopôle de l’Université de Lorraine, 54500 Vandoeuvre-les-Nancy, France; (C.D.); (N.P.); (C.G.); (H.K.)
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Zhang Y, Wang Y, Xu J, Wang Z, Zhao W, Zhao C. Visceral adipose tissue and osteoarthritis, a two-sample Mendelian randomized study. Front Med (Lausanne) 2024; 10:1324449. [PMID: 38249972 PMCID: PMC10799559 DOI: 10.3389/fmed.2023.1324449] [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: 10/19/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Background The relationship between visceral adipose tissue and osteoarthritis is not clear. The purpose of our study was to explore the relationship between visceral adipose tissue and osteoarthritis. Methods We used a two-sample Mendelian randomization method to select single-nucleotide polymorphisms (SNPs) significantly associated with visceral adipose tissue as instrumental variables to explore the relationship between visceral adipose tissue and all osteoarthritis, hand osteoarthritis, hip osteoarthritis, knee osteoarthritis, and spine osteoarthritis. The reliability of the results was tested using sensitivity analysis. Results Our findings indicated that visceral adipose tissue was associated with all osteoarthritis, hip osteoarthritis, knee osteoarthritis, and spine osteoarthritis (all osteoarthritis: OR = 1.399, 95% CI: 1.335-1.467, p = 7.95e-44; hip osteoarthritis: OR = 1.399, 95% CI: 1.284-1.524, p = 1.41e-14; knee osteoarthritis: OR = 1.794, 95% CI: 1.662-1.937, p = 1.33e-50; and spine osteoarthritis: OR = 1.445, 95% CI: 1.314-1.589, p = 2.89e-14). Sensitivity analysis demonstrated the reliability of these results. Conclusion Our study suggests that genetically predicted visceral adipose tissue is associated with osteoarthritis. Reducing the accumulation of visceral adipose tissue could potentially have an impact on the incidence of osteoarthritis.
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Affiliation(s)
- Yinzhen Zhang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Yanpeng Wang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Ji Xu
- Department of Spinal Orthopedics, Weifang Hospital of Traditional Chinese Medicine, Weifang, China
| | - Zhengyan Wang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Wenhai Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Changwei Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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Shin H, Prasad V, Lupancu T, Malik S, Achuthan A, Biondo M, Kingwell BA, Thiem M, Gottschalk M, Weighardt H, Förster I, de Steiger R, Hamilton JA, Lee KMC. The GM-CSF/CCL17 pathway in obesity-associated osteoarthritic pain and disease in mice. Osteoarthritis Cartilage 2023; 31:1327-1341. [PMID: 37225052 DOI: 10.1016/j.joca.2023.05.008] [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: 11/08/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES We have previously identified a granulocyte macrophage-colony stimulating factor (GM-CSF)/C-C motif ligand 17 (CCL17) pathway in monocytes/macrophages, in which GM-CSF regulates the formation of CCL17, and it is important for an experimental osteoarthritis (OA) model. We explore here additional OA models, including in the presence of obesity, such as a requirement for this pathway. DESIGN The roles of GM-CSF, CCL17, CCR4, and CCL22 in various experimental OA models, including those incorporating obesity (eight-week high-fat diet), were investigated using gene-deficient male mice. Pain-like behavior and arthritis were assessed by relative static weight distribution and histology, respectively. Cell populations (flow cytometry) and cytokine messenger RNA (mRNA) expression (qPCR) in knee infrapatellar fat pad were analyzed. Human OA sera were collected for circulating CCL17 levels (ELISA) and OA knee synovial tissue for gene expression (qPCR). RESULTS We present evidence that: i) GM-CSF, CCL17, and CCR4, but not CCL22, are required for the development of pain-like behavior and optimal disease in three experimental OA models, as well as for exacerbated OA development due to obesity, ii) obesity alone leads to spontaneous knee joint damage in a GM-CSF- and CCL17-dependent manner, and iii) in knee OA patients, early indications are that BMI correlates with a lower Oxford Knee Score (r = -0.458 and p = 0.0096), with elevated circulating CCL17 levels (r = 0.2108 and p = 0.0153) and with elevated GM-CSF and CCL17 gene expression in OA synovial tissue. CONCLUSIONS The above findings indicate that GM-CSF, CCL17, and CCR4 are involved in obesity-associated OA development, broadening their potential as targets for possible treatments for OA.
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Affiliation(s)
- Heonsu Shin
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Varun Prasad
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Tanya Lupancu
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Shveta Malik
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Adrian Achuthan
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Mark Biondo
- CSL Ltd, Bio21 Institute, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Bronwyn A Kingwell
- CSL Ltd, Bio21 Institute, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Manja Thiem
- Immunology and Environment, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Marlene Gottschalk
- Immunology and Environment, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Heike Weighardt
- Immunology and Environment, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Irmgard Förster
- Immunology and Environment, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Richard de Steiger
- Department of Surgery, Epworth Healthcare, University of Melbourne, Richmond, Victoria 3121, Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - John A Hamilton
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050 Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria 3021, Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Kevin M-C Lee
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050 Australia; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria 3000, Australia.
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Fu Y, Batushansky A, Kinter M, Huebner JL, Kraus VB, Griffin TM. Effects of Leptin and Body Weight on Inflammation and Knee Osteoarthritis Phenotypes in Female Rats. JBMR Plus 2023; 7:e10754. [PMID: 37457883 PMCID: PMC10339097 DOI: 10.1002/jbm4.10754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/22/2023] [Accepted: 04/13/2023] [Indexed: 07/18/2023] Open
Abstract
Leptin is a proinflammatory adipokine that contributes to obesity-associated osteoarthritis (OA), especially in women. However, the extent to which leptin causes knee OA separate from the effect of increased body weight is not clear. We hypothesized that leptin is necessary to induce knee OA in obese female rats but not sufficient to induce knee OA in lean rats lacking systemic metabolic inflammation. The effect of obesity without leptin signaling was modeled by comparing female lean Zucker rats to pair fed obese Zucker rats, which possess mutant fa alleles of the leptin receptor gene. The effect of leptin without obesity was modeled in female F344BN F1 hybrid rats by systemically administering recombinant rat leptin versus saline for 23 weeks via osmotic pumps. Primary OA outcomes included cartilage histopathology and subchondral bone micro-computed tomography. Secondary outcomes included targeted cartilage proteomics, serum inflammation, and synovial fluid inflammation following an acute intra-articular challenge with interleukin-1β (IL-1β). Compared to lean Zucker rats, obese Zucker rats developed more severe tibial osteophytes and focal cartilage lesions in the medial tibial plateau, with modest changes in proximal tibial epiphysis trabecular bone structure. In contrast, exogenous leptin treatment, which increased plasma leptin sixfold without altering body weight, caused mild generalized cartilage fibrillation and reduced Safranin O staining compared to vehicle-treated animals. Leptin also significantly increased subchondral and trabecular bone volume and bone mineral density in the proximal tibia. Cartilage metabolic and antioxidant enzyme protein levels were substantially elevated with leptin deficiency and minimally suppressed with leptin treatment. In contrast, leptin treatment induced greater changes in systemic and local inflammatory mediators compared to leptin receptor deficiency, including reduced serum IL-6 and increased synovial fluid IL-1β. In conclusion, rat models that separately elevate leptin or body weight develop distinct OA-associated phenotypes, revealing how obesity increases OA pathology through both leptin-dependent and independent pathways. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Yao Fu
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
| | - Albert Batushansky
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
| | - Michael Kinter
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
- Oklahoma Center for GeroscienceUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Janet L. Huebner
- Duke Molecular Physiology InstituteDuke University, School of Medicine, Duke UniversityDurhamNorth CarolinaUSA
| | - Virginia B. Kraus
- Duke Molecular Physiology InstituteDuke University, School of Medicine, Duke UniversityDurhamNorth CarolinaUSA
- Division of Rheumatology, Department of MedicineDuke University, School of Medicine, Duke UniversityDurhamNorth CarolinaUSA
| | - Timothy M. Griffin
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
- Oklahoma Center for GeroscienceUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
- Department of Biochemistry and Molecular BiologyUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
- Veterans Affairs Medical CenterOklahoma CityOklahomaUSA
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Szczerbowska-Boruchowska M, Surowka AD, Ostachowicz B, Piana K, Spaleniak A, Wrobel P, Dudala J, Ziomber-Lisiak A. Combined spectroscopic, biochemical and chemometric approach toward finding of biochemical markers of obesity. Biochim Biophys Acta Gen Subj 2023; 1867:130279. [PMID: 36384192 DOI: 10.1016/j.bbagen.2022.130279] [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: 08/23/2022] [Revised: 10/10/2022] [Accepted: 11/10/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Early-stage detection of subclinical obesity-driven systemic changes is a challenging area of medical diagnostics, where the most popular existing measures - such as body mass index - BMI - often fall short of providing a realistic estimate of adiposity and, therefore, of ongoing pathologies at the systemic, tissue and cellular level. In the quest for identifying new more robust diagnostic markers, whole-organ analysis of chemical elements is a promising approach for identifying candidate proxies of obesity status in the system. METHODS Total Reflection X-ray fluorescence (TXRF) coupled with biochemical assays, chemometrics and statistical validation was used as a new integrated pipeline for marker identification in external ear samples of obese animals. The specimens were taken from obese animals fed a high calorie diet as well as from lean intact animals fed a standard diet. RESULTS The most significant differences in the content of K, Fe, Br, and Rb between the studied groups of the animals were identified. However, with the methodology applied Rb was found the most robust biochemical discriminator of early-stage obesity effects, as validated by the logistic regression model. We observed no relationship between the levels of the elements consumed by the animals and their apparent content in the earlobe tissue samples. CONCLUSIONS Our preliminary study confirms that obesity alters tissue trace metal metabolism and shows the proposed new approach as an accurate and reliable methodology for detecting tissue elemental obesity-related alterations. GENERAL SIGNIFICANCE This result can be of practical significance for designing new point-of-care systems for obesity screening tests, taking advantage of direct/indirect Rb measurements.
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Affiliation(s)
| | - Artur D Surowka
- AGH University of Science and Technology, Faculty of Physics and Applied Computer Science, Al. Mickiewicza 30, Krakow 30-059, Poland
| | - Beata Ostachowicz
- AGH University of Science and Technology, Faculty of Physics and Applied Computer Science, Al. Mickiewicza 30, Krakow 30-059, Poland
| | - Kaja Piana
- AGH University of Science and Technology, Faculty of Physics and Applied Computer Science, Al. Mickiewicza 30, Krakow 30-059, Poland
| | - Anna Spaleniak
- AGH University of Science and Technology, Faculty of Physics and Applied Computer Science, Al. Mickiewicza 30, Krakow 30-059, Poland
| | - Pawel Wrobel
- AGH University of Science and Technology, Faculty of Physics and Applied Computer Science, Al. Mickiewicza 30, Krakow 30-059, Poland
| | - Joanna Dudala
- AGH University of Science and Technology, Faculty of Physics and Applied Computer Science, Al. Mickiewicza 30, Krakow 30-059, Poland
| | - Agata Ziomber-Lisiak
- Department of Pathophysiology, Jagiellonian University, Medical College, Krakow, Poland
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Telles RW, Machado LAC, Costa-Silva L, Barreto SM. Cohort Profile Update: The Brazilian Longitudinal Study of Adult Health Musculoskeletal (ELSA-Brasil MSK) cohort. Int J Epidemiol 2022; 51:e391-e400. [PMID: 35474011 DOI: 10.1093/ije/dyac084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/06/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
- Rosa Weiss Telles
- Faculdade de Medicina, Universidade Federal da Minas Gerais, Belo Horizonte, Brazil.,Hospital das Clínicas-UFMG/EBSERH, Belo Horizonte, Brazil
| | | | | | - Sandhi Maria Barreto
- Faculdade de Medicina, Universidade Federal da Minas Gerais, Belo Horizonte, Brazil.,Hospital das Clínicas-UFMG/EBSERH, Belo Horizonte, Brazil
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Andersson M, Haglund E, Aili K, Bremander A, Bergman S. Associations between metabolic factors and radiographic knee osteoarthritis in early disease - a cross-sectional study of individuals with knee pain. BMC Musculoskelet Disord 2022; 23:938. [PMID: 36307803 PMCID: PMC9615348 DOI: 10.1186/s12891-022-05881-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/12/2022] [Indexed: 05/06/2024] Open
Abstract
Objective Metabolic factors have been shown to be associated to severe radiographic knee osteoarthritis (RKOA). However, more knowledge is needed in early clinical knee osteoarthritis (KOA). The aim was to study associations between metabolic factors and radiographic knee osteoarthritis (OA) in individuals with knee pain. A second aim was to study associations between metabolic factors and RKOA in those with normal BMI and in those overweight/obese, respectively. Method This cross-sectional study included 282 individuals with knee pain (without cruciate ligament injury) and aged 30–67 years, and 70% women. Waist circumference, body mass index (BMI), proportion of fat and visceral fat area (VFA) were assessed. RKOA was defined as Ahlbäck grade 1 in at least one knee. Fasting blood samples were taken and triglycerides, cholesterol (total, low density lipoprotein (LDL) and high density lipoprotein (HDL)), C-reactive protein (CRP), glucose, HbA1C were analysed. Metabolic syndrome was defined in accordance with the International Diabetes Federation (IDF). Associations were analysed by logistic regression. Results Individuals with RKOA were older, had higher BMI, higher VFA, larger waist circumference and had increased total cholesterol, triglycerides and LDL-cholesterol, but not fasting glucose. There was no difference between the group with RKOA vs. non-radiographic group regarding the presence of metabolic syndrome. In a subgroup analysis of individuals with normal BMI (n = 126), those with RKOA had higher VFA, more central obesity, higher levels of CRP and total cholesterol, compared with individuals without RKOA. In individuals with obesity, age was the only outcome associated to RKOA. Conclusion There were clear associations between metabolic factors and RKOA in individuals with knee pain, also in those with normal BMI. In individuals with obesity age was the only variable associated to RKOA. Trial registration: clinicalTrials.gov Identifier: NCT04928170.
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11
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Loef M, van de Stadt L, Böhringer S, Bay-Jensen AC, Mobasheri A, Larkin J, Lafeber FPJG, Blanco FJ, Haugen IK, Berenbaum F, Giera M, Ioan-Facsinay A, Kloppenburg M. The association of the lipid profile with knee and hand osteoarthritis severity: the IMI-APPROACH cohort. Osteoarthritis Cartilage 2022; 30:1062-1069. [PMID: 35644463 DOI: 10.1016/j.joca.2022.05.008] [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] [Received: 12/22/2021] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the association of the lipidomic profile with osteoarthritis (OA) severity, considering the outcomes radiographic knee and hand OA, pain and function. DESIGN We used baseline data from the Applied Public-Private Research enabling OsteoArthritis Clinical Headway (APPROACH) cohort, comprising persons with knee OA fulfilling the clinical American College of Rheumatology classification criteria. Radiographic knee and hand OA severity was quantified with Kellgren-Lawrence sum scores. Knee and hand pain and function were assessed with validated questionnaires. We quantified fasted plasma higher order lipids and oxylipins with liquid chromatography with tandem mass spectrometry (LC-MS/MS)-based platforms. Using penalised linear regression, we assessed the variance in OA severity explained by lipidomics, with adjustment for clinical covariates (age, sex, body mass index (BMI) and lipid lowering medication), measurement batch and clinical centre. RESULTS In 216 participants (mean age 66 years, mean BMI 27.3 kg/m2, 75% women) we quantified 603 higher order lipids (triacylglycerols, diacylglycerols, cholesteryl esters, ceramides, free fatty acids, sphingomyelins, phospholipids) and 28 oxylipins. Lipidomics explained 3% and 2% of the variance in radiographic knee and hand OA severity, respectively. Lipids were not associated with knee pain or function. Lipidomics accounted for 12% and 6% of variance in hand pain and function, respectively. The investigated OA severity outcomes were associated with the lipidomic fraction of bound and free arachidonic acid, bound palmitoleic acid, oleic acid, linoleic acid and docosapentaenoic acid. CONCLUSIONS Within the APPROACH cohort lipidomics explained a minor portion of the variation in OA severity, which was most evident for the outcome hand pain. Our results suggest that eicosanoids may be involved in OA severity.
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Affiliation(s)
- M Loef
- Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.
| | - L van de Stadt
- Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.
| | - S Böhringer
- Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands.
| | - A-C Bay-Jensen
- Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.
| | - A Mobasheri
- Regenerative Medicine, State Research Institute Center of Innovative Medicine, Vilnius, Lithuania.
| | - J Larkin
- GlaxoSmithKline USA, Philadelphia, PA, USA.
| | - F P J G Lafeber
- Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, the Netherlands.
| | - F J Blanco
- Servicio de Reumatologia, INIBIC-Hospital Universitario A Coruña, A Coruña, Spain.
| | - I K Haugen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
| | - F Berenbaum
- Rheumatology, Sorbonne University, INSERM, AP-HP Saint-Antoine Hospital, Paris, France.
| | - M Giera
- Center of Proteomics and Metabolomics, Leiden University Medical Center, Leiden, the Netherlands.
| | - A Ioan-Facsinay
- Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.
| | - M Kloppenburg
- Rheumatology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
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12
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Andersson MLE, Haglund E, Aili K, Bremander A, Bergman S. Cohort profile: the Halland osteoarthritis (HALLOA) cohort-from knee pain to osteoarthritis: a longitudinal observational study in Sweden. BMJ Open 2022; 12:e057086. [PMID: 35835523 PMCID: PMC9289013 DOI: 10.1136/bmjopen-2021-057086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The overall objective in this study is to investigate the early development of radiographic knee osteoarthritis (OA) and its association with hand or/and knee OA, metabolic diseases, biomarkers, chronic pain, physical function and daily physical activity types. PARTICIPANTS The Halland osteoarthritis (HALLOA) cohort is a longitudinal cohort study that includes individuals with knee pain in the southwest of Sweden. Enrolment took place from 2017 to 2019. The inclusion criteria were current knee pain, with no former known radiographic knee OA and no cruciate ligament rupture or rheumatological disorder. The participants were recruited: (1) when seeking care for knee pain in primary healthcare or (2) by advertisements in local newspapers. There are 306 individuals included in the study, mean age (SD) 51.7 (8.7) years and 69% are women. The baseline and follow-ups include clinical tests, radiographical examinations, blood samples, metabolic measures, pain pressure thresholds, tests of physical functions, daily physical activity types and patient-reported outcomes. FINDINGS TO DATE There were associations between metabolic factors and radiographic knee OA, even in those with normal body mass index at baseline. In addition, clinical hand OA was positively associated with fasting plasma glucose. We also found that modifiable factors as increased visceral fat and total body fat were associated with increased pain sensitivity among individuals with knee pain. FUTURE PLANS By studying possible pathophysiological mechanisms of OA over time, we aim to provide new insights on OA progression, identify usable preventive measures helping the clinicians in the management of the disease and improve health for the patients. It is also important to study the development of chronic pain in OA, to get tools to identify individuals at risk and to be able to offer them treatment. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04928170).
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Affiliation(s)
- Maria L E Andersson
- Department of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Emma Haglund
- Department of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden
- Department of Enviromental and Biosciences, School of Business, Innovation and Sustainibility, Halmstad University, Halmstad, Sweden
| | - Katarina Aili
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ann Bremander
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark
| | - S Bergman
- Spenshult Research and Development Centre, Halmstad, Sweden
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Shahid A, Inam‐Ur‐Raheem M, Iahtisham‐Ul‐Haq , Nawaz MY, Rashid MH, Oz F, Proestos C, Aadil RM. Diet and lifestyle modifications: An update on non‐pharmacological approach in the management of osteoarthritis. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.16786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Arashi Shahid
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
| | - Muhammad Inam‐Ur‐Raheem
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
| | - Iahtisham‐Ul‐Haq
- Kauser Abdulla Malik School of Life Sciences Forman Christian College (A Chartered University) Punjab Pakistan
| | - Muhammad Yasir Nawaz
- Department of Pathology Faculty of Veterinary Science, University of Agriculture Faisalabad Faisalabad Pakistan
| | - Muhammad Hamdan Rashid
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
| | - Fatih Oz
- Department of Food Engineering, Faculty of Agriculture Ataturk University Erzurum Turkey
| | - Charalampos Proestos
- Laboratory of Food Chemistry, Department of Chemistry National and Kapodistrian University of Athens Zografou Athens Greece
| | - Rana Muhammad Aadil
- National Institute of Food Science and Technology University of Agriculture Faisalabad Pakistan
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Gløersen M, Steen Pettersen P, Neogi T, Jafarzadeh SR, Vistnes M, Thudium CS, Bay-Jensen AC, Sexton J, Kvien TK, Hammer HB, Haugen IK. Associations of Body Mass Index With Pain and the Mediating Role of Inflammatory Biomarkers in People With Hand Osteoarthritis. Arthritis Rheumatol 2022; 74:810-817. [PMID: 35137553 PMCID: PMC9050744 DOI: 10.1002/art.42056] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 11/26/2021] [Accepted: 12/16/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To examine the association of body mass index (BMI) with pain in people with hand osteoarthritis (OA), and explore whether this association, if causal, is mediated by systemic inflammatory biomarkers. METHODS In 281 Nor-Hand study participants, we estimated associations between BMI and hand pain, as measured by the Australian/Canadian Osteoarthritis Hand Index (AUSCAN; range 0-20) and Numerical Rating Scale (NRS; range 0-10); foot pain, as measured by NRS (range 0-10); knee/hip pain, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; range 0-20); painful total body joint count; and pain sensitization. We fit natural-effects models to estimate natural direct and natural indirect effects of BMI on pain through inflammatory biomarkers. RESULTS Each 5-unit increase in BMI was associated with more severe hand pain (on average increased AUSCAN by 0.64 [95% confidence interval (95% CI) 0.23, 1.08]), foot pain (on average increased NRS by 0.65 [95% CI 0.36, 0.92]), knee/hip pain (on average increased WOMAC by 1.31 [95% CI 0.87, 1.73]), generalized pain, and pain sensitization. Mediation analyses suggested that the effects of BMI on hand pain and painful total body joint count were partially mediated by leptin and high-sensitivity C-reactive protein (hsCRP), respectively. Effect sizes for mediation by leptin were larger for the hands than for the lower extremities, and were statistically significant for the hands only. CONCLUSION In people with hand OA, higher BMI is associated with greater pain severity in the hands, feet, and knees/hips. Systemic effects of obesity, measured by leptin, may play a larger mediating role for pain in the hands than in the lower extremities. Low-grade inflammation, measured by hsCRP, may contribute to generalized pain in overweight/obese individuals.
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Affiliation(s)
- Marthe Gløersen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway,University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Pernille Steen Pettersen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway,University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of Medicine, Boston, USA
| | - S. Reza Jafarzadeh
- Section of Rheumatology, Boston University School of Medicine, Boston, USA
| | - Maria Vistnes
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway,Division of Medicine, Diakonhjemmet Hospital, Oslo, Norway,Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | | | | | - Joe Sexton
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Tore K. Kvien
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway,University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Hilde B. Hammer
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway,University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Ida K. Haugen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
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15
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Loeser RF, Arbeeva L, Kelley K, Fodor AA, Sun S, Ulici V, Longobardi L, Cui Y, Stewart DA, Sumner SJ, Azcarate-Peril MA, Sartor RB, Carroll IM, Renner JB, Jordan JM, Nelson AE. Association of Increased Serum Lipopolysaccharide, But Not Microbial Dysbiosis, With Obesity-Related Osteoarthritis. Arthritis Rheumatol 2022; 74:227-236. [PMID: 34423918 PMCID: PMC8795472 DOI: 10.1002/art.41955] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/19/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To test the hypothesis that an altered gut microbiota (dysbiosis) plays a role in obesity-associated osteoarthritis (OA). METHODS Stool and blood samples were collected from 92 participants with a body mass index (BMI) ≥30 kg/m2 , recruited from the Johnston County Osteoarthritis Project. OA patients (n = 50) had hand and knee OA (Kellgren/Lawrence [K/L] grade ≥2 or arthroplasty). Controls (n = 42) had no hand OA and a K/L grade of 0-1 for the knees. Compositional analysis of stool samples was carried out by 16S ribosomal RNA amplicon sequencing. Alpha- and beta-diversity and differences in taxa relative abundances were determined. Blood samples were used for multiplex cytokine analysis and measures of lipopolysaccharide (LPS) and LPS binding protein. Germ-free mice were gavaged with patient- or control-pooled fecal samples and fed a 40% fat, high-sucrose diet for 40 weeks. Knee OA was evaluated histologically. RESULTS On average, OA patients were slightly older than the controls, consisted of more women, and had a higher mean BMI, higher mean Western Ontario and McMaster Universities Osteoarthritis Index pain score, and higher mean K/L grade. There were no significant differences in α- or β-diversity or genus level composition between patients and controls. Patients had higher plasma levels of osteopontin (P = 0.01) and serum LPS (P < 0.0001) compared to controls. Mice transplanted with patient or control microbiota exhibited a significant difference in α-diversity (P = 0.02) and β-diversity, but no differences in OA severity were observed. CONCLUSION The lack of differences in the gut microbiota, but increased serum LPS levels, suggest the possibility that increased intestinal permeability allowing for greater absorption of LPS, rather than a dysbiotic microbiota, may contribute to the development of OA associated with obesity.
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Affiliation(s)
- Richard F. Loeser
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Liubov Arbeeva
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Kathryn Kelley
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Anthony A. Fodor
- Dept. of Bioinformatics and Genomics, University of North Carolina-Charlotte, North Carolina
| | - Shan Sun
- Dept. of Bioinformatics and Genomics, University of North Carolina-Charlotte, North Carolina
| | - Veronica Ulici
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Lara Longobardi
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Yang Cui
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - Susan J. Sumner
- Department of Nutrition, University of North Carolina, Chapel Hill, NC
| | - M. Andrea Azcarate-Peril
- Division of Gastroenterology and Hepatology and UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - R. Balfour Sartor
- Division of Gastroenterology and Hepatology and Center for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Ian M. Carroll
- Department of Nutrition, University of North Carolina, Chapel Hill, NC
| | - Jordan B. Renner
- Department of Radiology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Joanne M. Jordan
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Amanda E. Nelson
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Jiang X, Zhong R, Dai W, Huang H, Yu Q, Zhang JA, Cai Y. Exploring Diagnostic Biomarkers and Comorbid Pathogenesis for Osteoarthritis and Metabolic Syndrome via Bioinformatics Approach. Int J Gen Med 2021; 14:6201-6213. [PMID: 34616175 PMCID: PMC8487858 DOI: 10.2147/ijgm.s325561] [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: 06/24/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MS) has grown in recognition to contribute to the pathogenesis of osteoarthritis (OA), which is the most prevalent arthritis characterized by joint dysfunction. However, the specific mechanism between OA and MS remains unclear. METHODS The gene expression profiles and clinical information data of OA and MS were retrieved from the Gene Expression Omnibus (GEO) database. The genes in the key module of MS were identified by weighted gene co-expression network analysis (WGCNA), which intersected with the differentially expressed genes (DEGs) between control and MS samples to obtain hub genes for MS. The potential functions and pathways of hub genes were detected through the Gene Ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG) analyses. The genes involved in the different KEGG pathways between the control and OA samples overlapped with the DEGs between the two groups via the Venn analysis to gain the hub genes for OA affected by MS (MOHGs). Additionally, the least absolute shrinkage and selection operator (LASSO) was performed on the MOHGs to establish a diagnostic model for each disease. RESULTS A total of 61 hub genes for MS were identified that significantly enriched in platelet activation, complement and coagulation cascades, and hematopoietic cell lineage. Besides, 4 candidate genes (ELOVL7, F2RL3, GP9, and ITGA2B) were screened among the 6 MOHGs to construct a diagnostic model, showing good performance for distinguishing controls from patients with MS and OA. GSEA suggested that these diagnostic genes were closely associated with immune response, adipocytokine signaling, fatty acid metabolism, cell cycle, and platelet activation. CONCLUSION Taken together, we identified 4 potential gene biomarkers for diagnosing MS and OA patients, providing a theoretical basis and reference for the diagnostics and treatment targets of MS and OA.
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Affiliation(s)
- Xiang Jiang
- Department of Orthopaedics and Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, People’s Republic of China
| | - Rongzhou Zhong
- Department of Orthopaedics and Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, People’s Republic of China
| | - Weifan Dai
- Department of Digital Hub, Decathlon International, Shanghai, 200131, People’s Republic of China
| | - Hui Huang
- Department of Orthopaedics and Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, People’s Republic of China
| | - Qinyuan Yu
- Department of Orthopaedics and Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, People’s Republic of China
| | - Jiji Alexander Zhang
- Department of Medicine, Heidelberg University Hospital, University of Heidelberg, Heidelberg, 69120, Germany
| | - Yanrong Cai
- Department of Medicine, Heidelberg University Hospital, University of Heidelberg, Heidelberg, 69120, Germany
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Obesity Is Preferentially Associated With Patellofemoral Compartment Wear: A Magnetic Resonance Imaging Assessment. J Am Acad Orthop Surg 2021; 29:e722-e731. [PMID: 33273404 DOI: 10.5435/jaaos-d-20-00596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A well-known association exists between obesity and knee osteoarthritis (OA) for both incidence and progression of the disease. However, the cartilage wear patterns in OA associated with obesity are less well studied. METHODS The OA initiative, a prospective sample of 4,796 patients, was used for this study. After the application of inclusion and exclusion criteria, patients were stratified into increasing body mass index (BMI) cohorts (BMI < 25, 25 ≤ BMI < 30, 30 ≤ BMI < 40, and 40 ≤ BMI). Knee MRIs were assessed using the semiquantitative MRI Osteoarthritis Knee Score scores. Patellofemoral (PF), medial, and lateral compartment cartilage scores were compared among BMI cohorts, controlling for confounders using linear regression models. RESULTS In total, 2,006 patients were present in our cohort, 773 men (38.5%) and 1,233 women (61.5%); the mean age was 61.7 ± 8.9 years. Increasing BMI was independently associated with increasing grades of PF wear for both right and left knees in the lateral patella facet (right knee β: 0.208, 95% confidence interval [CI]: 0.128 to 0.288, P < 0.001, left knee β: 0.147, 95% CI: 0.056 to 0.237, P = 0.002), medial femoral trochlea (right knee β: 0.135, 95% CI: 0.065 to 0.204, P < 0.001, left knee β: 0.142, 95% CI: 0.063 to 0.221, P < 0.001), and lateral femoral trochlea (right knee β: 0.163, 95% CI: 0.093 to 0.232, P < 0.001, left knee β: 0.147, 95% CI: 0.067 to 0.226, P < 0.001). For the right knee, increasing BMI was associated with medial compartment wear in the posterior femoral area (β: 0.070, 95% CI: 0.015 to 0.126, P = 0.013) and lateral compartment wear in the central tibial area (β: 0.070, 95% CI: 0.002 to 0.138, P = 0.045). For the left knee, increasing BMI was associated with medial compartment wear in the central femoral area (β: 0.093, 95% CI: 0.016 to 0.171, P = 0.018). DISCUSSION Obesity is preferentially associated with increasing cartilage wear in the PF compartment in comparison to the tibiofemoral compartment. Physical therapy and exercise programs that promote weight loss should be modified to decrease forces on the PF joint.
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Kim JW, Ju JH. Gut Microbiome Bridges Over Troubled Joints. JOURNAL OF RHEUMATIC DISEASES 2021; 28:111-112. [PMID: 37475991 PMCID: PMC10324901 DOI: 10.4078/jrd.2021.28.3.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 07/22/2023]
Affiliation(s)
- Ji Won Kim
- Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ji Hyeon Ju
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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19
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Loef M, van der Geest RJ, Lamb HJ, de Mutsert R, le Cessie S, Rosendaal FR, Kloppenburg M. Mediation of the association between obesity and osteoarthritis by blood pressure, vessel wall stiffness and subclinical atherosclerosis. Rheumatology (Oxford) 2021; 60:3268-3277. [PMID: 33347586 PMCID: PMC8516511 DOI: 10.1093/rheumatology/keaa778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/16/2020] [Indexed: 01/21/2023] Open
Abstract
Objective We investigated the role of blood pressure, vessel wall stiffness [pulse wave velocity (PWV)] and subclinical atherosclerosis markers [carotid intima-media thickness (cIMT), popliteal vessel wall thickness (pVWT)] as mediators of the association of obesity with OA. Methods We used cross-sectional data from a subset of the population-based NEO study (n = 6334). We classified clinical hand and knee OA by the ACR criteria, and structural knee OA, effusion and bone marrow lesions on MRI (n = 1285). cIMT was assessed with ultrasonography. pVWT was estimated on knee MRI (n = 1285), and PWV by abdominal velocity-encoded MRIs (n = 2580), in subpopulations. Associations between BMI and OA were assessed with logistic regression analyses, adjusted for age, sex and education. Blood pressure, cIMT, pVWT and PWV were added to the model to estimate mediation. Results The population consisted of 55% women, with a mean (s.d.) age of 56(6) years. Clinical hand OA was present in 8%, clinical knee OA in 10%, and structural knee OA in 12% of participants. BMI was positively associated with all OA outcomes. cIMT partially mediated the association of BMI with clinical hand OA [10.6 (6.2; 30.5)%], structural knee OA [3.1 (1.9; 7.3)%] and effusion [10.8 (6.0; 37.6)%]. Diastolic blood pressure [2.1 (1.6; 3.0)%] minimally mediated the association between BMI and clinical knee OA. PWV and pVWT did not mediate the association between BMI and OA. Conclusions cIMT and diastolic blood pressure minimally mediated the association of BMI with OA. This suggests that such mediation is trivial in the middle-aged population.
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Affiliation(s)
| | | | | | | | - Saskia le Cessie
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
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Rose BJ, Weyand JA, Liu B, Smith JF, Perez BR, Clark JC, Goodman M, Hirschi Budge KM, Eggett DL, Arroyo JA, Reynolds PR, Kooyman DL. Exposure to second-hand cigarette smoke exacerbates the progression of osteoarthritis in a surgical induced murine model. Histol Histopathol 2021; 36:347-353. [PMID: 33576000 DOI: 10.14670/hh-18-311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Osteoarthritis (OA), formerly understood to be a result of passive wear, is now known to be associated with chronic inflammation. Cigarette smoking promotes systemic inflammation and has been implicated in increased joint OA incidence in some studies, though the recent observational data on the association are contradictory. We hypothesize that second-hand smoke (SHS) treatment will increase the incidence of OA in a mouse model that has been subjected to a surgical destabilization of the medial meniscus (DMM). To test this hypothesis, we applied either SHS treatment or room air (RA) to mice for 28 days post-DMM surgery. Histopathology findings indicated that the knees of SHS mice exhibited more severe OA than their control counterparts. Increased expression of matrix metalloprotease-13 (MMP-13), an important extracellular protease known to degrade articular cartilage, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), an intracellular effector of inflammatory pathways, were observed in the SHS group. These findings provide greater understanding and evidence for a detrimental role of cigarette smoke on OA progression and systemic inflammation.
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Affiliation(s)
- Brandon J Rose
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Jeffery A Weyand
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Brady Liu
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Jacob F Smith
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Brian R Perez
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - J Christian Clark
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Michael Goodman
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Kelsey M Hirschi Budge
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Dennis L Eggett
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Juan A Arroyo
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - Paul R Reynolds
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
| | - David L Kooyman
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States
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Hao X, Shang X, Liu J, Chi R, Zhang J, Xu T. The gut microbiota in osteoarthritis: where do we stand and what can we do? Arthritis Res Ther 2021; 23:42. [PMID: 33504365 PMCID: PMC7839300 DOI: 10.1186/s13075-021-02427-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/19/2021] [Indexed: 12/12/2022] Open
Abstract
Osteoarthritis (OA) is one of the most frequent musculoskeletal diseases characterized by degeneration of articular cartilage, subchondral bone remodeling, and synovial membrane inflammation, which is a leading cause of global disability, morbidity, and decreased quality of life. Interpreting the potential mechanisms of OA pathogenesis is essential for developing novel prevention and disease-modifying therapeutic interventions. Gut microbiota is responsible for a series of metabolic, immunological, and structural and neurological functions, potentially elucidating the heterogeneity of OA phenotypes and individual features. In this narrative review, we summarized research evidence supporting the hypothesis of a “gut-joint axis” and the interaction between gut microbiota and the OA-relevant factors, including age, gender, genetics, metabolism, central nervous system, and joint injury, elucidating the underlying mechanisms of this intricate interaction. In the context, we also speculated the promising manipulation of gut microbiota in OA management, such as exercise and fecal microbiota transplantation (FMT), highlighting the clinical values of gut microbiota. Additionally, future research directions, such as more convincing studies by the interventions of gut microbiota, the gene regulation of host contributing to or attributed to the specific phenotypes of gut microbiota related to OA, and the relevance of distinct cell subgroups to gut microbiota, are expected. Moreover, gut microbiota is also the potential biomarker related to inflammation and gut dysbiosis that is able to predict OA progression and monitor the efficacy of therapeutic intervention.
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Affiliation(s)
- Xiaoxia Hao
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Xingru Shang
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Jiawei Liu
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Ruimin Chi
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Jiaming Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China. .,Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Tao Xu
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China.
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Pathophysiological Perspective of Osteoarthritis. ACTA ACUST UNITED AC 2020; 56:medicina56110614. [PMID: 33207632 PMCID: PMC7696673 DOI: 10.3390/medicina56110614] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022]
Abstract
Osteoarthritis (OA) is the most well-known degenerative disease among the geriatric and is a main cause of significant disability in daily living. It has a multifactorial etiology and is characterized by pathological changes in the knee joint structure including cartilage erosion, synovial inflammation, and subchondral sclerosis with osteophyte formation. To date, no efficient treatment is capable of altering the pathological progression of OA, and current therapy is broadly divided into pharmacological and nonpharmacological measures prior to surgical intervention. In this review, the significant risk factors and mediators, such as cytokines, proteolytic enzymes, and nitric oxide, that trigger the loss of the normal homeostasis and structural changes in the articular cartilage during the progression of OA are described. As the understanding of the mechanisms underlying OA improves, treatments are being developed that target specific mediators thought to promote the cartilage destruction that results from imbalanced catabolic and anabolic activity in the joint.
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Vincent TL. Of mice and men: converging on a common molecular understanding of osteoarthritis. THE LANCET. RHEUMATOLOGY 2020; 2:e633-e645. [PMID: 32989436 PMCID: PMC7511206 DOI: 10.1016/s2665-9913(20)30279-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Despite an increasing burden of osteoarthritis in developed societies, target discovery has been slow and there are currently no approved disease-modifying osteoarthritis drugs. This lack of progress is due in part to a series of misconceptions over the years: that osteoarthritis is an inevitable consequence of ageing, that damaged articular cartilage cannot heal itself, and that osteoarthritis is driven by synovial inflammation similar to that seen in rheumatoid arthritis. Molecular interrogation of disease through ex-vivo tissue analysis, in-vitro studies, and preclinical models have radically reshaped the knowledge landscape. Inflammation in osteoarthritis appears to be distinct from that seen in rheumatoid arthritis. Recent randomised controlled trials, using treatments repurposed from rheumatoid arthritis, have largely been unsuccessful. Genome-wide studies point to defects in repair pathways, which accords well with recent promise using growth factor therapies or Wnt pathway antagonism. Nerve growth factor has emerged as a robust target in osteoarthritis pain in phase 2-3 trials. These studies, both positive and negative, align well with those in preclinical surgical models of osteoarthritis, indicating that pathogenic mechanisms identified in mice can lead researchers to valid human targets. Several novel candidate pathways are emerging from preclinical studies that offer hope of future translational impact. Enhancing trust between industry, basic, and clinical scientists will optimise our collective chance of success.
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Affiliation(s)
- Tonia L Vincent
- Centre for Osteoarthritis Pathogenesis, Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
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Serum fatty acid chain length associates with prevalent symptomatic end-stage osteoarthritis, independent of BMI. Sci Rep 2020; 10:15459. [PMID: 32963331 PMCID: PMC7508826 DOI: 10.1038/s41598-020-71811-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 08/20/2020] [Indexed: 12/20/2022] Open
Abstract
Higher body mass index (BMI) is associated with osteoarthritis (OA) in both weight-bearing and non-weight-bearing joints, suggesting a link between OA and poor metabolic health beyond mechanical loading. This risk may be influenced by systemic factors accompanying BMI. Fluctuations in concentrations of metabolites may mark or even contribute to development of OA. This study explores the association of metabolites with radiographic knee/hip OA prevalence and progression. A 1H-NMR-metabolomics assay was performed on plasma samples of 1564 cases for prevalent OA and 2,125 controls collected from the Rotterdam Study, CHECK, GARP/NORREF and LUMC-arthroplasty cohorts. OA prevalence and 5 to 10 year progression was assessed by means of Kellgren-Lawrence (KL) score and the OARSI-atlas. End-stage knee/hip OA (TJA) was defined as indication for arthroplasty surgery. Controls did not have OA at baseline or follow-up. Principal component analysis of 227 metabolites demonstrated 23 factors, of which 19 remained interpretable after quality-control. Associations of factor scores with OA definitions were investigated with logistic regression. Fatty acids chain length (FALen), which was included in two factors which associated with TJA, was individually associated with both overall OA as well as TJA. Increased Fatty Acid chain Length is associated with OA.
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Özkuk K, Ateş Z. The effect of obesity on pain and disability in chronic shoulder pain patients. J Back Musculoskelet Rehabil 2020; 33:73-79. [PMID: 31006662 DOI: 10.3233/bmr-181384] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aimed to investigate the relationship between chronic shoulder pain and the increase in BMI. METHODS A prospective, cross-sectional study design was adopted for the study. Two hundred and eighty-five patients with chronic shoulder pain were evaluated for eligibility. A total of 94 patients were excluded from the study. The 191 remaining volunteers filled out a questionnaire (Pain (VAS), Shoulder Pain and Disability Index (SPADI)) and weight, height, C-reactive protein (CRP) results and 1-hour-rate of erythrocyte sedimentation rate (ESR) were measured. The participants were dived into the normal weight, overweight or obese group, considering the obesity classification defined by the World Health Organization (WHO). RESULTS A statistically significant correlation was found between the increase in BMI and pain (VAS), SPADI (pain, activity and total) and ESR. Although there was no statistically significant difference between the normal weight and overweight groups in all parameters, there was a statistically significant difference between the obese group and other groups. CONCLUSIONS Shoulder pain may associated with obesity and we recommend the addition of weight control to the treatment of patients with shoulder pain.
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Affiliation(s)
- Kağan Özkuk
- Department of Medical Ecology and Hydroclimatology, Usak University Faculty of Medicine, Usak, Turkey
| | - Zeynep Ateş
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
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Scherzer ZA, Alvarez C, Renner JB, Murphy LB, Schwartz TA, Jordan JM, Golightly YM, Nelson AE. Effects of Comorbid Cardiovascular Disease and Diabetes on Hand Osteoarthritis, Pain, and Functional State Transitions: The Johnston County Osteoarthritis Project. J Rheumatol 2020; 47:1541-1549. [PMID: 32062598 DOI: 10.3899/jrheum.191075] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study is to examine the course of hand osteoarthritis (HOA) and its relationship with cardiovascular disease (CVD) and diabetes (DM). METHODS Data were collected at 3 timepoints from 845 Johnston County Osteoarthritis Project participants (two-thirds women, one-third African Americans, mean age 60 yrs) with and without HOA, CVD, or DM. A diagnosis of radiographic HOA (rHOA) required a Kellgren-Lawrence severity grade of ≥ 2 in at least 3 joints in each hand. A 4-state progressive model included transitions based on rHOA and pain or function as defined using the Australian/Canadian HOA Index (AUSCAN). Markov multistate models estimated HR (aHR) and 95% CI for associations between DM or CVD and specific state transitions, adjusting for baseline and time-varying covariates. RESULTS Participants with DM (vs those without DM) were more likely to experience worsening pain with rHOA. Individuals who had or developed CVD (vs those who did not) were significantly less likely to experience symptomatic improvement, regardless of rHOA status. Those with DM or CVD (vs those without these comorbidities) were less likely to experience improvement in function, although this was statistically significant only for those with DM and no rHOA. CONCLUSION Overall, having or developing DM and/or CVD reduced the likelihood of symptomatic and functional improvement over time, suggesting an effect of comorbid CVD and DM on the clinical and radiographic course of HOA. Additional studies are needed to confirm these findings.
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Affiliation(s)
- Zachary A Scherzer
- Z.A. Scherzer, BS, Medical Student, Oakland University William Beaumont School of Medicine, Rochester, Missouri, and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carolina Alvarez
- C. Alvarez, MS, Statistician, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jordan B Renner
- J.B. Renner, MD, Professor of Radiology and Allied Health Sciences, Thurston Arthritis Research Center, and Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Louise B Murphy
- L.B. Murphy, PhD, Senior Service Fellow/Epidemiologist, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Todd A Schwartz
- T.A. Schwartz, DrPH, Associate Professor of Biostatistics, Thurston Arthritis Research Center, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joanne M Jordan
- J.M. Jordan, MD, MPH, Joseph P. Archie, Jr. Eminent Professor of Medicine and Vice Dean for Faculty Affairs and Leadership Development, Thurston Arthritis Research Center, and Department of Medicine, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yvonne M Golightly
- Y.M. Golightly, PT, PhD, Assistant Professor of Epidemiology, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amanda E Nelson
- A.E. Nelson, MD, MSCR, Associate Professor of Medicine, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Loef M, Ioan-Facsinay A, Mook-Kanamori DO, Willems van Dijk K, de Mutsert R, Kloppenburg M, Rosendaal FR. The association of plasma fatty acids with hand and knee osteoarthritis: the NEO study. Osteoarthritis Cartilage 2020; 28:223-230. [PMID: 31629023 DOI: 10.1016/j.joca.2019.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/20/2019] [Accepted: 10/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the association of postprandial and fasting plasma saturated fatty acid (SFAs), monounsaturated fatty acid (MUFAs) and polyunsaturated fatty acid (PUFAs) concentrations with hand and knee osteoarthritis (OA). DESIGN In the population-based NEO study clinical hand and knee OA were defined by the ACR classification criteria. Structural knee OA was defined on MRI. Hand and knee pain was determined by Australian/Canadian Hand Osteoarthritis Index (AUSCAN) and KOOS, respectively. Plasma was sampled fasted and 150 min after a standardized meal, and subsequently analysed using a nuclear magnetic resonance platform. Logistic regression analyses were used to investigate the association of total fatty acid, SFA, MUFA, total PUFA, omega-3 PUFA and omega-6 PUFA concentrations with clinical hand and knee OA, structural knee OA and hand and knee pain. Fatty acid concentrations were standardized (mean 0, SD 1). Analyses were stratified by sex and corrected for age, education, ethnicity and total body fat percentage. RESULTS Of the 5,328 participants (mean age 56 years, 58% women) 7% was classified with hand OA, 10% with knee OA and 4% with concurrent hand and knee OA. In men, postprandial SFAs (OR (95% CI)) 1.23 (1.00; 1.50), total PUFAs 1.26 (1.00; 1.58) and omega-3 PUFAs 1.24 (1.01; 1.52) were associated with hand OA. SFAs and PUFAs were associated with structural, but not clinical knee OA. Association of fasting fatty acid concentrations were weaker than postprandial concentrations. CONCLUSION Plasma postprandial SFA and PUFA levels were positively associated with clinical hand and structural knee OA in men, but not in women.
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Affiliation(s)
- M Loef
- Department of Rheumatology, Leiden University Medical center, the Netherlands.
| | - A Ioan-Facsinay
- Department of Rheumatology, Leiden University Medical center, the Netherlands.
| | - D O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical center, the Netherlands.
| | - K Willems van Dijk
- Department of Human Genetics, Leiden University Medical center, the Netherlands; Department of Internal Medicine, Leiden University Medical Center, the Netherlands.
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical center, the Netherlands.
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical center, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical center, the Netherlands.
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical center, the Netherlands.
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Clinical evaluation of fully automated thigh muscle and adipose tissue segmentation using a U-Net deep learning architecture in context of osteoarthritic knee pain. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:483-493. [PMID: 31872357 PMCID: PMC7351818 DOI: 10.1007/s10334-019-00816-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/23/2019] [Accepted: 11/28/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Segmentation of thigh muscle and adipose tissue is important for the understanding of musculoskeletal diseases such as osteoarthritis. Therefore, the purpose of this work is (a) to evaluate whether a fully automated approach provides accurate segmentation of muscles and adipose tissue cross-sectional areas (CSA) compared with manual segmentation and (b) to evaluate the validity of this method based on a previous clinical study. MATERIALS AND METHODS The segmentation method is based on U-Net architecture trained on 250 manually segmented thighs from the Osteoarthritis Initiative (OAI). The clinical evaluation is performed on a hold-out test set bilateral thighs of 48 subjects with unilateral knee pain. RESULTS The segmentation time of the method is < 1 s and demonstrated high agreement with the manual method (dice similarity coeffcient: 0.96 ± 0.01). In the clinical study, the automated method shows that similar to manual segmentation (- 5.7 ± 7.9%, p < 0.001, effect size: 0.69), painful knees display significantly lower quadriceps CSAs than contralateral painless knees (- 5.6 ± 7.6%, p < 0.001, effect size: 0.73). DISCUSSION Automated segmentation of thigh muscle and adipose tissues has high agreement with manual segmentations and can replicate the effect size seen in a clinical study on osteoarthritic pain.
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Liljensøe A, Laursen JO, Bliddal H, Søballe K, Mechlenburg I. Weight Loss Intervention Before Total Knee Replacement: A 12-Month Randomized Controlled Trial. Scand J Surg 2019; 110:3-12. [DOI: 10.1177/1457496919883812] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and Aims: Obesity is an increasing problem in patients after total knee replacement. The aim of this study was to investigate whether a weight loss intervention before primary total knee replacement would improve quality of life, knee function, mobility, and body composition 1 year after surgery. Material and Methods: Patients scheduled for total knee replacement due to osteoarthritis of the knee and obesity were randomized to a control group receiving standard care or to an intervention group receiving 8-week low-energy diet before total knee replacement. Patient-reported quality of life, 6-Min Walk Test, and body composition by dual-energy X-ray absorptiometry were assessed before intervention for the diet group, and within 1 week preoperatively for both groups, and the changes in outcome from baseline to 1 year after total knee replacement were compared between groups. The number of participants was lower than planned, which might introduce a type-2 error and underestimate the trend for a better outcome after weight loss. Results: The analyses are based on a total of 76 patients, 38 in each group. This study showed major improvement in both study groups in quality of life and knee function, though no statistically significant differences between the groups were observed 1 year after total knee replacement. The average weight loss after 8-week preoperative intervention was 10.7 kg and consisted of a 6.7 kg reduction in fat mass. One year after total knee replacement, the participants in the diet group managed to maintain the weight reduction, whereas there was no change in the control group. Conclusion: The results suggest that it is feasible and safe to implement an intensive weight loss program shortly before total knee replacement. The preoperative intervention resulted in a 10% body weight loss, improved body composition, lower cardiovascular risk factors, and sustained s-leptin.
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Affiliation(s)
- A. Liljensøe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - J. O. Laursen
- Department of Orthopedics, Hospital of Southern Jutland, Aabenraa, Denmark
| | - H. Bliddal
- The Parker Institute and Department of Rheumatology, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Denmark
| | - K. Søballe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - I. Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
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Long H, Xie D, Zeng C, Wei J, Wang Y, Yang T, Xu B, Qian Y, Li J, Wu Z, Lei G. Association between body composition and osteoarthritis: A systematic review and meta‐analysis. Int J Rheum Dis 2019; 22:2108-2118. [PMID: 31651091 DOI: 10.1111/1756-185x.13719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 08/12/2019] [Accepted: 09/03/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Huizhong Long
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Dongxing Xie
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Chao Zeng
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
- Center for Clinical Technology and Research of Joint Surgery of Hunan Province Changsha China
| | - Jie Wei
- Health Management Center Xiangya Hospital Central South University Changsha China
| | - Yilun Wang
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Tuo Yang
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Bei Xu
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Yuxuan Qian
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Jiatian Li
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Ziying Wu
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
| | - Guanghua Lei
- Department of Orthopaedics Xiangya Hospital Central South University Changsha China
- Center for Clinical Technology and Research of Joint Surgery of Hunan Province Changsha China
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Fonseca Mora MC, Milla Matute CA, Ferri F, Lo Menzo E, Szmostein S, Rosenthal RJ. Reduction of invasive interventions in severely obese with osteoarthritis after bariatric surgery. Surg Endosc 2019; 34:3606-3613. [PMID: 31559579 DOI: 10.1007/s00464-019-07138-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/17/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Osteoarthritis (OA) affects 56,000,000 Americans, 30% with obesity. Their risk of developing OA is 5 times higher. With each extra kilogram above ideal weight, the risk of OA increases to 13%. The study aim is to describe changes in OA treatment after undergoing bariatric surgery (BS). METHODS After IRB approval, we conducted a retrospective analysis of all severely obese patients and OA that underwent laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass from 2004 to 2018. Changes of OA severity were assessed based on the requirement of invasive intervention (INI) at 12 and 24 months after BS. INI was defined as the need for surgical drainage; articular injection; and surgical interventions such as meniscectomy, total hip replacement, and total knee replacement. RESULTS A total of 11.52% (N = 486) had OA diagnosed prior to BS, the most common location being unilateral hip 31.1% (N = 151). A total of 35.2% (N = 159) of patients required pain management (PM) for OA at 12 months. Of these, 90% (N = 144) required only INI and 5.6% (N = 9) required PM only. Baseline and postoperative BMI were associated to need for INI. At 12 months, the 66.7% (N = 301) who did not require INI had a baseline BMI of 44.70 ± 8.22 and total weight loss percent (TWL%) of 14.29 ± 13 (P = 0.05; 95% CI 0.96-1.00). LSG patients were the majority compared to other procedures (44.5%; N = 134). On the other hand, 64.3% (N = 175) did not require INI at 24 months and had a baseline BMI of 17.82±17.4 and TWL% of 2.43 ± 6 (P = 0.003; 95% CI 1.04-1.25). The risk to require INI was reduced by 69.9% at 12 months and 80% at 24 months. Need for pain medications at 12 months was reduced by 96.9%. CONCLUSION According to this study data, bariatric surgery reduces the need for INI in patients with OA. The effect seems to be related to the amount of weight loss. Additional studies conducted on a larger scale are necessary to validate findings.
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Affiliation(s)
- Maria C Fonseca Mora
- Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Cristian A Milla Matute
- Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Francisco Ferri
- Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Emanuele Lo Menzo
- Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Samuel Szmostein
- Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Raúl J Rosenthal
- Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
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Gut microbiota and obesity-associated osteoarthritis. Osteoarthritis Cartilage 2019; 27:1257-1265. [PMID: 31146016 DOI: 10.1016/j.joca.2019.05.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 05/16/2019] [Accepted: 05/18/2019] [Indexed: 02/02/2023]
Abstract
Obesity is a well-known primary risk factor for osteoarthritis (OA). In recent decades, the biomechanics-based theoretical paradigm for the pathogenesis of obesity-associated OA has been gradually but fundamentally modified. This modification is a result of accumulating evidence that biological factors also contribute to the etiology of the disease. The gut microbiota is a complicated ecosystem that profoundly influences the health of the host and can be modulated by the combined effects of environmental stimuli and genetic factors. Recently, enteric dysbacteriosis has been identified as a causal factor in the initiation and propagation of obesity-associated OA in animal models. Gut microbes and their components, microbe-associated lipid metabolites, and OA interact at both systemic and local levels through mechanisms that involve interplay with the innate immune system. However, the demonstration of causality in humans will require further studies. Nonetheless, probiotics, prebiotics, dietary habits and exercise, which aid the restoration of a healthy microbial community, are potential therapeutic approaches in the treatment of obesity-associated OA.
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Li S, Felson DT. What Is the Evidence to Support the Association Between Metabolic Syndrome and Osteoarthritis? A Systematic Review. Arthritis Care Res (Hoboken) 2019; 71:875-884. [PMID: 29999248 DOI: 10.1002/acr.23698] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/10/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE There is conflicting evidence on the association between metabolic syndrome (MetS) with the risk of osteoarthritis (OA). We aimed to systematically summarize the empirical evidence and discuss challenges in research methodologies in addressing this question. METHODS We performed a systematic literature review based on PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews on published epidemiologic studies that examined the association between MetS and the risk of OA. We included cross-sectional studies, case-control studies, and cohort studies with appropriate covariate adjustments. We extracted information on prevalence, incidence, crude and adjusted effect estimates, and the 95% confidence intervals from the articles, or this information was provided by the authors. We listed the main methodologic issues existing in current literature and provided recommendations for future research on this topic. RESULTS We identified 7 eligible studies on knee OA, 3 on hip OA, and 3 on hand OA. In studies that adjusted for body mass index or weight, MetS was not significantly associated with the risk of knee OA. No significant associations were reported for hip OA. For hand OA, the data were sparse and insufficient to reach a conclusion. Studies were mostly cross-sectional, exposure included only 1 time measurement, few studies had incident outcomes, and covariate adjustment was often insufficient. CONCLUSION Our review was unable to reach a definitive conclusion due to insufficient data, although the data suggest that knee and hip OA are not associated with MetS. Future longitudinal studies with incident OA cases, repeated measurement of MetS, and appropriate covariate adjustment are needed.
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Affiliation(s)
- Shanshan Li
- Boston University School of Medicine, Boston, Massachusetts
| | - David T Felson
- Boston University School of Medicine, Boston, Massachusetts, and Arthritis Research UK Epidemiology Unit and National Institute for Health Research Biomedical Research Centre, University of Manchester, Manchester, UK
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Abstract
The classification and monitoring of individuals with early knee osteoarthritis (OA) are important considerations for the design and evaluation of therapeutic interventions and require the identification of appropriate outcome measures. Potential outcome domains to assess for early OA include patient-reported outcomes (such as pain, function and quality of life), features of clinical examination (such as joint line tenderness and crepitus), objective measures of physical function, levels of physical activity, features of imaging modalities (such as of magnetic resonance imaging) and biochemical markers in body fluid. Patient characteristics such as adiposity and biomechanics of the knee could also have relevance to the assessment of early OA. Importantly, research is needed to enable the selection of outcome measures that are feasible, reliable and validated in individuals at risk of knee OA or with early knee OA. In this Perspectives article, potential outcome measures for early symptomatic knee OA are discussed, including those measures that could be of use in clinical practice and/or the research setting.
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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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Bergink AP, Rivadeneira F, Bierma-Zeinstra SM, Zillikens MC, Ikram MA, Uitterlinden AG, van Meurs JBJ. Are Bone Mineral Density and Fractures Related to the Incidence and Progression of Radiographic Osteoarthritis of the Knee, Hip, and Hand in Elderly Men and Women? The Rotterdam Study. Arthritis Rheumatol 2019; 71:361-369. [PMID: 30264891 DOI: 10.1002/art.40735] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 09/18/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine the longitudinal relationship between bone mineral density (BMD) and the incidence and progression of knee, hip, and hand osteoarthritis (OA), and to examine the relationship between prevalent vertebral and nonvertebral fractures and the incidence and progression of OA in elderly men and women in the Rotterdam Study. METHODS Age- and sex-specific quartiles of baseline femoral neck BMD data were constructed for 4,154 subjects. Radiographs were scored for incidence and progression of knee and hip OA, and for incidence of hand OA. Prevalent vertebral fractures were scored using the McCloskey/Kanis method, and prevalent nonvertebral fractures were reported by baseline interview. RESULTS Subjects in the highest quartile of femoral neck BMD had an increased risk of incident radiographic knee OA (ROA) (odds ratio [OR] 1.58 [95% confidence interval (95% CI) 1.14-2.18]), and an increased risk of incident hip ROA (OR 1.57 [95% CI 1.06-2.32]), compared to the lowest quartile. No significant relationship was found between high femoral neck BMD and progression of knee or hip ROA or the incidence of hand ROA. Prevalent vertebral and nonvertebral fractures were not related to an increase in the incidence or progression of knee or hip ROA. However, vertebral fractures were associated with incident hand ROA (OR 1.74 [95% CI 1.02-2.98]). CONCLUSION Results from the present study confirm earlier findings and thus provide strong evidence that high femoral neck BMD is a prognostic risk factor for the development of knee and hip ROA. Vertebral fractures were found to be a risk factor for incident hand ROA.
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Affiliation(s)
- Arjan P Bergink
- Erasmus Medical Center, Rotterdam, The Netherlands, and Center for Orthopedic Surgery OCON, Hengelo, The Netherlands
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Sapundzhieva T, Karalilova R, Batalov A. Body Mass Index Impact on Disease Activity, Clinical and Sonographic Remission Rates in Patients with Rheumatoid Arthritis. Curr Rheumatol Rev 2018; 15:215-223. [PMID: 30499417 DOI: 10.2174/1573397115666181130143239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 05/26/2018] [Accepted: 11/23/2018] [Indexed: 11/22/2022]
Abstract
AIM To investigate the impact of body mass index (BMI) on clinical disease activity indices and clinical and sonographic remission rates in patients with rheumatoid arthritis (RA). PATIENTS AND METHODS Sixty-three patients with RA were categorized according to BMI score into three groups: normal (BMI<25), overweight (BMI 25-30) and obese (BMI≥30). Thirty-three of them were treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), and 30 with biologic DMARDs (bDMARDs). Patients underwent clinical and laboratory assessment and musculoskeletal ultrasound examination (MSUS) at baseline and at 6 months after initiation of therapy. We evaluated the rate of clinical and sonographic remission (defined as Power Doppler score (PD) = 0) and its correlation with BMI score. RESULTS In the csDMARDs group, 60% of the normal weight patients reached DAS28 remission; 33.3% of the overweight; and 0% of the obese patients. In the bDMARDs group, the percentage of remission was as follows: 60% in the normal weight subgroup, 33.3% in the overweight; and 15.8% in the obese. Within the csDMARDs treatment group, two significant correlations were found: BMI score-DAS 28 at 6th month, rs = .372, p = .033; BMI score-DAS 28 categories, rs = .447, p = .014. Within the bDMARDs group, three significant correlations were identified: BMI score-PDUS at sixth month, rs = .506, p =.004; BMI score-DAS 28, rs = .511, p = .004; BMI score-DAS 28 categories, rs = .592, p = .001. Sonographic remission rates at 6 months were significantly higher in the normal BMI category in both treatment groups. CONCLUSION BMI influences the treatment response, clinical disease activity indices and the rates of clinical and sonographic remission in patients with RA. Obesity and overweight are associated with lower remission rates regardless of the type of treatment.
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Affiliation(s)
- Tanya Sapundzhieva
- Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv; Plovdiv, Bulgaria.,Rheumatology Clinic, UMHAT 'Kaspela', Plovdiv, Bulgaria
| | - Rositsa Karalilova
- Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv; Plovdiv, Bulgaria.,Rheumatology Clinic, UMHAT 'Kaspela', Plovdiv, Bulgaria
| | - Anastas Batalov
- Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv; Plovdiv, Bulgaria.,Rheumatology Clinic, UMHAT 'Kaspela', Plovdiv, Bulgaria
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Kumar P, Mahalingam K. In silico approach to identify non-synonymous SNPs with highest predicted deleterious effect on protein function in human obesity related gene, neuronal growth regulator 1 ( NEGR1). 3 Biotech 2018; 8:466. [PMID: 30402368 DOI: 10.1007/s13205-018-1463-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/24/2018] [Indexed: 11/29/2022] Open
Abstract
Neuronal growth regulator 1 (NEGR1) is a candidate gene for human obesity, which encodes the neural cell adhesion and growth molecule. The aim of the current study was to recognize the non-synonymous SNPs (nsSNPs) with the highest predicted deleterious effect on protein function of the NEGR1 gene. We have used five computational tools, namely, PolyPhen, SIFT, PROVEAN, MutPred and M-CAP, to predict the deleterious and pathogenic nsSNPs of the NEGR1 gene. Homology modeling approach was used to model the native and mutant NEGR1 protein models. Furthermore, structural validation was performed by the PROCHECK server to interpret the stability of the predicted models. We have predicted four potential deleterious nsSNPs, i.e., rs145524630 (Ala70Thr), rs267598710 (Pro168Leu), rs373419972 (Arg239Cys) and rs375352213 (Leu158Phe), which might be involved in causing obesity phenotypes. The predicted mutant models showed higher root mean square deviation and free energy values under the PyMoL and SWISS-PDB viewer, respectively. Additionally, the FTSite server predicted one nsSNP, i.e., rs145524630 (Ala70Thr) out of four identified nsSNPs found in the NEGR1 protein-binding site. There were four potential deleterious and pathogenic nsSNPs, i.e., rs145524630, rs267598710, rs373419972 and rs375352213, identified from the above-mentioned tools. In future, further functional in vitro and in vivo analysis could lead to better knowledge about these nsSNPs on the influence of the NEGR1 gene in causing human obesity. Hence, the present computational examination suggest that predicated nsSNPs may feasibly be a drug target and play an important role in contributing to human obesity.
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Affiliation(s)
- Permendra Kumar
- Department of Bio-Medical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, 632014 Tamilnadu India
| | - Kulandaivelu Mahalingam
- Department of Bio-Medical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, 632014 Tamilnadu India
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Collins KH, Sharif B, Reimer RA, Sanmartin C, Herzog W, Chin R, Marshall DA. Association of Metabolic Markers with self-reported osteoarthritis among middle-aged BMI-defined non-obese individuals: a cross-sectional study. BMC OBESITY 2018; 5:23. [PMID: 30186613 PMCID: PMC6120068 DOI: 10.1186/s40608-018-0201-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 05/24/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic degenerative joint disease. While it is well-established that obesity affects OA through increased axial loading on the joint cartilage, the indirect effect of obesity through metabolic processes among the body mass index (BMI)-defined non-obese population, i.e., BMI < 30 kg/m2, is less known. Our goal was to evaluate the association of metabolic markers including body fat percentage (BF%), waist circumference, maximum weight gain during adulthood and serum creatinine with self-reported OA to establish if such measures offer additional information over BMI among the non-obese population between 40 and 65 years of age. METHODS Cross-sectional data from two cycles of the Canadian Health Measures Survey (CHMS) in 2007-2009 and 2009-2011 were analyzed. Sex-specific logistic regression models were developed to evaluate the association of self-reported OA with metabolic markers. Models were separately adjusted for age, BMI categories and serum creatinine, and a stratified analysis across BM categories was performed. In a secondary analysis, we evaluated the association of self-reported OA, cardiovascular diseases and hypertension across BF% categories. RESULTS Of 2462 individuals, 217 (8.8%) self-reported OA. After adjusting for age and BMI, those within BF%-defined overweight/obese category had 2.67 (95% CI: 1.32-3.51) and 2.11(95% CI: 1.38-3.21) times higher odds of reporting self-reported OA compared to those within BF%-defined athletic/acceptable category for females and males, respectively. BF% was also significantly associated with self-reported OA after adjusting for age and serum creatinine only among females (OR: 1.47, 95%CI: 1.12-1.84). Furthermore, among the BMI-defined overweight group, the age-adjusted odds of self-reported OA was significantly higher for overweight/obese BF% compared to athletic/acceptable BF% in both females and males. In a secondary analysis, we showed that the association of self-reported OA and hypertension/cardiovascular diseases is significantly higher among BF% overweight/obese (OR: 1.37, 95%CI: 1.19-3.09) compared to BF% athletic/acceptable (OR: 1.13, 95%CI: 0.87-2.82). CONCLUSION Our results provide corroborating evidence for a relationship between body fat and OA in a population-based study, while no significant independent correlates were found between other metabolic markers and OA prevalence. Future investigation on the longitudinal relationship between BF and OA among this sub-population may inform targeted prevention opportunities.
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Affiliation(s)
- Kelsey H. Collins
- Human Performance Laboratory, University of Calgary, Calgary, AB Canada
| | - Behnam Sharif
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Raylene A. Reimer
- Faculty of Kinesiology and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB Canada
| | | | - Walter Herzog
- Human Performance Laboratory, University of Calgary, Calgary, AB Canada
| | - Rick Chin
- Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Deborah A. Marshall
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
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Efficacy of Hydroxychloroquine in Hand Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Trial. Arthritis Care Res (Hoboken) 2018; 70:1320-1325. [DOI: 10.1002/acr.23471] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/07/2017] [Indexed: 01/16/2023]
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Jiang L, Zhu X, Rong J, Xing B, Wang S, Liu A, Chu M, Huang G. Obesity, osteoarthritis and genetic risk: The rs182052 polymorphism in the ADIPOQ gene is potentially associated with risk of knee osteoarthritis. Bone Joint Res 2018; 7:494-500. [PMID: 30123499 PMCID: PMC6076358 DOI: 10.1302/2046-3758.77.bjr-2017-0274.r1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives Given the function of adiponectin (ADIPOQ) on the inflammatory condition of obesity and osteoarthritis (OA), we hypothesized that the ADIPOQ gene might be a candidate gene for a marker of susceptibility to OA. Methods We systematically screened three tagging polymorphisms (rs182052, rs2082940 and rs6773957) in the ADIPOQ gene, and evaluated the association between the genetic variants and OA risk in a case-controlled study that included 196 OA patients and 442 controls in a northern Chinese population. Genotyping was performed using the Sequenom MassARRAY iPLEX platform. Results The single nucleotide polymorphism (SNP) rs182052 was found to be potentially associated with knee OA risk (additive model: odds ratio = 1.38; 95% confidence interval 1.07 to 1.76; p = 0.012). Furthermore, a non-significant association was observed for rs182052 and body mass index with regard to OA risk in interaction analyses (p = 0.063). Similarly, no significant interaction was detected for rs182052 and age with regard to OA risk (p = 0.614). Conclusion These findings suggest that the SNP rs182052 in the ADIPOQ gene may potentially modify individual susceptibility to knee OA in the Chinese population. Further studies are warranted to investigate our findings in more depth. Cite this article: L. Jiang, X. Zhu, J. Rong, B. Xing, S. Wang, A. Liu, M. Chu, G. Huang. Obesity, osteoarthritis and genetic risk: The rs182052 polymorphism in the ADIPOQ gene is potentially associated with risk of knee osteoarthritis. Bone Joint Res 2018;7:494–500. DOI: 10.1302/2046-3758.77.BJR-2017-0274.R1.
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Affiliation(s)
- L Jiang
- Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - X Zhu
- Baoshan Center for Disease Control and Prevention,Shanghai, China
| | - J Rong
- Second Department of Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - B Xing
- Hongqi Community Health Service Center, Xiangfang District, Harbin, Heilongjiang Province, China
| | - S Wang
- Second Department of Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - A Liu
- Department of Nutrition, China National Center for Food Safety Risk Assessment, Beijing, China
| | - M Chu
- Department of Epidemiology, Public Health College, Nantong University, Nantong, Jiangsu Province, China
| | - G Huang
- Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Loef M, Schoones JW, Kloppenburg M, Ioan-Facsinay A. Fatty acids and osteoarthritis: different types, different effects. Joint Bone Spine 2018; 86:451-458. [PMID: 30081198 DOI: 10.1016/j.jbspin.2018.07.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/20/2018] [Indexed: 12/15/2022]
Abstract
While the association between obesity and osteoarthritis used to be solely regarded as a result of increased mechanical loading, systemic factors also likely play a role in the pathophysiology of osteoarthritis. Nutrient excess leading to obesity may result in lipotoxicity, which might be involved in the development of osteoarthritis. The different fatty acid types have distinct effects on inflammation. This review focusses on the currently available studies, summarizing the effects of the different fatty acid types on osteoarthritis and involved joint tissues. In animal studies omega-3 polyunsaturated fatty acids reduced the expression of inflammatory markers, cartilage degradation and oxidative stress in chondrocytes. In contrast, these markers were increased upon omega-6 polyunsaturated fatty acid and saturated fatty acid stimulation. Additionally, a decrease in pain and dysfunction was observed upon omega-3 supplementation in cats and dogs. In line, most human in vitro studies show pro-apoptotic and pro-inflammatory actions of saturated fatty acids. While all polyunsaturated fatty acids reduced markers of oxidative stress, omega-3 polyunsaturated fatty acids additionally decreased prostaglandin production. Human intervention studies with omega-3 polyunsaturated fatty acid supplementation may indicate a beneficial effect on pain and function and might be associated with less structural damage. In contrast, an adverse effect of saturated fatty acids on osteoarthritis has been observed. Monounsaturated fatty acids have been infrequently studied and findings are inconclusive. Existing studies indicate a promising effect of especially omega-3 polyunsaturated fatty acids on osteoarthritis signs and symptoms. However, more human intervention studies are warranted to draw robust conclusions.
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Affiliation(s)
- Marieke Loef
- Department of rheumatology, C1-R, Leiden university medical center, 2300 RC Leiden, The Netherlands.
| | | | - Margreet Kloppenburg
- Department of rheumatology, C1-R, Leiden university medical center, 2300 RC Leiden, The Netherlands; Department of clinical epidemiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Andreea Ioan-Facsinay
- Department of rheumatology, C1-R, Leiden university medical center, 2300 RC Leiden, The Netherlands
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Kasprzak K, Wojtunik-Kulesza K, Oniszczuk T, Kuboń M, Oniszczuk A. Secondary Metabolites, Dietary Fiber and Conjugated Fatty Acids as Functional Food Ingredients against Overweight and Obesity. Nat Prod Commun 2018. [DOI: 10.1177/1934578x1801300836] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Obesity is a common serious health problem leading to many serious health disorders. This phenomenon is defined as the over-storage of lipids in adipose tissue that occurs when there is an imbalance between the energy intake and energy used. During obesity, many metabolic alterations occur that can damage several organs, such as vascular or skeletal muscle resulting in the dysfunction of these tissues. In this review, we will discuss molecular genetics and causes of obesity, some of the disorders related to human obesity as well as anti-obesity tool. An interesting solution to the obesity problem is natural substances, revealing anti-obesity activity, as well as functional food enriched with aforementioned substances. Functional foods are products exhibiting a potentially positive effect on health beyond basic nutrition. They contain well-known biologically active natural compounds, which promote optimal health and reduce the risk of many diseases, including obesity.
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Affiliation(s)
- Kamila Kasprzak
- Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland
| | | | - Tomasz Oniszczuk
- Department of Food Process Engineering, Lublin University of Life Sciences, 44 Doświadczalna Street, 20-236 Lublin, Poland
| | - Maciej Kuboń
- Department of Agricultural Engineering and Informatics, Faculty of Production Engineering and Energetics, University of Agriculture in Krakow, ul. Balicka 116B 30-149, Kraków, Poland
| | - Anna Oniszczuk
- Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland
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Walsh TP, Quinn SJ, Evans AM, Yaxley A, Chisholm JA, Kow L, Shanahan EM. Fat mass, but not fat-free mass, predicts increased foot pain with obesity, independent of bariatric surgery. Surg Obes Relat Dis 2018; 14:1389-1395. [PMID: 30057094 DOI: 10.1016/j.soard.2018.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/07/2018] [Accepted: 06/14/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Foot pain is a common manifestation of obesity. OBJECTIVE To determine if bariatric surgery is associated with a reduction in foot pain and if body mass index (BMI) or body composition predict a change in foot pain. SETTING University hospital. METHODS Participants with foot pain awaiting bariatric surgery were recruited for this prospective study. Multivariable linear regression was used to determine predictors of change in foot pain between baseline and 6-month follow-up using body composition (fat mass index and fat-free mass index) or BMI, adjusting for, depression, age, sex, and group (surgery versus control). RESULTS Forty-five participants (38 female), mean ± standard deviation age of 45.7 ± 9.4 years, were recruited for this study. Twenty-nine participants mean ± standard deviation BMI of 44.8 ± 7.0 kg underwent bariatric surgery, while 16 participants mean ± standard deviation BMI of 47.9 ± 5.2 kg were on the waiting list (control). One participant was lost to follow-up. The treatment group lost a mean of 24.3 kg (95% confidence interval [CI] 21.1-27.5), while the control group gained 1.2 kg (95% CI -2.5 to 4.9), respectively. In multivariable analysis, bariatric surgery was significantly associated with reduced foot pain at 6-month follow-up -32.6 points (95% CI -43.8 to -21.4, P < .001), while fat mass index was significantly associated with increased pain at follow-up 1.5 points (95% CI .2 to 2.8, P = .027), after controlling for fat-free mass index, age, sex, and depression. CONCLUSIONS Bariatric surgery was significantly associated with reduced foot pain. Higher baseline fat mass index, but not fat-free mass index or BMI, was predictive of increased foot pain at follow-up. Foot pain may be mediated by metabolic, rather than mechanical, factors in bariatric surgery candidates.
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Affiliation(s)
- Tom P Walsh
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia; Department of Orthopaedics and Trauma, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
| | - Stephen J Quinn
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, Australia
| | - Angela M Evans
- Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Alison Yaxley
- Nutrition & Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Jacob A Chisholm
- Department of Gastrointestinal Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Lilian Kow
- Department of Gastrointestinal Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - E Michael Shanahan
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia; Department of Rheumatology, Southern Adelaide Local Health Network, South Australia, Australia
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Thomas S, Browne H, Mobasheri A, Rayman MP. What is the evidence for a role for diet and nutrition in osteoarthritis? Rheumatology (Oxford) 2018; 57:iv61-iv74. [PMID: 29684218 PMCID: PMC5905611 DOI: 10.1093/rheumatology/key011] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Indexed: 01/01/2023] Open
Abstract
As current treatment options in OA are very limited, OA patients would benefit greatly from some ability to self-manage their condition. Since diet may potentially affect OA, we reviewed the literature on the relationship between nutrition and OA risk or progression, aiming to provide guidance for clinicians. For overweight/obese patients, weight reduction, ideally incorporating exercise, is paramount. The association between metabolic syndrome, type-2 diabetes and OA risk or progression may partly explain the apparent benefit of dietary-lipid modification resulting from increased consumption of long-chain omega-3 fatty-acids from oily fish/fish oil supplements. A strong association between OA and raised serum cholesterol together with clinical effects in statin users suggests a potential benefit of reduction of cholesterol by dietary means. Patients should ensure that they meet the recommended intakes for micronutrients such as vitamin K, which has a role in bone/cartilage mineralization. Evidence for a role of vitamin D supplementation in OA is unconvincing.
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Affiliation(s)
- Sally Thomas
- Department of Nutritional Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Heather Browne
- Department of Nutritional Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Ali Mobasheri
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Arthritis Research UK Centre for Musculoskeletal Ageing Research, Queen's Medical Centre, Nottingham, UK.,Department of Regenerative Medicine, State Research Institute, Centre for Innovative Medicine, Santariskiu 5, 08661 Vilnius, Republic of Lithuania
| | - Margaret P Rayman
- Department of Nutritional Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
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Akahane M, Maeyashiki A, Tanaka Y, Imamura T. The impact of musculoskeletal diseases on the presence of locomotive syndrome. Mod Rheumatol 2018. [PMID: 29529893 DOI: 10.1080/14397595.2018.1452173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES We assessed the impact of musculoskeletal diseases, depressive mental state, and hypertension on locomotive syndrome, a condition of reduced mobility requiring nursing care. Since locomotive syndrome is a major public health issue that needs attention, its relationship with functional inconvenience in performing daily activities was also investigated. METHODS We conducted a cross-sectional study using an Internet panel survey, comprising 747 persons aged 30-90 years. Demographics, personal medical history, and daily activity data were assessed. The 25-question Geriatric Locomotive Function Scale was used to diagnose locomotive syndrome. Stepwise linear regression analysis and logistic regression analysis were conducted to evaluate the association between locomotive syndrome, musculoskeletal diseases, and functional inconvenience. RESULTS Aging, osteoporosis, and low back pain significantly increased the risk of locomotive syndrome, followed by knee osteoarthritis and lumbar spinal stenosis. Locomotive syndrome was significantly related to depressive mental state and hypertension, and led to functional inconvenience in Seiza sitting, cleaning, shopping, and strolling. CONCLUSION Locomotive syndrome was associated with functional inconvenience in performing common daily activities involving the lower extremities and spine. Osteoporosis and aging were significantly associated with locomotive syndrome. The risk of locomotive syndrome may be decreased by treating comorbid osteoporosis and instituting exercise and diet-related modifications.
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Affiliation(s)
- Manabu Akahane
- a Department of Public Health, Health Management and Policy , Nara Medical University Faculty of Medicine , Kashihara, Nara , Japan
| | - Akie Maeyashiki
- a Department of Public Health, Health Management and Policy , Nara Medical University Faculty of Medicine , Kashihara, Nara , Japan
| | - Yasuhito Tanaka
- b Department of Orthopedic Surgery , Nara Medical University , Kashihara, Nara , Japan
| | - Tomoaki Imamura
- a Department of Public Health, Health Management and Policy , Nara Medical University Faculty of Medicine , Kashihara, Nara , Japan
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de Visser HM, Mastbergen SC, Kozijn AE, Coeleveld K, Pouran B, van Rijen MH, Lafeber FPJG, Weinans H. Metabolic dysregulation accelerates injury-induced joint degeneration, driven by local inflammation; an in vivo rat study. J Orthop Res 2018; 36:881-890. [PMID: 28840952 DOI: 10.1002/jor.23712] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/19/2017] [Indexed: 02/04/2023]
Abstract
Evidence is growing for the existence of an obesity-related phenotype of osteoarthritis in which low-grade inflammation and a disturbed metabolic profile play a role. The contribution of an obesity-induced metabolic dysbalance to the progression of the features of osteoarthritis upon mechanically induced cartilage damage was studied in a rat in vivo model. Forty Wistar rats were randomly allocated 1:1 to a standard diet or a high-fat diet. After 12 weeks, in 14 out of 20 rats in each group, cartilage was mechanically damaged in the right knee joint. The remaining six animals in each group served as controls. After a subsequent 12 weeks, serum was collected for metabolic state, subchondral bone changes assessed by μCT imaging, osteoarthritis severity determined by histology, and macrophage presence assessed by CD68 staining. The high-fat diet increased statistically all relevant metabolic parameters, resulting in a dysmetabolic state and subsequent synovial inflammation, whereas cartilage degeneration was hardly influenced. The high-fat condition in combination with mechanical cartilage damage resulted in a clear statistically significant progression of the osteoarthritic features, with increased synovitis and multiple large osteophytes. Both the synovium and osteophytes contained numerous CD68 positive cells. It is concluded that a metabolic dysbalance due to a high-fat diet increases joint inflammation without cartilage degeneration. The dysmetabolic state clearly accelerates progression of osteoarthritis upon surgically induced cartilage damage supported by inflammatory responses as demonstrated by histology and increased CD68 expressing cells localized on the synovial membrane and osteophytes. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:881-890, 2018.
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Affiliation(s)
- Huub M de Visser
- Department of Orthopaedics, University Medical Center Utrecht, F.02.127, 3508 GA, Utrecht, 85500, The Netherlands.,Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Simon C Mastbergen
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne E Kozijn
- Department of Orthopaedics, University Medical Center Utrecht, F.02.127, 3508 GA, Utrecht, 85500, The Netherlands.,Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.,Metabolic Health Research, TNO, Leiden, The Netherlands
| | - Katja Coeleveld
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Behdad Pouran
- Department of Orthopaedics, University Medical Center Utrecht, F.02.127, 3508 GA, Utrecht, 85500, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Mattie H van Rijen
- Department of Orthopaedics, University Medical Center Utrecht, F.02.127, 3508 GA, Utrecht, 85500, The Netherlands
| | - Floris P J G Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Harrie Weinans
- Department of Orthopaedics, University Medical Center Utrecht, F.02.127, 3508 GA, Utrecht, 85500, The Netherlands.,Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
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48
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Urban H, Little CB. The role of fat and inflammation in the pathogenesis and management of osteoarthritis. Rheumatology (Oxford) 2018; 57:iv10-iv21. [DOI: 10.1093/rheumatology/kex399] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Hema Urban
- Institute of Bone and Joint Research, Sydney, New South Wales, Australia
- Raymond Purves Bone and Joint Research Labs, Kolling Institute, Northern Sydney Local Health District, University of Sydney at Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia
- Rheumatology Department, Royal North Shore Hospital, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher B Little
- Institute of Bone and Joint Research, Sydney, New South Wales, Australia
- Raymond Purves Bone and Joint Research Labs, Kolling Institute, Northern Sydney Local Health District, University of Sydney at Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia
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49
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Masiero S, Vittadini F, Ferroni C, Bosco A, Serra R, Frigo AC, Frizziero A. The role of thermal balneotherapy in the treatment of obese patient with knee osteoarthritis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:243-252. [PMID: 28940031 DOI: 10.1007/s00484-017-1445-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/13/2017] [Accepted: 09/13/2017] [Indexed: 05/21/2023]
Abstract
Osteoarthritis (OA) is the most common form of arthritis clinically characterized by joint pain, functional limitation, and reduced quality of life. Several studies have shown a clear link between obesity and higher risk of knee OA. According to the multifactorial OA pathogenesis, the management of this condition requires a multidisciplinary approach. The objective of this study is to evaluate hydrokinesitherapy effects in thermal setting in obese patients with knee OA. Fifty-three patients were assessed for eligibility, of which 33 refused the treatment, while 10 patients dropped out after the enrollment for personal reasons or inability to adhere to the program. Ten patients (8 females, 2 males, mean age of 59.4 years) with obesity (range BMI 30-45 kg/m2) and knee OA (II-III grade of Kellgren-Lawrence scale) treated with hydrokinetic therapy in thermal water (two sessions per week for 8 consecutive weeks) completed the study. Primary outcome measure was pain (VAS). Secondary outcomes were clinical knee evaluation (range of motion-ROM, lower-limb muscle strength), WOMAC, and Lequesne Algofunctional Index. Patellar tendon and peri-articular soft tissue ultrasound evaluation and gait analysis at baseline (T0), at the end of treatment (T1), and at 6 months of follow-up (T2) were performed. Significant decrease on VAS pain during walking on a flat surface and going up/down stairs was reached from baseline at T1 (p = 0.0039; p = 0.0098) and was maintained at T2 (p = 0.00954) exclusively for VAS pain during walking on a flat surface. WOMAC score showed a significant reduction between T0 and T1 (p = 0.0137) and between T0 and T2 (p = 0.006438), as ROM evaluations. Kinematic path assessment did not show significant results in individual gait steps, except for the space-time variables of the average speed and the values of ground reaction force (GRF) obtained with force platforms. Hydrokinesitherapy in thermal environment in obese patients with knee OA may determine pain relief, joint function improvement, and walking speed increase until 6 months of follow-up.
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Affiliation(s)
| | | | | | - Anna Bosco
- Universita degli Studi di Padova, Padua, Italy
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Adiposity Measures and Plasma Adipokines in Females with Rheumatoid and Osteoarthritis. Mediators Inflamm 2017; 2017:4302412. [PMID: 29225423 PMCID: PMC5687138 DOI: 10.1155/2017/4302412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/25/2017] [Accepted: 10/02/2017] [Indexed: 01/19/2023] Open
Abstract
The objective of this study was to examine the relationship between adipokines and adiposity in individuals with rheumatoid and osteoarthritis in the Atlantic PATH cohort. Using a nested case-control analysis, participants in the Atlantic PATH cohort with rheumatoid or osteoarthritis were matched for measures of adiposity with participants without a history of arthritis. Both measured and self-reported data were used to examine disease status, adiposity, and lifestyle factors. Immunoassays were used to measure plasma markers. BMI was positively correlated with percentage body fat, fat mass index (FMI), and a change in BMI from 18 years of age in all 3 groups. There were no statistical differences between levels of plasma adipokines; adiponectin levels were 6.6, 7.9, and 8.2 μg/ml, leptin levels were 10.3, 13.7, and 11.5 ng/ml, and resistin levels were 10.0, 12.1, and 10.8 ng/ml in participants without arthritis, with rheumatoid arthritis, and with osteoarthritis, respectively. Those with higher levels of adiponectin were more likely to have osteoarthritis (but not rheumatoid arthritis). No association was found between arthritis types and leptin or resistin. This study demonstrates differences in measures of adiposity and adipokines in specific types of arthritis and highlights the need for more research targeting specific adipokines during arthritic disease progression.
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