Relationship between Serum Magnesium Concentration and Radiographic Knee Osteoarthritis

Omeprazole and risk of osteoarthritis: insights from a mendelian randomization study in the UK Biobank

BACKGROUND

A former cohort study has raised concern regarding the unanticipated hazard of omeprazole in expediting osteoarthritis (OA) advancement. The precise nature of their causal evidence, however, remains undetermined. The present research endeavors to investigate the underlying causal link between omeprazole and OA through the application of mendelian randomization (MR) analysis.

METHODS

The study incorporated the ukb-a-106 and ukb-b-14,486 datasets. The investigation of causal effects employed methodologies such as MR-Egger, Weighted median, Inverse variance weighted (IVW) with multiplicative random effects, and IVW (fixed effects). The IVW approach was predominantly considered for result interpretation. Sensitivity analysis was conducted, encompassing assessments for heterogeneity, horizontal pleiotropy, and the Leave-one-out techniques.

RESULTS

The outcomes of the MR analysis indicated a causal relationship between omeprazole and OA, with omeprazole identified as a contributing risk factor for OA development (IVW model: OR = 1.2473, P < 0.01 in ukb-a-106; OR = 1.1288, P < 0.05 in ukb-b-14,486). The sensitivity analysis underscored the robustness and dependability of the above-mentioned analytical findings.

CONCLUSION

This study, employing MR, reveals that omeprazole, as an exposure factor, elevates the risk of OA. Considering the drug's efficacy and associated adverse events, clinical practitioners should exercise caution regarding prolonged omeprazole use, particularly in populations with heightened OA risks. Further robust and high-quality research is warranted to validate our findings and guide clinical practice.

Systemic and local antiinflammatory effect of magnesium chloride in experimental arthritis

OBJECTIVE

Despite some knowledge gaps in scientific evidence, MgCl2 is largely used for pain relief in musculoskeletal diseases. Mg salts were shown to provide analgesia postoperatively in orthopedic surgery and low Mg levels were linked to arthritis development and severity. We determined the anti-inflammatory activity of MgCl2 in an acute arthritis model.

METHODS

Mice received 0.1 mg/25µL Zymosan (Zy) or saline into the knees. Joint pain was evaluated using von Frey test; cell influx, and interleukin (IL)-1 level were assessed in joint lavage at 6 h. Synovia were excised for histopathology and analysis of immunoexpression of nuclear factor kappa B (NFκB) and tumor necrosis factor (TNF)-α. Groups (n = 6/group) received either 90 mg/kg MgCl2/100 µL or saline per os (systemic) or 500 µg/25 µL MgCl2 or saline intra-articularly (i.a.) 30 min prior to Zy.

RESULTS

MgCl2 given either systemically or locally significantly reduced cell influx (p = 0.0012 and p = 0.0269, respectively), pain (p = 0.0005 and p = 0.0038, respectively), and intra-articular IL-1 level (p = 0.0391), as compared to saline. Systemic MgCl2 significantly decreased NFκB (p < 0.05) immmunoexpression, as compared to saline.

CONCLUSION

MgCl2 given systemically or locally displayed anti-inflammatory activity in a severe acute arthritis model reducing cell influx, pain, and cytokine release. MgCl2 operates at least partially via inhibiting NFκB activation. This is the first in vivo demonstration that MgCl2 decreases cytokine release in arthritis, prompting reduction of inflammation and pain relief.

Effects of traditional Chinese herb hot compress combined with therapeutic exercise on pain, proprioception, and functional performance among older adults with knee osteoarthritis: A randomized controlled trial

Background: Knee osteoarthritis (KOA) is one of the most common chronic progressive diseases with degenerative destruction of articular cartilage and bone, leading to knee pain, impaired proprioception, and reduced functional performance. This study was to investigate the effects of an 8-week Traditional Chinese herb hot compress (TCHHC) combined with therapeutic exercise (TE) on pain, proprioception, and functional performance among older adults with KOA. Methods: Twenty-seven older adults with KOA were recruited and randomly assigned to the TCHHC + TE or TE groups. Thirteen participants received TCHHC + TE, and fourteen received TE. At pre- (week 0) and post-intervention (week 9), their pain, joint proprioception, and functional performance were measured. Two-way ANOVA with repeated measures was adopted to analyze the data. Results: Compared with week 0, the pain score, proprioception thresholds of knee extension and ankle plantarflexion, and the times of TUG and 20-m walk tests decreased more significantly in the TCHHC + TE group than in the TE group at week 9. Conclusion: Compared with TE, the 8-week TCHHC + TE was superior in relieving pain, recovering proprioception, and improving functional performance among older adults with KOA. It is recommended that TCHHC should be adopted prior to TE to enhance the effects of KOA rehabilitation.

Concentration of Selected Macronutrients and Toxic Elements in the Blood in Relation to Pain Severity and Hydrogen Magnetic Resonance Spectroscopy in People with Osteoarthritis of the Spine

Macronutrients and toxic elements may play an important role in the pathogenesis of osteoarthritis of the spine. The objective of this study was to evaluate the relationship between the concentrations of Ca, Mg, Pb, Cd and Hg in blood with the results of hydrogen magnetic resonance spectroscopy and the severity of pain. Patients with osteoarthritis of the spine (n = 90) and control subjects (n = 40) were studied. The concentrations of mineral components in blood were determined by atomic absorption spectrometry (ASA). Spinal pain severity was assessed using the Visual Analog Scale (VAS). Hydrogen magnetic resonance spectroscopy (¹H-MRS) was used to determine the fat/water ratio in the bodies of L1, L5 and the L4/5 intervertebral disc. The median concentration of Mg in the serum of subjects with spinal degenerative disease was significantly lower (p < 0.001) than that in healthy subjects. The median concentration of Cd in the blood of subjects with osteoarthritis of the spine was significantly higher (p < 0.05) than that in the control group. Significantly lower (p < 0.05) median molar ratios of Ca to Cd and Pb as well as Mg to Pb and Cd were observed among patients with osteoarthritis of the spine. Significant differences (p < 0.05) were observed in the value of the fat/water ratio in selected spinal structures, depending on normal or abnormal serum Ca and Mg concentrations. The study showed some abnormal macronutrient concentrations, as well as disturbed ratios of beneficial elements to toxic elements in the blood of people with osteoarthritis of the spine.

Associations of Dietary Macroelements with Knee Joint Structures, Symptoms, Quality of Life, and Comorbid Conditions in People with Symptomatic Knee Osteoarthritis

Background: Osteoarthritis (OA), the most common joint disease in the elderly, has no cure. Macroelements are vital in human health and their relationships with OA are not clear. Clarifying the relationships between macroelements and OA may assist knee OA management. Methods: This study was a post-hoc analysis using data from a two-year randomized controlled trial among 392 participants with knee OA. Dietary macroelements, including calcium, magnesium, potassium, and phosphorus were computed-based on a semi-quantitative food frequency questionnaire at baseline. Knee joint structures (including cartilage volume, cartilage defect, bone marrow lesions, and effusion-synovitis volume), OA symptoms, quality of life, and OA comorbid conditions (including lower limb muscle strength and depressive symptoms) were assessed at baseline and month 24. Western Ontario and McMaster Universities (WOMAC) Index and depressive symptoms were assessed at baseline and months 3, 6, 12, and 24. Quality of life and lower limb muscle strength were assessed at baseline and months 6, 12, and 24. All analyses were conducted using mixed-effects models. Results: Higher dietary magnesium and potassium were associated with fewer OA symptoms, higher quality of life, greater lower limb muscle strength, and fewer depressive symptoms, but not with knee joint structures. Higher dietary calcium and phosphorus was not associated with any of the OA-related outcomes, except that dietary phosphorus was associated with greater lower limb muscle strength. Conclusions: In the longitudinal analyses, higher dietary magnesium and potassium intake are associated with fewer OA symptoms, higher quality of life, and milder comorbid conditions in patients with knee OA, suggesting dietary magnesium and potassium may have beneficial effects on OA and could be used for knee OA management.

Increased Wnt/β-catenin signaling contributes to autophagy inhibition resulting from a dietary magnesium deficiency in injury-induced osteoarthritis

Background

Dietary magnesium deficiency, which is common in modern diet, has been associated with osteoarthritis (OA) susceptibility. Despite this clinical association, no study has addressed if dietary magnesium deficiency accelerates OA development, especially at molecular level. This study aimed to explore aggravating effects of dietary magnesium deficiency on cartilage damage in an injury-induced murine OA model and to determine the underlying mechanism.

Methods

Twelve-week-old C57BL/6J mice subject to injury-induced OA modeling were randomized into different diet groups in which the mice were fed a diet with daily recommended magnesium content (500 mg/kg) or diets with low magnesium content (100 or 300 mg/kg). Articular cartilage damage was evaluated using the OARSI score. To determine molecular mechanisms in vitro, mouse chondrocytes were treated with media of low magnesium conditions at 0.1 and 0.4 mM, compared with normal magnesium condition at 0.7 mM as control. Anabolic and catabolic factors, autophagy markers, β-catenin, Wnt ligands, and a magnesium channel transient receptor potential cation channel subfamily member 7 (TRPM7) were analyzed by quantitative real-time PCR and immunoblotting. Autolysosomes were detected by DALGreen staining via fluorescence microscopy and autophagosomes were evaluated by transmission electron microscopy. Autophagy markers, β-catenin, and TRPM7 were assessed in vivo in the mouse cartilage, comparing between dietary magnesium deficiency and normal diet, by immunohistochemistry.

Results

Dietary magnesium deficiency aggravated injury-induced cartilage damage, indicated by significant higher OARSI scores. Autophagy markers LC3-II and Beclin-1 were decreased both in low magnesium diet-fed mice and low magnesium-treated chondrocytes. The number of autolysosomes and autophagosomes was also reduced under low magnesium conditions. Moreover, magnesium deficiency induced decreased anabolic and increased catabolic effect of chondrocytes which could be restored by autophagy activator rapamycin. In addition, reduced autophagy under low magnesium conditions is mediated by activated Wnt/β-catenin signaling. The expression of TRPM7 also decreased in low magnesium diet-fed mice, indicating that downstream changes could be regulated through this channel.

Conclusions

Dietary magnesium deficiency contributes to OA development, which is mediated by reduced autophagy through Wnt/β-catenin signaling activation. These findings indicated potential benefits of adequate dietary magnesium for OA patients or those individuals at high risk of OA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13075-022-02848-0.

Proton pump inhibitor therapy and risk of knee replacement surgery: a general population-based cohort study

OBJECTIVE

Proton pump inhibitors (PPIs) are among the most commonly used medications for patients with osteoarthritis (OA). Various types of PPIs have different impacts on lowering serum magnesium level that may affect knee OA progression. We aimed to compare the risk of clinically relevant endpoint of knee replacement (KR) among initiators of five different PPIs with that among histamine-2 receptor antagonist (H2RA) initiators.

DESIGN

Among patients with knee OA (≥50 years) in The Health Improvement Network database in the UK we conducted five sequential propensity-score matched cohort studies to compare the risk of KR over 5-year among patients who initiated omeprazole (n = 2,672), pantoprazole (n = 664), lansoprazole (n = 3,747), rabeprazole (n = 751), or esomeprazole (n = 827) with those who initiated H2RA.

RESULTS

The prevalence of PPI prescriptions among participants with knee OA increased from 12.7% in 2000-44.0% in 2017. Two-hundred-and-seventy-four KRs (30.8/1,000 person-years) occurred in omeprazole initiators and 230 KRs (25.4/1,000 person-years) in H2RA initiators. Compared with H2RA initiators, the risk of KR was 21% higher in omeprazole initiators (hazard ratio [HR] = 1.21,95% confidence interval [CI]:1.01-1.44). Similar results were observed when pantoprazole use was compared with H2RA use (HR = 1.38,95%CI:1.00-1.90). No such an increased risk of KR was observed among lansoprazole (HR = 1.06,95%CI:0.92-1.23), rabeprazole (HR = 0.97,95%CI:0.73-1.30), or esomeprazole (HR = 0.83,95%CI:0.60-1.15) initiators compared with that among H2RA initiators.

CONCLUSIONS

In this population-based cohort study, initiation of omeprazole or pantoprazole use was associated with a higher risk of KR than initiation of H2RA use. This study raises concern regarding an unexpected risk of omeprazole and pantoprazole on accelerating OA progression.

The Impact of Trace Elements on Osteoarthritis

Osteoarthritis (OA) is a progressive degenerative disease characterized by cartilage degradation, synovial inflammation, subchondral sclerosis and osteophyte formation. It has a multifactorial etiology with potential contributions from heredity, endocrine function, abnormal mechanical load and nutrition. Of particular considerations are trace element status. Several trace elements, such as boron and magnesium are essential for normal development of the bone and joint in human. While cadmium correlates with the severity of OA. The present review focuses on the roles of trace elements (boron, cadmium, copper, iron, magnesium, manganese, selenium, zinc) in OA and explores the mechanisms by which they act.

The application prospect of metal/metal oxide nanoparticles in the treatment of osteoarthritis

The current understanding of osteoarthritis is developing from a mechanical disease caused by cartilage wear to a complex biological response involving inflammation, oxidative stress and other aspects. Nanoparticles are widely used in drug delivery due to its good stability in vivo and cell uptake efficiency. In addition to the above advantages, metal/metal oxide NPs, such as cerium oxide and manganese dioxide, can also simulate the activity of antioxidant enzymes and catalyze the degradation of superoxide anions and hydrogen peroxide. Degrading of metal/metal oxide nanoparticles releases metal ions, which may slow down the progression of osteoarthritis by inhibiting inflammation, promoting cartilage repair and inhibiting cartilage ossification. In present review, we focused on recent research works concerning osteoarthritis treating with metal/metal oxide nanoparticles, and introduced some potential nanoparticles that may have therapeutic effects.

Research status of biodegradable metals designed for oral and maxillofacial applications: A review

The oral and maxillofacial regions have complex anatomical structures and different tissue types, which have vital health and aesthetic functions. Biodegradable metals (BMs) is a promising bioactive materials to treat oral and maxillofacial diseases. This review summarizes the research status and future research directions of BMs for oral and maxillofacial applications. Mg-based BMs and Zn-based BMs for bone fracture fixation systems, and guided bone regeneration (GBR) membranes, are discussed in detail. Zn-based BMs with a moderate degradation rate and superior mechanical properties for GBR membranes show great potential for clinical translation. Fe-based BMs have a relatively low degradation rate and insoluble degradation products, which greatly limit their application and clinical translation. Furthermore, we proposed potential future research directions for BMs in the oral and maxillofacial regions, including 3D printed BM bone scaffolds, surface modification for BMs GBR membranes, and BMs containing hydrogels for cartilage regeneration, soft tissue regeneration, and nerve regeneration. Taken together, the progress made in the development of BMs in oral and maxillofacial regions has laid a foundation for further clinical translation.

Magnesium in joint health and osteoarthritis

Osteoarthritis (OA) is a prevalent debilitating age-related skeletal disease. The hallmark of OA is the degradation of articular cartilage that cushions the joint during movement. It is characterized by chronic pain and disability. Magnesium, a critical trace element in the human body, plays a pivotal role in metabolism homeostasis and the energy balance. Humans obtain magnesium mainly from the diet. However, inadequate magnesium intake is not uncommon. Moreover, the magnesium status deteriorates with ageing. There has been a growing body of clinical studies pointing to an intimate relationship between dietary magnesium and OA although the conclusion remains controversial. As reported, the magnesium ion concentration is essential to determine cell fate. Firstly, the low-concentration magnesium ions induced human fibroblasts senescence. Magnesium supplementation was also able to mitigate chondrocyte apoptosis, and to facilitate chondrocyte proliferation and differentiation. In this literature review, we will outline the existing evidence in animals and humans. We will also discuss the controversies on plasma or intracellular level of magnesium as the indicator of magnesium status. In addition, we put forward the interplay between dietary magnesium intake and intestinal microbiome to modulate the inflammatory milieu in the conjecture of OA pathogenesis. This leads to an emerging hypothesis that the synergistic effect of magnesium and probiotics may open a new avenue for the prevention and treatment of OA.

The associations between serum trace elements and bone mineral density in children under 3 years of age

We examined the associations of age and serum magnesium, iron, lead, copper, and zinc levels with bone mineral density (BMD) in 2412 children under 3 years of age in order to find a tool to monitor BMD in children without the use of expensive imaging techniques. One-way ANOVA and chi-square tests were used to determine the associations of age and serum trace elements with BMD. Multivariable logistic regression analysis was used to test the correlation of five serum trace elements with BMD after adjustments for potential confounding factors in children under 3 years of age. Significant associations between age and four serum trace elements and BMD were found. Compared to the group with the lowest serum levels detected, the adjusted odds ratio (OR) for the incidence of normal bone mineral density in the third magnesium concentration tertile, the third iron concentration tertile, the fifth copper concentration quintile, the third zinc concentration quintile, and the fifth zinc concentration quintile were 1.30 (95% confidence interval (CI) 1.02–1.67), 1.43 (95% CI 1.11–1.84), 1.42 (95% CI 1.04–1.94), 1.46 (95% CI 1.05–2.04), and 1.48 (95% CI 1.06–2.06), respectively. However, there was no significant correlation between serum lead level and BMD in this study. Age and serum magnesium, iron, copper, and zinc levels are positively associated with BMD in children under 3 years old.

Physical Distancing Measures and Walking Activity in Middle-aged and Older Residents in Changsha, China, During the COVID-19 Epidemic Period: Longitudinal Observational Study

BACKGROUND

Physical distancing measures taken to contain COVID-19 transmission may substantially reduce physical activity levels and cause individuals to adopt a more sedentary lifestyle.

OBJECTIVE

The objective of this study is to determine if there was any change in daily steps, an important component of daily physical activity, and examine risk factors for frequent low daily steps during the COVID-19 epidemic.

METHODS

We used data collected from the Step Study, a population-based longitudinal study of walking activity among residents aged ≥40 years in Changsha, China. Daily steps were collected via a smartphone linked to WeChat, a social networking platform. We plotted mean daily steps and the prevalence of low daily steps (≤1500 steps/day) 30 days before (reference period) and 30 days after (epidemic period) January 21, 2020 (date of the first COVID-19 case diagnosed in Changsha), and compared it with the same corresponding period from 2019. We examined the association of risk factors with the prevalence of frequent low daily steps (≤1500 steps/day for ≥14 days) using logistic regression.

RESULTS

Among 3544 participants (mean age 51.6 years; n=1226 females, 34.6%), mean daily steps dropped from 8097 to 5440 and the prevalence of low daily steps increased from 3% (2287/76,136 person-day) to 18.5% (12,951/70,183 person-day) during the reference and epidemic periods, respectively. No such phenomenon was observed during the corresponding period in 2019. Older age (P for interaction=.001) and female sex (P for interaction<.001) were both associated with a higher prevalence of frequent low daily steps and were more pronounced during the epidemic period. More education was associated with a lower prevalence of frequent low daily steps during the reference period but not the epidemic period (P for interaction=.34). Body mass index or comorbidity were not associated with frequent low daily steps during either period.

CONCLUSIONS

Daily steps of Changsha residents aged ≥40 years dropped significantly during the COVID-19 period, especially among older adults and females. Although successful physical distancing, measured by the rapid downward trend in daily step counts of residents, played a critical role in the containment of the COVID-19 epidemic, our findings of an increase in the prevalence of frequent low daily steps raise concerns about unintended effects on physical activity.

Micronutrients: Essential Treatment for Inflammatory Arthritis?

PURPOSE OF REVIEW

Synovial inflammation is characteristic of inflammatory chronic arthropathies and can cause progressive articular damage, chronic pain, and functional loss. Scientific research has increasingly focused on investigating anti-inflammatory micronutrients present in fruits, vegetables, spices, seeds, tea, and wine. This review aims to examine the anti-inflammatory effect of polyphenols (phytonutrients present in plants) and other micronutrients described in randomized clinical trials conducted in patients with chronic inflammatory arthropathies.

RECENT FINDINGS

There is an increasing evidence that differences in micronutrient intake might play an essential role in pathogenesis, therapeutic response, and remission of synovitis. Randomized clinical trials with specific micronutrient- or nutrient-enriched food intake show improvement of symptoms and modulation of both pro- and anti-inflammatory mediators. We found convincing evidence of the anti-inflammatory effect of several micronutrients in arthritis symptoms and inflammation. Although in clinical practice nutritional recommendations to patients with chronic joint inflammation are not consistently prescribed, the addition of these nutrients to day-to-day eating habits could potentially change the natural history of inflammatory arthritis. Future research is needed for a consensus on the specific nutritional recommendations for patients with chronic synovial inflammation.

Associations of serum iron and ferritin with hyperuricemia and serum uric acid

OBJECTIVES

To assess the serum iron and ferritin levels in relation to the prevalence of hyperuricemia (HU) and the serum uric acid (SUA) level.

METHODS

Serum iron and ferritin concentrations were detected by Ferene method and chemiluminescence method, respectively. SUA level was detected by uricase-PAP method. HU was defined as SUA ≥ 416 μmol/L for male and ≥ 357 μmol/L for female. Multivariable-adjusted logistic regressions were constructed to investigate the associations between serum iron/ferritin levels and prevalence of HU. Pearson correlation analysis and multivariable linear regression were performed to examine the correlations between serum iron/ferritin levels and SUA level.

RESULTS

A total of 2824 subjects (mean age 52.2 ± 7.2) were included. The overall prevalence of HU was 17.3%. Compared with the lowest quartile, the multivariable-adjusted odds ratios (OR) and its 95% confidence interval (CI) of HU were 1.33 (95%CI 0.97-1.82), 1.17 (95%CI 0.85-1.60), and 1.56 (95%CI 1.14-2.13) in the second, third, and fourth quartiles of serum iron, respectively (P for trend = 0.012), and were 1.29 (95%CI 0.89-1.88) in the second, 2.13 (95%CI 1.47-3.07) in the third, and 2.25 (95%CI 1.54-3.29) in the fourth quartile of serum ferritin (P for trend < 0.001). Pearson correlation coefficient indicated a weak positive correlation between serum iron (r = 0.2, P < 0.001) and ferritin (r = 0.3, P < 0.001) levels and SUA. Such positive correlations were further confirmed by multiple linear regression (serum iron: standardized β = 0.059, P < 0.001; serum ferritin: standardized β = 0.061, P = 0.001).

CONCLUSIONS

Both serum iron and ferritin showed a positive correlation with the prevalence of HU, and a weak positive correlation with SUA level. Key Points • Subjects with higher levels of serum iron or ferritin had higher prevalence of HU. • There was a weak positive correlation between serum iron/ferritin levels and SUA level.

Association between serum zinc and copper concentrations and copper/zinc ratio with the prevalence of knee chondrocalcinosis: a cross-sectional study

Background

Patients with chondrocalcinosis may suffer from a series of symptoms resembling acute gouty arthritis or septic arthritis, but the aetiology and pathogenesis of chondrocalcinosis have not been fully elucidated yet. This study was aimed to assess serum zinc and copper concentrations, as well as the ratio of serum copper to zinc concentrations (Cu/Zn ratio), in relation to the prevalence of knee chondrocalcinosis.

Methods

Data included in this analysis were retrieved from a large population-based cross-sectional study. A bilateral knee anteroposterior radiograph was obtained from each subject. Radiographic knee chondrocalcinosis was diagnosed if definite linear cartilage calcification was detected. Serum zinc and copper concentrations were measured using the spectrophotometric flow injection methods by Roche modular P800. The relations of serum zinc and copper concentrations and Cu/Zn ratio to the prevalence of knee chondrocalcinosis were examined using generalized estimating equations, respectively.

Results

The prevalence of knee chondrocalcinosis was 1.2% in the sample of this study (n = 12,362). In comparison with the lowest tertile, the odds ratios (ORs) of knee chondrocalcinosis adjusted by age, sex and body mass index were 0.74 (95% CI 0.50–1.09) in the second and 0.56 (95% CI 0.36–0.86) in the third tertiles of serum zinc concentrations (P for trend = 0.009), were 1.26 (95% CI 0.77–2.05) in the second and 2.01 (95% CI 1.25–3.24) in the third tertile of serum copper concentrations (P for trend = 0.003), and were 1.02 (95% CI 0.61–1.69) in the second and 2.23 (95% CI 1.38–3.59) in the third tertile of Cu/Zn ratio (P for trend < 0.001) respectively. These findings were not materially altered by adjustment for potential confounders.

Conclusions

The present study observed that higher serum zinc concentrations, lower serum copper concentrations or lower Cu/Zn ratio are associated with a lower prevalence of knee chondrocalcinosis in a dose-response relationship manner.

Association between dietary selenium intake and the prevalence of osteoporosis: a cross-sectional study

Objective

To examine the correlation between dietary selenium (Se) intake and the prevalence of osteoporosis (OP) in the general middle-aged and older population in China.

Methods

Data for analyses were collected from a population based cross-sectional study performed at the Xiangya Hospital Health Management Centre. Dietary Se intake was evaluated using a validated semi-quantitative food frequency questionnaire. OP was diagnosed on the basis of bone mineral density scans using a compact radiographic absorptiometry system. The correlation between dietary Se intake and the prevalence of OP was primarily examined by multivariable logistic regression.

Results

This cross-sectional study included a total of 6267 subjects (mean age: 52.2 ± 7.4 years; 42% women), and the prevalence of OP among the included subjects was 9.6% (2.3% in men and 19.7% in women). Compared with the lowest quartile, the energy intake, age, gender and body mass index (BMI)-adjusted odds ratios of OP were 0.72 (95% confidence interval [CI] 0.55–0.94), 0.72 (95% CI 0.51–1.01) and 0.47 (95% CI 0.31–0.73) for the second, third and fourth quartiles of dietary Se intake, respectively (P for trend = 0.001). The results remained consistent in male and female subjects. Adjustment for additional potential confounders (i.e., smoking status, drinking status, physical activity level, nutritional supplements, diabetes, hypertension, fibre intake, and calcium intake) did not cause substantial changes to the results.

Conclusions

In the middle-aged and older humans, participants with lower levels of dietary Se intake have a higher prevalence of OP in a dose-response manner.

Intra-articular injection of magnesium chloride attenuates osteoarthritis progression in rats

OBJECTIVE

To explore the effects of Mg²⁺ on the expression of osteoarthritic markers in human cartilage and synovium tissue explants. To investigate the therapeutic effect of intra-articular injection of Mg²⁺ in an established rat OA (Osteoarthritis) model of anterior cruciate ligament transection with partial medial meniscectomy (ACLT + PMM).

DESIGN

Human cartilage and synovium explants were collected from total knee replacement surgeries and incubated with MgCl₂ (20 mmol/L) in vitro. A rat OA model was established by ACLT + PMM surgery in 450-500 g male Sprague Dawley (SD) rats. To select the optimal dose, intra-articular injections of MgCl₂ (0.05, 0.5, 5 mol/L) were performed at 4 weeks after the surgery every 3 days for 2 weeks. The effect of optimized MgCl₂ was further determined by histology, immunohistochemistry, and quantitative real-time polymerase chain reaction.

RESULTS

The expressions of osteoarthritic markers in human cartilage and synovium explants were inhibited by Mg²⁺in vitro. Immunohistochemical analysis further suggested the inhibitory effects of Mg²⁺ on the expression of MMP-13 and IL-6 in the human tissue explants. Cartilage degeneration and synovitis in ACLT + PMM rats were significantly improved by intra-articular injections of Mg²⁺ (0.5 mol/L). Immunohistochemical analysis also showed the regulatory effects of Mg²⁺ on osteoarthritic markers in both cartilage and synovium in rats, consistent with in vitro results.

CONCLUSION

Intra-articular injections of Mg²⁺ at 0.5 mol/L attenuate the progression of OA in the ACLT + PMM rat model. Such effect was at least in part explained by the promotion of cartilage matrix synthesis and the suppression of synovial inflammation.

The relationship between magnesium and osteoarthritis of knee: A MOOSE guided systematic review and meta-analysis

The impact of magnesium on risk of knee osteoarthritis (KOE) is still under investigation. This meta-analysis evaluated the relationship between magnesium and risk of KOE.A comprehensive search was performed to identify retrospective cohort study or cross-sectional study of the association between magnesium and KOE from the Cochrane library, PubMed, and Embase. The search time limit was from the establishment of the database to December 2018. Two evaluators selected the literature, extracted the data, and evaluated the quality of the literature according to the inclusion and exclusion criteria, independently. Meta-analysis was performed using RevMan 5.3 software and publication bias was assessed using Begg and Egger test and funnel plot.Finally, 6 studies were included with a total of 15,715 participants. Although higher daily intake of magnesium was associated with a significantly reduced risk of fracture in patients with KOE (OR = 0.66, 95%CI: 0.56, 0.78; P < .00001), it was not significant for lowering the risk of KOE (OR = 0.80; 95% CI: 0.61, 1.04; P = .1). Meta-analysis also showed that population with higher serum magnesium levels had significantly lower risk of KOE (odds ratio (OR) = 0.84; 95% confidence interval (CI): 0.72, 0.98; P = .03). Further subgroup analysis showed that the relationship between serum magnesium level and KOE risk was significantly affected by serum magnesium level (P = .006 for quartiles 4 vs 1).Higher level of magnesium intake was not associated with lower risk of KOE. However, higher daily intake of magnesium may be inversely associated with risk of fracture in KOE patients.

Association of high-sensitivity C-reactive protein in middle-aged and elderly Chinese people with hyperuricaemia and risk of coronary heart disease: a cross-sectional study

OBJECTIVES

Patients with hyperuricaemia are at relatively high risk of developing coronary heart disease (CHD). The purpose of this study was to examine the relationship between high-sensitivity C-reactive protein (hs-CRP) and CHD risk in a middle-aged and elderly population with hyperuricaemia.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

This study was conducted in a health examination centre of China. Participants were diagnosed with hyperuricaemia based on uric acid concentrations. Specifically, males with a uric acid concentration ≥416 μmol/L were included, as well as females with a concentration ≥360 μmol/L.

MAIN OUTCOME MEASURES

10-year CHD risk for each individual was evaluated using Framingham risk score based on the Adult Treatment Panel III charts.

RESULTS

A total of 517 patients with hyperuricaemia (438 males and 79 females) aged from 40 to 85 years old were included in the present study. 193 (37.3%) patients were defined with relatively high 10-year CHD risk. Compared with the lowest quintile, the crude ORs of relatively high 10-year CHD risks were 1.43 (95% CI 0.78 to 2.63, p=0.245), 2.05 (95% CI 1.14 to 3.67, p=0.016), 2.77 (95% CI 1.54 to 4.98, p=0.001), 2.12 (95% CI 1.18 to 3.80, p=0.012) in the second, third, fourth and fifth quintiles of serum hs-CRP level, respectively (p for trend=0.057). The multivariable-adjusted ORs of relatively high 10-year CHD risk were 1.40 (95% CI 0.75 to 2.61, p=0.291) in the second, 2.05 (95% CI 1.13 to 3.72, p=0.019) in the third, 2.69 (95% CI 1.47 to 4.89, p=0.001) in the fourth and 2.10 (95% CI 1.15 to 3.84, p=0.016) in the fifth quintile of serum hs-CRP level when compared with the lowest quintile (p for trend=0.068).

CONCLUSION

This study showed that ORs of relatively high 10-year CHD risk were raised in patients with hyperuricaemia with higher serum hs-CRP level; however, there was a not significant but borderline trend association and that more research is needed.

Association between dietary iron intake and the prevalence of nonalcoholic fatty liver disease: A cross-sectional study

The aim was to test the association between dietary iron intake and the prevalence of nonalcoholic fatty liver disease (NAFLD) in a large sample of middle-aged and elderly Chinese population.The data included in this analysis were collected from a population-based cross-sectional study, that is, the Xiangya Hospital Health Management Center Study. Dietary iron intake was assessed using a validated semiquantitative food frequency questionnaire. The relationship between dietary iron intake and the prevalence of NAFLD was examined using logistic and spline regressions.A cross-sectional study including 5445 subjects was conducted. The prevalence of NAFLD was 36.9%. Compared with the lowest quintile, the energy-adjusted odds ratios (ORs) of NAFLD were 1.33 (95% confidence interval [CI]: 1.07-1.64), 1.80 (95% CI: 1.41-2.29) and 2.11 (95% CI: 1.60-2.80) in the 3rd, 4th, and 5th quintile of iron intake, respectively (P-value for trend <.001). In addition, dietary iron intake was positively associated with the OR of NAFLD in a dose-response relationship manner (test for trend P < .001). However, after stratifying the data by gender, such association only remained in the male, but not in the female population. With adjustment of additional potential confounders, the results did not change materially.Subjects with higher dietary iron intake were subject to a higher prevalence of NAFLD in a dose-response relationship manner. However, such association probably only exists in males, but not in females.

Thiazide diuretics and risk of knee replacement surgery among patients with knee osteoarthritis: a general population-based cohort study

OBJECTIVE

Thiazide diuretic use is associated with higher bone mineral density (BMD) and possibly lower serum magnesium levels than loop diuretic use, and both high BMD and low serum magnesium have been linked to high prevalent knee osteoarthritis. This study aimed to compare the risk of a clinically relevant endpoint, knee replacement (KR) surgery, among initiators of thiazide and loop diuretics.

DESIGN

Among patients aged ≥50 years with a diagnosis of knee osteoarthritis in The Health Improvement Network (THIN) in United Kingdom, we conducted a propensity score-matched cohort study to examine the relation of thiazide diuretic initiation vs loop diuretic initiation to the risk of KR over 5 years.

RESULTS

Among thiazide and loop diuretic initiators (n = 3,488 for each group; mean age: 73 years; female ratio: 59%), 359 (28.6/1,000 person-years) and 283 (24.1/1,000 person-years) KRs occurred during the follow-up period, respectively. The hazard ratio (HR) of KR for thiazide diuretic initiation vs loop diuretic initiation was 1.26 (95% confidence interval [CI]: 1.08-1.47). The adherence-adjusted HR of KR for continuous use of thiazide diuretics was 1.44 (95% CI: 1.21-1.72).

CONCLUSIONS

In this population-based cohort of patients with knee osteoarthritis, thiazide diuretic use was associated with a higher risk of KR than loop diuretic use. This association may potentially be due to thiazide diuretics' effect on BMD and serum magnesium.

The Association between Dietary Magnesium Intake and Magnetic Resonance Parameters for Knee Osteoarthritis

The aim of the study was to evaluate the relationship between dietary magnesium (Mg) intake and prevalence of knee osteoarthritis (OA), a topic poorly explored in the literature. Overall, 783 people participating in the Osteoarthritis Initiative (59.8% females; mean age: 62.3 years) and having an MRI assessment were enrolled in this cross-sectional study. Mg intake was measured with a semi-quantitative food frequency questionnaire, and its association with knee OA was evaluated for an increased intake of 100 mg/day. Using an adjusted linear regression analysis, a higher Mg intake (i.e., increase of 100 mg/day) corresponded to a significant increase in mean cartilage thickness, cartilage volume at medial tibia, cartilage volume and mean cartilage thickness at central medial femur, and cartilage volume and mean cartilage thickness in the central medial tibiofemoral compartment. In conclusion, an increased Mg dietary intake is associated with a better knee cartilage architecture, also when adjusting for potential confounders, suggesting a potential role of Mg in the prevention and treatment of knee OA.

The role of magnesium in different inflammatory diseases

Magnesium deficiency (MgD) can cause inflammation in human body. The known mechanisms of inflammation caused by MgD include activation of phagocytic cells, opening of calcium channels, activation of the N-methyl-D-aspartate (NMDA) receptor, and activation of nuclear factor (NF)-κB. In addition, MgD causes systemic stress response through neuroendocrinological pathways. The inflammation caused by MgD can result in pro-atherogenic changes in the metabolism of lipoproteins, endothelial dysfunction, and high blood pressure. Studies suggest that magnesium may play an important role in the pathophysiology of some inflammatory diseases. Several clinical trials and laboratory studies have been done on the functional role of magnesium. In this study, we review some inflammatory diseases, in which the magnesium has a role in their pathophysiology. Among these diseases, diabetes, asthma, preeclampsia, atherosclerosis, heart damage, and rheumatoid arthritis have been highlighted.

Association Between Dietary Selenium Intake and the Prevalence of Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

Objective: The aim was to examine the association between dietary selenium intake and nonalcoholic fatty liver disease (NAFLD) in a large group of middle-aged and elderly Chinese persons.Method: The data included in this analysis were from a population-based study, the Xiangya Hospital Health Management Center Study. NAFLD was diagnosed by (1) imaging or histological evidence of hepatic steatosis; (2) absence of specific etiologies of NAFLD; and (3) no heavy consumption of alcohol. Dietary selenium intake was assessed using a validated semi-quantitative food frequency questionnaire. The association between dietary selenium intake and the prevalence of NAFLD was evaluated using logistic and spline regression in a cross-sectional study of 5436 subjects.Results: The prevalence of NAFLD was 36.8%. Compared with the lowest quintile, the energy-adjusted odds ratios for NAFLD were 1.27 (95% confidence interval [CI], 1.07-1.52), 1.30 (95% CI, 1.09-1.55), and 1.58 (95% CI, 1.33-1.89) for the third, fourth, and fifth quintiles of selenium intake, respectively, and there was a positive dose-response relationship (r = 0.88, p for trend = 0.008). Similar results were observed for men and women separately. The findings were not materially altered by adjustment for potential confounders (i.e., age, gender, body mass index, smoking status, diabetes, hypertension, activity level, nutritional supplements, energy intake, fat intake, fiber intake, cholesterol and saturated fatty acid intake).Conclusions: In this middle-aged and elderly population, subjects with higher dietary selenium intake, even below the recommended nutrient intake in China, had higher prevalence of NAFLD in a dose-response relationship manner.

Dose-response relationship between higher serum calcium level and higher prevalence of hyperuricemia: A cross-sectional study

The aim of the study was to examine the relationship between serum calcium (Ca) levels and the prevalence of hyperuricemia (HU).The data included in this analysis were extracted from a population-based study conducted at the Xiangya Hospital Health Management Centre. Serum Ca levels were measured using the Arsenazo III method. HU was defined as the uric acid ≥416 μmol/L for male subjects, and ≥360 μmol/L for female subjects. The association between serum Ca levels and the prevalence of HU was evaluated using logistic and spline regression.The present study included a total of 6337 subjects. The overall prevalence of HU for the target population was 17.5%. Compared with the lowest quintile, the odds ratios adjusted by age, sex, body mass index, smoking, and drinking for HU were 1.51 [95% confidence interval (CI): 1.20-1.91], 1.43 (95% CI: 1.13-1.82), 2.02 (95% CI: 1.61-2.54), and 2.54 (95% CI: 2.02-3.18) for the second, third, fourth, and fifth quintiles of serum Ca levels, respectively (P for trend <.001), and a positive dose-response relationship was observed. Similar results were observed for men and women, respectively. The findings were not materially altered by the adjustment for further potential confounders.Subjects with higher serum Ca levels are subject to a higher prevalence of HU in a dose-response relationship manner.

White blood cell count: an independent predictor of coronary heart disease risk in middle-aged and elderly population with hyperuricemia

Previous studies have shown that hyperuricemia is an independent risk factor for cardiovascular disease. The aim of the study was to examine the association between white blood cell (WBC) count and coronary heart disease (CHD) risk in middle-aged and elderly population with hyperuricemia.Data included in this analysis were from a population-based cross-sectional study, that is, the Xiangya Hospital Health Management Center Study. Hyperuricemia was defined as uric acid ≥416 μmol/L in male population and ≥360 μmol/L in female population. The WBC count was classified into 3 categories based on the tertile distribution of the study population. Framingham risk scores calculated by the Adult Treatment Panel III charts were used to estimate 10-year CHD risk for each participant. The relationship between WBC count and CHD risk in patients with hyperuricemia was examined using the multivariable logistic analysis.A total of 1148 hyperuricemia patients (855 males and 293 females) aged from 40 to 85 years were included and 418 (36.4%) of them were defined with relatively high 10-year CHD risk. Compared with the lowest tertile, the crude odds ratios (ORs) of high 10-year CHD risk were 1.43 (95% confidence interval [CI] 1.06-1.92) and 1.56 (95% CI 1.16-2.11) in the 2nd and 3rd tertiles of WBC count (P for trend = .004), and the multivariable adjusted ORs of high 10-year CHD risk were 1.39 (95% CI 1.03-1.89) and 1.47 (95% CI 1.08-2.00) in the 2nd and 3rd tertiles of WBC count (P for trend = .015).This study indicated that WBC count was associated with CHD risk in patients with hyperuricemia, suggesting that WBC count, an easily accessible biomarker, could probably predict CHD risk in middle-aged and elderly population with hyperuricemia.

Association between serum magnesium concentration and metabolic syndrome, diabetes, hypertension and hyperuricaemia in knee osteoarthritis: a cross-sectional study in Hunan Province, China

OBJECTIVES

To examine the associations between serum magnesium (Mg) concentration with the prevalence of metabolic syndrome (MetS), diabetes mellitus (DM), hypertension (HP) and hyperuricaemia (HU) in patients with radiographic knee osteoarthritis (OA).

METHODS

The present study was conducted at the Health Management Center of Xiangya Hospital. Radiographic OA was evaluated for patients aged over 40 years with basic characteristics and blood biochemical assessment. Serum Mg concentration was measured using the chemiluminescence method. MetS, DM, HP and HU were diagnosed based on standard protocols. The associations between serum Mg concentration with MetS, DM, HP and HU were evaluated by conducting multivariable adjusted logistic regression.

RESULTS

A total of 962 patients with radiographic knee OA were included. Compared with the lowest quintile, the multivariable adjusted ORs and related 95% CIs of DM were 0.40 (95% CI 0.23 to 0.70, p=0.001), 0.33 (95% CI 0.18 to 0.60, p<0.001), 0.27 (95% CI 0.14 to 0.52, p<0.001) and 0.22 (95% CI 0.11 to 0.44, p<0.001) in the second, third, fourth and highest quintiles of serum Mg, respectively (p for trend <0.001); the multivariable adjusted ORs of HU were 0.33 (95% CI 0.19 to 0.59, p<0.001), 0.52 (95% CI 0.30 to 0.91, p=0.022) and 0.39 (95% CI 0.22 to 0.70, p=0.001) in the third, fourth and highest quintiles of serum Mg, respectively (p for trend <0.001); and the multivariable adjusted ORs of MetS were 0.59 (95% CI 0.36 to 0.94, p=0.027) in the second and 0.56 (95% CI 0.34 to 0.93, p=0.024) in the highest quintiles of serum Mg. However, the inverse association between serum Mg and the prevalence of MetS was non-linear (p for trend=0.067). There was no significant association between serum Mg and HP in patients with OA.

CONCLUSIONS

The serum Mg concentration was inversely associated with the prevalence of MetS, DM and HU in patients with radiographic knee OA.

LEVEL OF EVIDENCE

Level III, cross-sectional study.

Low magnesium intake is associated with increased knee pain in subjects with radiographic knee osteoarthritis: data from the Osteoarthritis Initiative

OBJECTIVE

As magnesium mediates bone and muscle metabolism, inflammation, and pain signaling, we aimed to evaluate whether magnesium intake is associated with knee pain and function in radiographic knee osteoarthritis (OA).

METHODS

We investigated the associations between knee pain/function metrics and magnesium intake from food and supplements in 2548 Osteoarthritis Initiative cohort participants with prevalent radiographic knee OA (Kellgren-Lawrence score ≥2). Magnesium intake was assessed by Food Frequency Questionnaire (FFQ) at baseline. WOMAC and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were reported annually with total follow up of 48 months. Analyses used linear mixed models.

RESULTS

Among participants with baseline radiographic knee OA the mean total magnesium intake was 309.9 mg/day (SD 132.6) for men, and 287.9 mg/day (SD 118.1) for women, with 68% of men and 44% of women below the estimated average requirement. Subjects with lower magnesium intake had worse knee OA pain and function scores, throughout the 48 months (P < 0.001). After adjustment for age, sex, race, body mass index (BMI), calorie intake, fiber intake, pain medication use, physical activity, renal insufficiency, smoking, and alcohol use, lower magnesium intake remained associated with worse pain and function outcomes (1.4 points higher WOMAC and 1.5 points lower KOOS scores for every 50 mg of daily magnesium intake, P < 0.05). Fiber intake was an effect modifier (P for interaction <0.05). The association between magnesium intake and knee pain and function scores was strongest among subjects with low fiber intake.

CONCLUSION

Lower magnesium intake was associated with worse pain and function in knee OA, especially among individuals with low fiber intake.

Association between metabolic syndrome and knee osteoarthritis: a cross-sectional study

Background

Osteoarthritis (OA) is the most prevalent chronic joint disease in China. The aim of this study was to examine the association between metabolic syndrome (MetS) and knee OA in a population-based Chinese study.

Methods

Data included in this analysis is from a cross-sectional study, i.e., the Xiangya Hospital Health Management Center Study. MetS was diagnosed according to the criteria defined by the Chinese Diabetes Society. Radiographic knee OA was defined as changes equivalent to Kellgren-Lawrence (K-L) grade 2 or above at least one side. Associations between MetS and its components with OA were evaluated by conducting multivariable adjusted logistic regression.

Results

A total of 5764 participants were included in the present study. The unadjusted OR (1.27, 95%CI: 1.10–1.47, P = 0.001), age-sex adjusted OR (1.17, 95%CI: 1.01–1.36, P = 0.041) and multivariable adjusted OR (1.17, 95%CI: 1.01–1.36, P = 0.043) all suggested a positive association between MetS and knee OA. Besides, its components (e.g., overweight, hypertension and dyslipidemia) were also associated with the prevalence of radiographic knee OA respectively, after adjusting for some confounding factors. In addition, with the accumulation of MetS components, the prevalence of knee OA increased. Furthermore, MetS as a whole was associated with the prevalence of knee osteophyte (OSP) (OR = 1.72, 95%CI: 1.42–2.09, P < 0.001), but not joint space narrowing (JSN) (OR = 1.06, 95%CI: 0.91–1.23, P = 0.449).

Conclusions

The findings of the present study indicated that there was a positive association between the prevalence of MetS and knee OA. However, MetS as a whole was associated with the higher prevalence of knee OSP, but not JSN, which should shed light on our understanding the association between MetS and OA.

Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis

Background

The aim was to assess serum magnesium levels in relation to prevalence of knee chondrocalcinosis in two population-based Chinese studies.

Methods

Data included in this analysis consisted of two population-based cross-sectional studies, i.e., the Xiangya Hospital Health Management Center Study and the Xiangya Osteoarthritis (XO) Study I. A bilateral knee anteroposterior radiograph was obtained from each subject. Radiographic knee chondrocalcinosis was present if there was definite linear cartilage calcification. Serum magnesium concentration was measured using the chemiluminescence method. We examined the relation of serum magnesium levels to prevalence of knee chondrocalcinosis using generalized estimating equations.

Results

The prevalence of knee chondrocalcinosis was 1.4% in the Xiangya Hospital Health Management Center Study (n = 12,631). Compared with the lowest tertile, the age, sex and body mass index (BMI)-adjusted odds ratios (ORs) of chondrocalcinosis were 0.59 (95% CI 0.40–0.87) and 0.49 (95% CI 0.33–0.72) in the second and the third tertiles of serum magnesium, respectively (P for trend <0.001). The prevalence of knee chondrocalcinosis in the XO Study I (n = 1316) was 4.1%. The age, sex and BMI-adjusted ORs of chondrocalcinosis were 0.67 (95% CI 0.34–1.30) in the second and 0.45 (95% CI 0.21–0.94) in the third tertile of serum magnesium when compared with the lowest tertile (P for trend = 0.030). Similar results were observed in men and women in both studies. Adjusting for additional potential confounders did not change the results materially.

Conclusions

Subjects with lower levels of serum magnesium, even within the normal range, had higher prevalence of knee chondrocalcinosis in a dose-response relationship manner, suggesting that magnesium may have a preventive or therapeutic potential for knee chondrocalcinosis.

Electronic supplementary material

The online version of this article (doi:10.1186/s13075-017-1450-6) contains supplementary material, which is available to authorized users.

Serum magnesium level is not associated with inflammation in patients with knee osteoarthritis

Objectives

In this study, we aimed to evaluate the relationship of serum magnesium (Mg) with the radiological severity and inflammation in the patients with knee osteoarthritis (OA).

Patients and methods

A total of 75 patients (61 females, 14 males; mean age 67.5±9.9 years; range 44 to 92 years) with the Kellgren-Lawrence Grade 1-4 knee OA were included in the study. Serum Mg levels (mg/dL) and inflammatory markers including erythrocyte sedimentation rate (ESR; mm/h) and C-reactive protein (CRP; mg/dL) were recorded. Serum Mg levels of the patients with mild OA (Grade 1-2) and severe OA (Grade 3-4) were compared. The correlation between Mg and both inflammatory markers was analyzed.

Results

Severe OA group had significantly lower Mg levels than the mild OA group (p=0.044). Serum Mg level was not found to be correlated with either inflammatory biomarkers.

Conclusion

Although serum Mg is associated with the radiological severity of knee OA, it is not associated with inflammatory biomarkers including ESR and CRP.

Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis

To examine the analgesic effect and safety of single-dose intra-articular (IA) magnesium (Mg) after arthroscopic surgery. Pubmed, Embase and Cochrane library were searched through in January 2016. Eight RCTs and eight experimental studies were included. The IA Mg exhibited a significantly lower pain score when compared with placebo (MD, -0.41, 95% CI, -0.78 to -0.05, p = 0.03). There was no significant difference between Mg and bupivacaine in terms of pain relief and the time to first analgesic request. Furthermore, statistically significant differences both in pain score (MD, -0.62, 95% CI, -0.81 to -0.42, p < 0.00001) and time to first analgesic request (MD, 6.25, 95% CI, 5.22 to 7.29, p < 0.00001) were observed between Mg plus bupivacaine and bupivacaine alone. There was no statistically significant difference among the various groups with respect to adverse reactions. Most of the included in vitro studies reported the chondrocyte protective effect of Mg supplementation. There were also two in vivo studies showing the cartilage protective effect of IA Mg. The single-dose IA Mg following arthroscopic surgery was effective in pain relief without increasing adverse reactions, and it could also enhance the analgesic effect of bupivacaine. In addition, Mg seemed to possess the cartilage or chondrocyte protective effect based on experimental studies.

Adherence to a Mediterranean diet is associated with lower prevalence of osteoarthritis: Data from the osteoarthritis initiative

BACKGROUND & AIMS

The Mediterranean diet appears to be beneficial for several medical conditions, but data regarding osteoarthritis (OA) are not available. The aim of this study was to investigate if adherence to the Mediterranean diet is associated with a lower prevalence of OA of the knee in a large cohort from North America.

METHODS

4358 community-dwelling participants (2527 females; mean age: 61.2 years) from the Osteoarthritis Initiative were included. Adherence to the Mediterranean diet was evaluated through a validated Mediterranean diet score (aMED) categorized into quartiles (Q). Knee OA was diagnosed both clinically and radiologically. The strength of the association between aMED (divided in quartiles) and knee OA was investigated through a logistic regression analysis and reported as odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for potential confounders.

RESULTS

Participants with a higher adherence to Mediterranean diet had a significantly lower prevalence of knee OA compared to those with lower adherence (Q4: 25.2% vs. Q1: 33.8%; p < 0.0001). Using a logistic regression analysis, adjusting for 10 potential confounders with those in the lowest quartile of aMED as reference, participants with the highest aMED had a significant reduction in presence of knee OA (OR, 0.83; 95% CIs: 0.69-0.99, p = 0.04). Among the individual components of Mediterranean diet, only higher use of cereals was associated with lower odds of having knee OA (OR: 0.76; 95%CI: 0.60-0.98; p = 0.03).

CONCLUSIONS

Higher adherence to a Mediterranean diet is associated with lower prevalence of knee OA. This remained when adjusting for potential confounders.

Relationship between cigarette smoking and hyperuricemia in middle-aged and elderly population: a cross-sectional study

The aim of the study was to estimate the cross-sectional association between cigarette smoking and the prevalence of hyperuricemia (HU) in the middle-aged and elderly males and females. A total of 3415 males and 2932 females were included in this study. HU was defined as SUA≥ 416 mmol/L for males and ≥360 mmol/L for females. The smoking status was classified into four categories based on daily smoking habit: (1) 0/day; (2) 1-10/day; (3) 11-20/day; and (4) >20/day. Multivariable logistic regressions were conducted to examine the aforementioned association. The prevalence of HU in the male and female sample was 25.0 and 10.0 %, respectively. In male subjects, the prevalence of HU in smokers (22.8 %) was significantly lower than that in non-smokers (26.5 %) (p = 0.016). Meanwhile, with adjustment for potential confounding factors, the prevalence of HU in smokers was still lower (OR = 0.83, 95 % CI 0.70-0.98, P = 0.033). Furthermore, a significantly inverse association between smoking status and HU was observed in the multivariable model. The multivariable-adjusted OR (95 % CI) for HU in the second, third and fourth category of smoking status was 0.84 (95 % CI 0.66-1.06), 0.90 (95 % CI 0.69-1.18) and 0.76 (95 % CI 0.58-0.99), respectively, compared with that in the first category. A clear trend (P for trend was 0.036) was observed. However, there was no significant association between cigarette smoking and HU in female subjects (P for trend was 0.739). This study indicated an inverse association between cigarette smoking and the prevalence of HU in the middle-aged and elderly male population, independent of some major confounding factors. The findings of this study expect further prospective studies to confirm the causal relationship.

Associations of cigarette smoking, betel quid chewing and alcohol consumption with high-sensitivity C-reactive protein in early radiographic knee osteoarthritis: a cross-sectional study

OBJECTIVES

High-sensitivity C-reactive protein (hsCRP) is possibly related to osteoarthritis (OA) progression and a variety of OA-related symptoms. This study aimed to examine associations between cigarette smoking, betel quid chewing and alcohol consumption and hsCRP in early radiographic knee OA.

DESIGN

Cross-sectional health examination survey.

SETTING

This primary study was conducted in a health examination centre in China.

PARTICIPANTS

936 (656 men and 280 women) patients with early radiographic knee OA were included in this cross-sectional study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Smoking status was classified into four levels based on daily smoking habit: 0/day, 1-10/day, 11-20/day and >20/day. Betel quid chewing and alcohol consumption status was divided into 'Yes' or 'No'. Early radiographic knee OA was defined as Kellgren Lawrence (K-L) grade 1 or 2 in at least one leg, and elevated hsCRP was assessed as ≥ 3.0 mg/L.

RESULTS

After adjustment for a number of potential confounding factors, a significant positive association between cigarette smoking and hsCRP was observed in the multivariable model. The multivariable-adjusted ORs (95% CI) of elevated hsCRP (≥ 3.0 mg/L) in the second (1-10/day, n=133), third (11-20/day, n=59) and highest (>20/day, n=104) cigarette smoking categories were 1.54 (95% CI 0.91 to 2.61), 1.27 (95% CI 0.57 to 2.79) and 2.09 (95% CI 1.20 to 3.64), respectively, compared with the non-smoker category (n=640). In addition, there was a positive dose-response relationship between cigarette smoking and elevated hsCRP (p for trend=0.01). No significant associations between betel quid chewing and alcohol consumption and hsCRP were observed in the multivariable model.

CONCLUSIONS

This study indicated that cigarette smoking was positively associated with serum hsCRP level in patients with early radiographic knee OA. However, in view of the nature of cross-sectional designs, the results need to be confirmed by further prospective studies.

Association between high-sensitivity C-reactive protein and hyperuricemia

The aim of the study was to examine the cross-sectional association between high-sensitivity C-reactive protein (hsCRP) and hyperuricemia (HU). The hsCRP was measured by latex turbidity method. Uric acid was detected on Beckman Coulter AU 5800. HU was defined as uric acid ≥416 μmol/L for the male population and ≥360 μmol/L for the female population. A multivariable logistic analysis model was applied to test the association after adjusting for a number of potential confounding factors. A total of 1935 subjects were included in this study. According to the multivariable regression model, the relative odds of the prevalence of HU were increased by 0.56 times in the third quintile (OR 1.56, 95 % CI 1.03-2.38, P = 0.04), 0.55 times in the fourth quintile (OR 1.55, 95 % CI 1.01-2.36, P = 0.04) and 0.96 times in the fifth quintile (OR 1.96, 95 % CI 1.29-2.98, P < 0.01) of hsCRP comparing with the lowest quintile, and P for trend was smaller than 0.01. In the male population, a positive association existed in the highest quintile of hsCRP (OR 1.66, 95 % CI 1.04-2.66, P = 0.04), and P for trend was 0.07. In the female population, the multivariable-adjusted ORs (95 % CI) of HU in the fourth and fifth quintile of hsCRP were 3.02 (95 % CI 1.09-8.35, P = 0.03) and 3.66 (95 % CI 1.36-9.89, P = 0.01), respectively, and P for trend was smaller than 0.01. The findings of this cross-sectional study suggest that the hsCRP level is positively associated with the prevalence of HU. Level of evidence Cross-sectional study, Level III.

Serum Calcium Concentration Is Inversely Associated With Radiographic Knee Osteoarthritis: A Cross-Sectional Study

To examine the relationship between serum calcium (Ca) concentration and radiographic knee osteoarthritis (OA).This study covered a total of 2855 subjects. The serum Ca concentration was detected by the Arsenazo III method. The radiographic OA of the knee was defined as changes equivalent to Kellgren-Lawrence grade 2 on 1 side at least. The serum Ca concentration was categorized into 4 quartiles, which are ≤2.27, 2.28-2.34, 2.35-2.41, and ≥2.42 mmol/L, respectively. The relationship between serum Ca and radiographic knee OA was examined using the multivariable logistic analysis after adjusting a series of potential confounding factors. For each quartile of the relationship between serum Ca concentration and radiographic knee OA, the OR with 95% CI was calculated, and the one with the lowest value was considered to be the reference.An inverse association existed between serum Ca concentration and radiographic OA of the knee in the multivariable model and the model where the factors of age, sex, and BMI were adjusted. The multivariable-adjusted OR (95% CI) for radiographic knee OA in the second, third, and fourth quartiles of serum Ca concentration were 1.05 (95% CI: 0.83-1.31), 1.01 (95% CI: 0.80-1.27), and 0.79 (95% CI: 0.62-1.00), respectively, in comparison with the reference (first) quartile. A trend approaching to statistical significant (P = 0.06) was observed. Meanwhile, the relative odds of radiographic OA of the knee were decreased by 0.79 times in the fourth quartile in comparison with the reference.There is likely to be an inverse association between serum Ca concentration and radiographic OA of the knee.

Association between Dietary Vitamin C Intake and Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study among Middle-Aged and Older Adults

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) has become one of the most prevalent chronic liver disease all over the world. The objective of this study was to evaluate the association between dietary vitamin C intake and NAFLD.

METHOD

Subjects were diagnosed with NAFLD by abdominal ultrasound examination and the consumption of alcohol was less than 40g/day for men or less than 20g/day for women. Vitamin C intake was classified into four categories according to the quartile distribution in the study population: ≤74.80 mg/day, 74.81-110.15 mg/day, 110.16-146.06 mg/day, and ≥146.07 mg/day. The energy and multi-variable adjusted odds ratio (OR), as well as their corresponding 95% confidence interval (CI), were used to determine the relationship between dietary vitamin C intake and NAFLD through logistic regression.

RESULT

The present cross-sectional study included 3471 subjects. A significant inverse association between dietary vitamin C intake and NAFLD was observed in the energy-adjusted and the multivariable model. The multivariable adjusted ORs (95%CI) for NAFLD were 0.69 (95%CI: 0.54-0.89), 0.93 (95%CI: 0.72-1.20), and 0.71 (95%CI: 0.53-0.95) in the second, third and fourth dietary vitamin C intake quartiles, respectively, compared with the lowest (first) quartile. The relative odds of NAFLD was decreased by 0.71 times in the fourth quartile of dietary vitamin C intake compared with the lowest quartile. After stratifying data by sex or the status of obesity, the inverse association remained valid in the male population or non-obesity population, but not in the female population or obesity population.

CONCLUSION

There might be a moderate inverse association between dietary vitamin C intake and NAFLD in middle-aged and older adults, especially for the male population and non-obesity population.

The associations of serum uric acid level and hyperuricemia with knee osteoarthritis

To examine the cross-sectional associations of the serum uric acid level and hyperuricemia (HU) with the radiographic features of osteoarthritis (OA), including osteophytes (OST) and joint space narrowing (JSN), a total of 4685 subjects were included in this study. Blood samples were drawn from all subjects. Serum uric acid and some other indexes were detected. OST and JSN were assessed for each subject according to the Osteoarthritis Research Society International (OARSI) atlas. A multivariable logistic analysis model was applied to test the target associations after adjusting a number of potential confounding factors. The prevalence of OST was increased in the highest tertile of uric acid compared to the lowest in female subjects (OR 1.46, 95 % CI 1.07-1.99, P for trend = 0.02). Meanwhile, a positive association between OST and HU was observed in female subjects (OR 1.43, 95 % CI 1.01-2.03, P = 0.05). However, serum uric acid and HU were not significantly associated with JSN in male subjects. The findings of this study indicated that the serum uric acid concentration and prevalence of HU are positively associated with OST of the knee in the female population. Level of evidence Cross-sectional study, Level III.

Higher blood hematocrit predicts hyperuricemia: a prospective study of 62,897 person-years of follow-up

This prospective study aimed to investigate the relationship between higher hematocrit (Hct) level and hyperuricemia (HU) incidence. A total of 27,540 subjects were included. Baseline Hct was classified into four categories based on the quartile distribution of the study population. A cox proportional hazards regression was used to evaluate the risk of HU incidence across the Hct quartiles after adjusting a number of potential confounding factors. Out of the 62,897 person-years of follow-up, 2745 new cases of HU were developed. In models adjusted for known risk factors of HU, higher Hct was used to predict HU incidence independently in a graded manner (p = 0.02): compared with subjects in the lowest quartile, subjects in the highest quartile of Hct (hazard ratio = 1.20; 95% confidence interval: 1.03-1.41) were n20% more likely to develop HU. Sensitivity analysis indicated that the hazard ratios increased with the extension of the minimum follow-up interval. When the minimum follow-up interval was restricted to 4 years, subjects in the highest quartile of Hct were 70% more likely to develop HU, compared with the lowest quartile. Higher Hct, a routinely measured inexpensive biomarker was independently associated with the incidence of HU even within the normal range.