The associations of phase angle with the structural severity and quadriceps strength among patients with hip osteoarthritis: the SPSS-OK study

INTRODUCTION/OBJECTIVES

This study examined whether phase angle (PhA) is associated with hip osteoarthritis (HOA) severity and quadriceps strength in patients with HOA.

METHOD

A series of 549 patients with HOA, obtained from the Screening for People Suffering Sarcopenia in the Orthopedic cohort of Kobe study, were analyzed. PhA and quadriceps strength were measured using bioelectrical impedance analysis and a handheld dynamometer, respectively. The HOA severity was graded using the Kellgren-Lawrence radiographic scale. We estimated (1) mean differences in PhA by differences in HOA severity and (2) mean differences in quadriceps strength by differences in PhA using general linear models.

RESULTS

The patients' mean age was 64.9 years, and 85% were women. A decreasing trend of PhA associated with increasing HOA severity was observed (P for trend < 0.001). PhA was statistically associated with a decrease in HOA grade 4 compared with that associated with HOA grade 1 (mean difference, - 0.40°; 95% confidence interval (CI), - 0.51° to - 0.30°). PhA per leg was associated with greater quadriceps strength per leg independent of age, sex, leg muscle mass, and HOA severity (mean difference per 1° increase, 3.80 Nm; 95% CI, 0.93 to 6.66). There was insufficient evidence of any difference in the association between PhA and quadriceps strength by HOA severity and sex (P for interaction = 0.07 and 0.06, respectively).

CONCLUSIONS

PhA gradually decreased with increasing HOA severity, especially in patients with end-stage HOA. Paying close attention to PhA might provide a key to increasing quadriceps strength, regardless of HOA severity. Key Points • PhA gradually decreased with progression of HOA, particularly in patients with end-stage HOA. • PhA was positively associated with quadriceps strength, regardless of HOA severity. • PhA could be one of the indicators of quadriceps strength in patients with HOA.

Serum intestinal permeability biomarkers are associated with erosive hand osteoarthritis and radiographic severity: results from the DIGICOD cohort

OBJECTIVE

To investigate the association between intestinal permeability alteration and erosive hand osteoarthritis (EHOA).

METHODS

Serum concentrations of four intestinal permeability biomarkers (lipopolysaccharide binding protein (LBP), FABP2, sCD14, Zonulin-related proteins (ZRP) along with calprotectin, and high-sensitivity C-Reactive Protein (hs-CRP) were assessed in 410 patients of the DIGICOD cohort. The study compared patients with EHOA (≥ 2 erosion in Verbruggen score N=140) to those without EHOA (N=270) using the Mann-Whitney U test. Logistic regression was performed to adjust for potential covariates. The Spearman rank test was used to investigate the correlation between intestinal permeability biomarkers and seven clinical variables associated with HOA clinical and radiographic severity.

RESULTS

Serum levels of LBP and ZRP were found to be higher in patients with EHOA compared to those without EHOA (p=0.001, p=0.04). Additionally, LBP and ZRP remained associated with EHOA in a logistic regression model adjusted for age, body mass index, and sex (p=0.017, p=0.005). ZRP was positively correlated with Verbruggen score and Kellgren-Lawrence sum score of both hands (r=0.14 p=0.005, r=0.12 p=0.023). LBP was positively correlated with the number of erosive joints (r=0.14 p=0.0006). Hs-CRP and LBP were positively correlated with AUSCAN pain (r=0.14 p=0.008, r=0.10 p=0.042).

CONCLUSIONS

LBP and ZRP were associated with EHOA with clinical and radiographic severity in HOA. These results overall support the role of intestinal permeability in both symptoms and structural alteration in HOA.