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Kumar P, Kumar S, Abhilasha A, Singh A, Kumar U. The Role of Matrix Metalloproteinase 13 and Vitamin D in Osteoarthritis: A Hospital-Based Observational Study. Cureus 2023; 15:e45437. [PMID: 37859901 PMCID: PMC10582788 DOI: 10.7759/cureus.45437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Osteoarthritis (OA) is the most common form of degenerative joint disease characterized by the progressive degeneration of articular cartilage, osteophyte formation, and joint space narrowing. Matrix metalloproteinases (MMPs) are potential biomarkers for osteoarthritis. Aims and objective The study's aim is the estimation of serum and synovial fluid matrix metalloproteinase (MMP) 13 and serum vitamin D levels in the grade 3 and grade 4 stages of osteoarthritis according to the Kellgren and Lawrence (KL) system of classification. Materials and methods A total of 100 subjects were included; of them, 25 patients with grade 3 and 25 patients with grade 4 knee osteoarthritis diagnosed clinically and radiologically according to the Kellgren and Lawrence criteria have been enrolled in the study, and 50 patients with knee pain having a diagnosis other than degenerative OA of the knee were taken as controls. Venous blood and synovial fluid have been collected from all of them for the estimation of MMP-13 and vitamin D. The enzyme-linked immunosorbent assay (ELISA) and chemiluminescent microparticle immunoassay (CMIA) methods were used for the estimation of MMP-13 and vitamin D, respectively. Results The mean value of synovial fluid MMP-13 was found to be elevated in grade 4 as compared to grade 3 and the control group, whereas the mean value of serum MMP-13 was found to be elevated in grade 3 as compared to grade 4 and control. The level of serum vitamin D was found deficient in OA patients as compared to control. The Kruskal-Wallis test was performed to compare these groups, and there was a significant difference between these groups (p-value of <0.05). Summary and conclusion High synovial and serum MMP-13 is associated with knee structural abnormalities in patients with knee OA as compared to the control group suggesting that MMP-13 can be a biomarker in knee OA, whereas the decreased level of vitamin D may be associated with an increased risk for the progression of OA; hence, serum vitamin D may be a good indicator for the prediction of the initiation of OA.
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Affiliation(s)
- Purushottam Kumar
- Department of Biochemistry, Nalanda Medical College and Hospital, Patna, IND
| | - Santosh Kumar
- Department of Biochemistry, Nalanda Medical College and Hospital, Patna, IND
| | - Abhilasha Abhilasha
- Department of Biochemistry, Nalanda Medical College and Hospital, Patna, IND
| | - Akrity Singh
- Department of Trauma and Emergency Medicine, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Uday Kumar
- Department of Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, IND
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Salis Z, Lui LY, Lane NE, Ensrud K, Sainsbury A. Investigation of the association of weight loss with radiographic hip osteoarthritis in older community-dwelling female adults. J Am Geriatr Soc 2023; 71:2451-2461. [PMID: 37074126 PMCID: PMC10624600 DOI: 10.1111/jgs.18371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/06/2023] [Accepted: 03/18/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Most guidelines recommending weight loss for hip osteoarthritis are based on research on knee osteoarthritis. Prior studies found no association between weight loss and hip osteoarthritis, but no previous studies have targeted older adults. Therefore, we aimed to determine whether there is any clear benefit of weight loss for radiographic hip osteoarthritis in older adults because weight loss is associated with health risks in older adults. METHODS We used data from white female participants aged ≥65 years from the Study of Osteoporotic Fractures. Our exposure of interest was weight change from baseline to follow-up at 8 years. Our outcomes were the development of radiographic hip osteoarthritis (RHOA) and the progression of RHOA over 8 years. Generalized estimating equations (clustering of 2 hips per participant) were used to investigate the association between exposure and outcomes adjusted for major covariates. RESULTS There was a total of 11,018 hips from 5509 participants. There was no associated benefit of weight loss for either of our outcomes. The odds ratios (95% confidence intervals) for the development and progression of RHOA were 0.99 (0.92-1.07) and 0.97 (0.86-1.09) for each 5% weight loss, respectively. The results were consistent in sensitivity analyses where participants were limited to those who reported trying to lose weight and who also had a body mass index in the overweight or obese range. CONCLUSION Our findings suggest no associated benefit of weight loss in older female adults in the structure of the hip joint as assessed by radiography.
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Affiliation(s)
- Zubeyir Salis
- Centre for Big Data Research in Health, The University of New South Wales, Kensington, New South Wales, Australia
| | - Li-Yung Lui
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Nancy E Lane
- Department of Medicine, School of Medicine, University of California at Davis, Sacramento, California, USA
| | - Kristine Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
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Sapundzhiev L, Sapundzhieva T, Mitev M, Simitchiev K, Batalov A. Correlation between Bone Mineral Density and Progression of Hip Osteoarthritis in Adult Men and Women in Bulgaria-Results from a 7-Year Study. Life (Basel) 2023; 13:life13020421. [PMID: 36836778 PMCID: PMC9961715 DOI: 10.3390/life13020421] [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: 12/22/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Changes in clinical presentation, radiographic progression (RP), bone mineral density (BMD), bone turnover (BT), and cartilage turnover (CT) markers were compared in two groups of patients with hip osteoarthritis (HOA) over a period of 7 years. Each group consisted of 150 patients, including a control group on standard-of-care therapy (SC) with simple analgesics and physical exercises, and a study group (SG) on standard-of-care therapy supplemented by vitamin D3 and intravenous administration of zoledronic acid (5 mg) yearly for 3 consecutive years. Patient groups were homogenized regarding the following: (1) radiographic grade (RG), including 75 patients with hip OA RG II according to the Kellgren-Lawrence grading system (K/L), and 75 with RG III on K/L; (2) radiographic model (RM), as each of the K/L grades was subdivided into three subgroups consisting of 25 patients of different RMs: atrophic ('A'), intermediate ('I'), and hypertrophic ('H'); (3) gender-equal ratio of men and women in each subgroup (Female/Male = 15/10). The following parameters were assessed: (1) clinical parameters (CP), pain at walking (WP-VAS 100 mm), functional ability (WOMAC-C), and time to total hip replacement (tTHR); (2) radiographic indicators(RI)-joint space width (JSW) and speed of joint space narrowing (JSN), changes in BMD (DXA), including proximal femur (PF-BMD), lumbar spine (LS-BMD), and total body (TB-BMD); (3) laboratory parameters (LP)-vitamin D3 levels and levels of BT/CT markers. RV were assessed every 12 months, whereas CV/LV were assessed every 6 months. Results: Cross-sectional analysis (CsA) at baseline showed statistically significant differences (SSD) at p < 0.05 in CP (WP, WOMAC-C); BMD of all sites and levels of CT/BT markers between the 'A' and 'H' RM groups in all patients. Longitudinal analysis (LtA) showed SSD (p < 0.05) between CG and SG in all CP (WP, WOMAC-C, tTHR) parameters of RP (mJSW, JSN), BMD of all sites, and levels of CT/BT markers for all 'A' models and in 30% of 'I'-RMs (those with elevated markers for BT/CT at baseline and during the observation period). Conclusion: The presence of SSD at baseline ('A' vs. 'H') supported the thesis that at least two different subgroups of HOA exist: one associated with 'A' and the other with 'H' models. D3 supplementation and the intravenous administration of bisphosphonate were the treatment strategies that slowed down RP and postponed tTHR by over 12 months in the 'A' and 'I' RM with elevated BT/CT markers.
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Affiliation(s)
- Lyubomir Sapundzhiev
- Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4001 Plovdiv, Bulgaria
- Rheumatology Department, University Hospital ‘Pulmed’ Plovdiv, 4002 Plovdiv, Bulgaria
- Correspondence:
| | - Tanya Sapundzhieva
- Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4001 Plovdiv, Bulgaria
- Rheumatology Department, University Hospital ‘Pulmed’ Plovdiv, 4002 Plovdiv, Bulgaria
| | - Martin Mitev
- Rheumatology Department, University Hospital ‘Pulmed’ Plovdiv, 4002 Plovdiv, Bulgaria
| | - Kiril Simitchiev
- Department of Analytical Chemistry and Computer Chemistry, Faculty of Chemistry, University of Plovdiv, 4001 Plovdiv, Bulgaria
| | - Anastas Batalov
- Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4001 Plovdiv, Bulgaria
- Rheumatology Clinic, University Hospital ‘Kaspela’, 4001 Plovdiv, Bulgaria
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Naoum S. The Role of Vitamin D in the Development and Progression of Osteoarthritis. ROMANIAN JOURNAL OF MILITARY MEDICINE 2023. [DOI: 10.55453/rjmm.2023.126.3.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
"Low levels of vitamin D in patients with osteoarthritis (ΟΑ) rather adversely affect the structure and function of articular cartilage. Low levels of vitamin D are also associated with joint pain, limited physical activity, quality of life, as well as decreased muscle strength, primarily in the lower extremities with adverse OA progression. A high percentage of low vitamin D levels was found in patients with OA and joint arthroplasty as well as a less satisfactory postoperative follow-up in patients with low vitamin D levels. The administration of vitamin D supplementation in patients with knee osteoarthritis has been associated with improved articular cartilage architecture, and reduced joint pain, combined with improved functionality and quality of life in patients with OA. "
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Orthobiologics for the Management of Early Arthritis in the Middle-Aged Athlete. Sports Med Arthrosc Rev 2022; 30:e9-e16. [PMID: 35533063 DOI: 10.1097/jsa.0000000000000337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article is dedicated to the use of orthobiologic therapies in the management of early osteoarthritis in middle-aged athletes. Understanding a patient's presenting symptoms, physical examination, imaging results, and goals is of critical importance in applying orthobiologic therapies. The field of orthobiologics is expanding at a rapid pace, and the clinical studies examining the utility of each treatment lag behind the direct-to-consumer marketing that leads to these products being used. Here we provide a review of the available treatments, emerging treatments, and the current literature supporting or refuting their use. Currently studied orthobiologics include autologous and allogenic cell therapies, autologous blood products, hyaluronic acid, gene therapies, Wnt inhibitors, and a variety of systemic treatments.
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Jhun J, Woo JS, Kwon JY, Na HS, Cho KH, Kim SA, Kim SJ, Moon SJ, Park SH, Cho ML. Vitamin D Attenuates Pain and Cartilage Destruction in OA Animals via Enhancing Autophagic Flux and Attenuating Inflammatory Cell Death. Immune Netw 2022; 22:e34. [PMID: 36081528 PMCID: PMC9433191 DOI: 10.4110/in.2022.22.e34] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/28/2022] [Accepted: 04/10/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- JooYeon Jhun
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jin Seok Woo
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
| | - Ji Ye Kwon
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
| | - Hyun Sik Na
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Keun-Hyung Cho
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Seon Ae Kim
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Seok Jung Kim
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Su-Jin Moon
- Division of Rheumatology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Korea
| | - Sung-Hwan Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Mi-La Cho
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Medical Life Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
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Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence. Int J Mol Sci 2021; 22:ijms222312920. [PMID: 34884724 PMCID: PMC8658017 DOI: 10.3390/ijms222312920] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 12/30/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative inflammatory condition of the joint cartilage that currently affects approximately 58 million adults in the world. It is characterized by pain, stiffness, and a reduced range of motion with regard to the arthritic joints. These symptoms can cause in the long term a greater risk of overweight/obesity, diabetes mellitus, and falls and fractures. Although the current guidelines for the treatment of OA suggest, as the gold standard for this condition, pharmacological treatment characterized by non-steroidal anti-inflammatory drugs (NSAID), opioids, and cyclooxygenase (COX)-2-specific drugs, a great interest has been applied to nutraceutical supplements, which include a heterogeneous class of molecules with great potential to reduce inflammation, oxidative stress, pain, and joint stiffness and improve cartilage formation. The purpose of this review is to describe the potential application of nutraceuticals in OA, highlighting its molecular mechanisms of actions and data of efficacy and safety (when available).
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Hussain SM, Wang Y, Heath AK, Giles GG, English DR, Eyles DW, Williamson EJ, Graves SE, Wluka AE, Cicuttini FM. Association between circulating 25-hydroxyvitamin D concentrations and hip replacement for osteoarthritis: a prospective cohort study. BMC Musculoskelet Disord 2021; 22:887. [PMID: 34666727 PMCID: PMC8524987 DOI: 10.1186/s12891-021-04779-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the association between circulating 25(OH)D concentrations and incidence of total hip replacement for osteoarthritis in a prospective cohort study. METHODS This study examined a random sample of 2651 participants in the Melbourne Collaborative Cohort Study who had 25(OH)D concentrations measured from dried blood spots collected in 1990-1994. Participants who underwent total hip replacement for osteoarthritis between January 2001 and December 2018 were identified by linking the cohort records to the Australian Orthopaedic Association National Joint Replacement Registry. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of total hip replacement for osteoarthritis in relation to 25(OH)D concentrations, adjusted for confounders. RESULTS Eighty-six men and eighty-seven women had a total hip replacement for osteoarthritis. Compared with men in the lowest (1st) quartile of 25(OH)D concentration, the HR for total hip replacement was 2.32 (95% CI 1.05, 5.13) for those in the 2nd quartile, 2.77 (95% CI 1.28, 6.00) for those in the 3rd quartile, and 1.73 (95% CI 0.75, 4.02) for those in the highest quartile of 25(OH)D concentrations (p for trend 0.02). There was little evidence of an association in women. CONCLUSIONS Higher circulating 25(OH)D concentrations were associated with an increased risk of total hip replacement for osteoarthritis in men but not in women. Although the underlying mechanism warrants further investigation, our findings highlight the need to determine the optimal levels of circulating 25(OH)D to reduce the risk of hip osteoarthritis.
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Affiliation(s)
- Sultana Monira Hussain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Graham G Giles
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3053, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
| | - Dallas R English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3053, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
| | - Darryl W Eyles
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, 4072, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia
| | - Elizabeth J Williamson
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Stephen E Graves
- Department of Surgery, Flinders University, Bedford Park, SA, 5042, Australia
- Australian Orthopaedic Association National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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A Mendelian randomization study on the role of serum parathyroid hormone and 25-hydroxyvitamin D in osteoarthritis. Osteoarthritis Cartilage 2021; 29:1282-1290. [PMID: 33975017 DOI: 10.1016/j.joca.2021.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Serum parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] have been demonstrated to be associated with pathogenesis and progression of osteoarthritis (OA). This study aimed to determine the potential causal relationship between serum PTH and 25(OH)D levels and risk of OA. DESIGN We applied the two-sample Mendelian randomization (MR) approach to estimate the causal roles of serum PTH and 25(OH)D on OA. The instrumental variables for serum PTH and 25(OH)D were derived from two large genome-wide association studies (GWAS), which included 29,155 and 79,366 individuals, respectively. Summary-level data for overall, hip and knee OA were extracted from a GWAS meta-analysis, including 455,221 individuals. All participants included in this study were from the European population. RESULTS An inverse association was observed between serum PTH levels and risk of OA (random-effects: Effect = 0.71; 95% CI: 0.54 to 0.92; fixed-effects: Effect = 0.71; 95% CI: 0.61 to 0.82). Stratified by site, serum PTH levels were found to be inversely associated with knee OA (random-effects: Effect = 0.53; 95% CI: 0.41 to 0.68; fixed-effects: Effect = 0.53; 95% CI: 0.41 to 0.68). However, there was no evidence of the causal effect of serum 25(OH)D levels on OA. CONCLUSIONS The present study indicates an inverse causal relationship between serum PTH concentrations and development of OA. Moreover, a site-specific association was also observed between serum PTH levels and knee OA. The potential mechanisms by which serum PTH affects OA need to be further investigated.
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Pradelli L, Sinigaglia T, Migliore A, Checchia GA, Franceschi F, Frediani B, Iannone F, Romanini E. Non-Surgical Treatment of Knee Osteoarthritis: Multidisciplinary Italian Consensus on Best Practice. Ther Clin Risk Manag 2021; 17:507-530. [PMID: 34093017 PMCID: PMC8170371 DOI: 10.2147/tcrm.s288196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/25/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of this document is to provide a set of indications on the national best practice management of knee osteoarthritis based on an analysis of the existing literature and the contribution of experts in the field. During the first phase of the project, in agreement with the multidisciplinary panel of experts, the main guidelines on the topic were selected. Each guideline was assessed through the AGREEII system to identify their strong/weak points and a summary of the recommendations contained in the various documents was drawn up. The panel drew up a list of therapeutic options to be included in the document and some of these topics were selected for in-depth analysis and review. The search strategy for the required literature reviews was constructed using the PICOS approach. The results obtained from the literature reviews, the in-depth analyses conducted by the members of the scientific societies involved and the analysis of the existing guidelines enabled an initial draft of the consensus document to be elaborated. This document was examined at the consensus conference held on 28 May 2019, in the presence of a multidisciplinary group consisting of members of the various scientific societies involved. Single recommendations were discussed in work groups with a view to combining the indications given by the literature examined with the experience of the specialists involved. The recommendations discussed were then put to the vote in a plenary assembly. The final document contains 26 practice recommendations which leading specialists involved in the management of knee OA in Italy agree upon.
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Affiliation(s)
| | | | | | | | | | | | | | - Emilio Romanini
- RomaPro Center for Hip and Knee Arthroplasty, polo Sanitario San Feliciano, Rome, Italy
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Park H, Park CY. Risk of Osteoarthritis is Positively Associated with Vitamin D Status, but Not Bone Mineral Density, in Older Adults in the United States. J Am Coll Nutr 2021; 40:562-570. [PMID: 34032559 DOI: 10.1080/07315724.2020.1787907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We examined the risk of osteoarthritis (OA) according to vitamin D status and bone mineral density (BMD) using a cross-sectional nationally representative database. METHODS National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2010 were used to assess the relationship between OA and vitamin D status in adults aged ≥40 years (n = 2934). NHANES data from 2005 to 2010 and 2013 to 2014 were analyzed to investigate the association between OA and BMD (n = 5949). Vitamin D status was categorized as serum 25-hydroxyvitamin D (25OHD) <20 ng/mL or ≥20 ng/mL. Bone health was classified according to T-score (normal, osteopenia, or osteoporosis) and BMD tertile. Risk of OA was assessed using logistic regression and adjusted for covariates. RESULTS Participants with serum 25OHD <20 ng/mL had a 37% lower risk of OA (95% confidence interval (CI) [0.39-0.99], P = 0.046). When stratified by sex, the odds ratio for OA in men with lower vitamin D status was 0.35 (95% CI [0.15-0.81], P = 0.02). No association was found in women. The risk for OA did not differ according to BMD tertile or T-score classification. CONCLUSIONS The risk of OA is lower in older men with 25OHD less than 20 ng/mL but not in older women. Bone mineral density is not associated with OA risk in older adults in the United States.
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Affiliation(s)
- Hansaem Park
- Department of Food and Nutrition, Chonnam National University, Gwangju, Republic of Korea
| | - Clara Yongjoo Park
- Department of Food and Nutrition, Chonnam National University, Gwangju, Republic of Korea
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Zhao ZX, He Y, Peng LH, Luo X, Liu M, He CS, Chen J. Does vitamin D improve symptomatic and structural outcomes in knee osteoarthritis? A systematic review and meta-analysis. Aging Clin Exp Res 2021; 33:2393-2403. [PMID: 33783714 DOI: 10.1007/s40520-020-01778-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To provide evidence on the effects of vitamin D supplementation on knee osteoarthritis (KOA) and new targets for clinical prevention and treatment of KOA. METHOD The PubMed, Embase, Web of science, Wanfang, CNKI and SinoMed databases were retrieved to investigate the effects of vitamin D supplementation on patients with KOA. The search time was from databases establishment to 15 November 2020. RevMan5.3 software was used for meta-analysis. The results were expressed as standardized mean difference (SMD) with 95% confidence interval (CI) or weighted mean difference (WMD) with 95% confidence interval (CI). RESULTS A total of 1599 patients with osteoarthritis of the knee were included in the study, which involved six articles. The results of the meta-analysis showed that vitamin D supplementation is statistically significant for WOMAC score (SMD = - 0.67, 95% CI - 1.23 to - 0.12) in patients with KOA, including WOMAC pain score (SMD = - 0.32, 95% CI - 0.63 to - 0.02), function score (SMD = - 0.34, 95% CI - 0.60 to - 0.08) and stiffness score (SMD = - 0.13, 95% CI - 0.26 to - 0.01). In subgroup analysis, vitamin D supplementation less than 2000 IU was statistically significant for the reduction of stiffness score (SMD = - 0.22, 95% CI - 0.40 to - 0.04). Vitamin D supplements can reduce synovial fluid volume progression in patients with KOA (SMD = - 0.20, 95% CI - 0.39 to - 0.02). There was no statistical significance in improving tibia cartilage volume (SMD = 0.12, 95% CI - 0.05 to 0.29), joint space width (SMD = - 0.10, 95% CI - 0.26 to 0.05) and bone marrow lesions (SMD = 0.03, 95% CI - 0.26 to 0.31). CONCLUSION Vitamin D supplements can improve WOMAC pain and function in patients with KOA. But there is a lack of strong evidence that vitamin D supplementation can prevent structural progression in patients with KOA.
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Affiliation(s)
- Zi-Xia Zhao
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Yue He
- Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Li-Hui Peng
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Xiao Luo
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Mao Liu
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Cheng-Song He
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Jie Chen
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China.
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Myszka A, Piontek J, Tomczyk J, Lisowska-Gaczorek A, Zalewska M. Relationships between osteoarthritic changes (osteophytes, porosity, eburnation) based on historical skeletal material. Ann Hum Biol 2020; 47:263-272. [PMID: 32295434 DOI: 10.1080/03014460.2020.1741682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Three main diagnostic types of osteoarthritic changes are distinguished in clinical and anthropological literature: osteophytes, porosity, and eburnation. The nature of the relationship between these changes and how lesions progress over time is still unclear.Aim: The aim of the present study is the analysis of the relationships between osteophytes, porosity, and eburnation based on skeletal material.Subjects and methods: The analysis employed the skeletal collection from Cedynia (199 individuals) from tenth to fourteenth-century Poland. Marginal osteophytes (OP), porosity (POR), and eburnation (EB) were examined on a shoulder, elbow, wrist, hip, knee, and ankle.Results: Osteophytes and porosity occurred independently of each other. Combinations of osteophytes and porosity (OP + POR) and osteophytes, porosity, and eburnation (OP + POR + EB) were rarely observed. Combinations of osteophytes and eburnation (OP + EB) or porosity and eburnation (POR + EB) were not found. There was a significant correlation between osteophytes and porosity in the scapula, proximal end of the ulna and proximal end of the femur. Osteophytes and eburnation were correlated at the distal end of the ulna. Porosity and eburnation were correlated at the distal end of the radius and distal end of the ulna. When all joints were considered together, all the types of osteoarthritic changes were correlated. However, the relationship between osteophytes and eburnation and between porosity and eburnation was only slightly significant. Osteophytes preceded porosity, but there were a few cases where more developed porosity accompanied less developed osteophytes.Conclusions: The findings indicate that correlations between osteoarthritic changes are weak, albeit statistically significant and further studies of the relationship between changes are necessary.
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Affiliation(s)
- Anna Myszka
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Janusz Piontek
- Institute of Anthropology, Adam Mickiewicz University in Poznań, Poznań, Poland
| | - Jacek Tomczyk
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | | | - Marta Zalewska
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
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Yu Y, Liu D, Feng D, Zhao J. Association between Vitamin D and Knee Osteoarthritis: A PRISMA-Compliant Meta-analysis. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2020; 159:281-287. [PMID: 32150754 DOI: 10.1055/a-1098-8815] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous investigations showed inconsistent results for associations between vitamin D and knee osteoarthritis (OA). The present study aimed to make a systematic review and meta-analysis for the association between vitamin D and knee OA. METHODS We systematically searched for articles published in the databases PubMed, Web of Science, EMBASE, Medline, and Google Scholar through July 2019. All statistical analyses were made using STATA 12.0 software. The Q test and I2 were applied to examine heterogeneities between studies. RESULTS The study indicated that there were no significant associations between serum levels of 25-hydroxy (OH) vitamin D and prevalence, incidence or progression of knee radiographic OA (ROA), and joint space narrowing (JSN). However, a subgroup study showed significant associations of low vitamin D levels with the progression of knee OA. Additionally, the present study showed no significant effect of vitamin D supplementation on knee OA. CONCLUSIONS The results do not support that serum levels of 25(OH) vitamin D are associated with the risks of knee OA, except perhaps with progression of knee OA. In addition, vitamin D supplementation may not have a clinically significant effect on pain control or structure (tibial cartilage volume and JSW) progression in patients with knee OA. Longer-term clinical trials are essential to explore the effect of vitamin D supplementation on knee OA.
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Affiliation(s)
- Yinghao Yu
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Dongcheng Liu
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Dehong Feng
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Jijun Zhao
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
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Zhang Y, Francis EC, Xia T, Kemper K, Williams J, Chen L. Adherence to DASH dietary pattern is inversely associated with osteoarthritis in Americans. Int J Food Sci Nutr 2020; 71:750-756. [DOI: 10.1080/09637486.2020.1722075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Yurong Zhang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
| | - Ellen C. Francis
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Tong Xia
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Karen Kemper
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Joel Williams
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Liwei Chen
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
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Li S, Niu G, Dong XN, Liu Z, Song C, Leng H. Vitamin D Inhibits Activities of Metalloproteinase-9/-13 in Articular Cartilage In Vivo and In Vitro. J Nutr Sci Vitaminol (Tokyo) 2019; 65:107-112. [PMID: 31061278 DOI: 10.3177/jnsv.65.107] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Low levels of serum vitamin D have been shown to accelerate progression of osteoarthritis. However, the role of vitamin D in articular cartilage degradation and osteoarthritis development is still unclear. This study investigated the effects of vitamin D on articular cartilage degradation by testing matrix metalloproteinase (MMPs) activities in articular cartilage using the rat vitamin D deficiency model at the animal level and rat articular chondrocytes at the cell level. The in vivo study showed vitamin D deficiency increased the expressions of MMP-9 and MMP-13 in rat articular cartilage, and the increase was inhibited by 1α,25(OH)2D3 supplementation. The increased production of MMP-9 and MMP-13 in the articular chondrocytes induced by tumor necrosis factor-α (TNF-α) or phorbol-12-myristate-13-acetate (PMA) was significantly suppressed by concomitant treatment with 1α,25(OH)2D3 in vitro. The increased level of C-telopeptide of type II collagen (CTX-II) induced by TNF-α or PMA was also significantly suppressed by concomitant treatment with 1α,25(OH)2D3 in vitro. Thus, vitamin D intake may inhibit MMP activities and take part in the process of articular cartilage degeneration and osteoarthritis progression.
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Affiliation(s)
- Siwei Li
- Department of Orthopedics, Peking University Third Hospital.,Department of Orthopedics, Ansteel Group Hospital
| | - Guodong Niu
- Department of Orthopedics, Peking University Third Hospital.,Beijing Key Lab of Spine Diseases
| | - X Neil Dong
- Department of Health and Kinesiology, The University of Texas at Tyler
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital
| | - Chunli Song
- Department of Orthopedics, Ansteel Group Hospital
| | - Huijie Leng
- Department of Orthopedics, Peking University Third Hospital
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Ferre IM, Roof MA, Anoushiravani AA, Wasterlain AS, Lajam CM. Understanding the Observed Sex Discrepancy in the Prevalence of Osteoarthritis. JBJS Rev 2019; 7:e8. [PMID: 31567717 DOI: 10.2106/jbjs.rvw.18.00182] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Isabella M Ferre
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | - Mackenzie A Roof
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | | | - Amy S Wasterlain
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
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18
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Heidari B, Babaei M. Therapeutic and Preventive Potential of Vitamin D Supplementation in Knee Osteoarthritis. ACR Open Rheumatol 2019; 1:318-326. [PMID: 31777808 PMCID: PMC6857993 DOI: 10.1002/acr2.1042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 05/15/2019] [Indexed: 12/14/2022] Open
Abstract
Objective Vitamin D deficiency is linked with pain, function, and radiographic progression of knee osteoarthritis (KOA), but the results of studies addressing the association and effect of vitamin D supplementation for pain, function, quality of life, radiographic disease, and progression are inconsistent. The aim of this review is to determine the therapeutic and preventive potential of vitamin D supplementation in KOA. Method Eligible pertinent English language studies published in 2000 and thereafter in Medline/PubMed, Scopus, and Google Scholar were selected by using keywords that include “knee osteoarthritis,” “vitamin D supplementation,” “pain,” “structural abnormalities,” “treatment,” and “progression.” Results The results of a few studies showed a preventive potential for vitamin D in KOA, but most of the randomized clinical trials that assessed the therapeutic efficacy of vitamin D supplementation in KOA found no clear therapeutic effect, with the exception of one study that found a small but significant effect of vitamin D on pain and knee function. Nonetheless, the results of a few longitudinal studies as well as systematic reviews are promising and thus encourage further studies. Inconsistent results on the effect of vitamin D on KOA may be attributed to factors such as severity of KOA, baseline level of serum vitamin D, duration of treatment, and vitamin D dosages. Conclusion Given the multiple skeletal and extraskeletal benefits of vitamin D supplementation in elderly people, the issue of vitamin D supplementation in KOA requires further study to elucidate the dosage and duration of treatment that provides the most effective therapeutic effect.
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Park CY. Vitamin D in the Prevention and Treatment of Osteoarthritis: From Clinical Interventions to Cellular Evidence. Nutrients 2019; 11:E243. [PMID: 30678273 PMCID: PMC6413222 DOI: 10.3390/nu11020243] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/03/2019] [Accepted: 01/06/2019] [Indexed: 12/11/2022] Open
Abstract
Older adults are recommended vitamin D to prevent fractures. Though this population is also at risk of osteoarthritis (OA), the effect of vitamin D on OA is unclear and may differ by disease state. The relationship between vitamin D and OA during OA initiation and progression were considered in this narrative review of in vivo and in vitro studies. Regarding OA initiation in humans, the small number of published observational studies suggest a lack of association between induction of OA and vitamin D status. Most randomized controlled trials were performed in White OA patients with relatively high vitamin D status (>50 nmol/L). These studies found no benefit of vitamin D supplementation on OA progression. However, subset analyses and one randomized controlled pilot trial indicated that vitamin D supplementation may alleviate joint pain in OA patients with low vitamin D status (<50 nmol/L). As the etiology of OA is recently being more fully uncovered, better animal and cell models are needed. According to currently available clinical results, evidence is lacking to set a vitamin D level to prevent OA, and increasing vitamin D status above 50 nmol/L does not seem to benefit OA patients.
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Zhang W, Robertson WB, Zhao J, Chen W, Xu J. Emerging Trend in the Pharmacotherapy of Osteoarthritis. Front Endocrinol (Lausanne) 2019; 10:431. [PMID: 31312184 PMCID: PMC6614338 DOI: 10.3389/fendo.2019.00431] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 06/14/2019] [Indexed: 12/25/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disorder and one of the most prevalent diseases among the elderly population. Due to the limited spontaneous healing capacity of articular cartilage, it still remains challenging to find satisfactory treatment for OA. This review covers the emerging trends of pharmacologic therapies for OA such as traditional OA drugs (acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, serotonin-norepinephrine reuptake inhibitors (SNRIs), intra-articular injections of corticosteroids, and dietary supplements), which are effective in pain relief but not in reversing damage, and are frequently associated with adverse events. Alternatively, disease-modifying drugs provide promising alternatives for the management of OA. The development of these emerging OA therapeutic agents requires a comprehensive understanding of the pathophysiology of OA progression. The process of cartilage anabolism/catabolism, subchondral bone remodeling and synovial inflammation are identified as potential targets. These emerging OA drugs such as bone morphogenetic protein-7 (BMP-7), fibroblast growth factor-18 (FGF-18), human serum albumin (HSA), interleukin-1 (IL-1) inhibitor, β-Nerve growth factor (β-NGF) antibody, matrix extracellular phosphoglycoprotein (MEPE) and inverse agonist of retinoic acid-related orphan receptor alpha (RORα) etc. have shown potential to modify progression of OA with minimal adverse effects. However, large-scale randomized controlled trials (RCTs) are needed to investigate the safety and efficacy before translation from bench to bedside.
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Affiliation(s)
- Wei Zhang
- School of Medicine, Southeast University, Nanjing, China
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - William Brett Robertson
- Australian Institute of Robotic Orthopaedics, Perth, WA, Australia
- School of Surgery, The University of Western Australia, Perth, WA, Australia
- School of Science, Faculty of Science and Engineering, Curtin University, Perth, WA, Australia
- Department of Materials Science and Engineering, College of Engineering, University of North Texas, Denton, TX, United States
| | - Jinmin Zhao
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Weiwei Chen
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Nanning, China
- *Correspondence: Weiwei Chen
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
- Jiake Xu
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Abstract
The increase in global lifespan has in turn increased the prevalence of osteoarthritis which is now the most common type of arthritis. Cartilage tissue located on articular joints erodes during osteoarthritis which causes pain and may lead to a crippling loss of function in patients. The pathophysiology of osteoarthritis has been understudied and currently no disease modifying treatments exist. The only current end-point treatment remains joint replacement surgery. The primary risk factor for osteoarthritis is age. Clinical and basic research is now focused on understanding the ageing process of cartilage and its role in osteoarthritis. This chapter will outline the physiology of cartilage tissue, the clinical presentation and treatment options for the disease and the cellular ageing processes which are involved in the pathophysiology of the disease.
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O'Neill TW, McCabe PS, McBeth J. Update on the epidemiology, risk factors and disease outcomes of osteoarthritis. Best Pract Res Clin Rheumatol 2018; 32:312-326. [PMID: 30527434 DOI: 10.1016/j.berh.2018.10.007] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 10/12/2018] [Accepted: 10/12/2018] [Indexed: 12/20/2022]
Abstract
Osteoarthritis (OA) is the most frequent form of arthritis and a leading cause of pain and disability worldwide. OA can affect any synovial joint, although the hip, knee, hand, foot and spine are the most commonly affected sites. Knowledge about the occurrence and risk factors for OA is important to define the clinical and public health burden of the disease to understand mechanisms of disease occurrence and may also help to inform the development of population-wide prevention strategies. In this article, we review the occurrence and risk factors for OA and also consider patient-reported outcome measures that have been used for the assessment of the disease.
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Affiliation(s)
- Terence W O'Neill
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Paul S McCabe
- Royal Oldham Hospital, Pennine Acute NHS Trust, Rochdale Rd, Oldham OL1 2JH, UK
| | - John McBeth
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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Withanage ND, Perera S, Peiris H, Athiththan LV. Serum 25-hydroxyvitamin D, serum calcium and vitamin D receptor (VDR) polymorphisms in a selected population with lumbar disc herniation-A case control study. PLoS One 2018; 13:e0205841. [PMID: 30356314 PMCID: PMC6200232 DOI: 10.1371/journal.pone.0205841] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/02/2018] [Indexed: 12/03/2022] Open
Abstract
Background Association of Vitamin D receptor (VDR) polymorphisms with lumbar disc herniation (LDH) have been identified in several ethnic groups globally. Despite abundant sunlight, vitamin D deficiency is reported in many tropical countries. As vitamin D is a key modulator for intestinal calcium absorption, low vitamin D could contribute to low serum calcium leading to abnormalities of skeletal homeostasis. Therefore, present study was aimed to study the association of serum 25-hydroxyvitamin D (25(OH)D), serum calcium and VDR polymorphisms in a selected Sri Lankan population. Materials & methods A case control study was conducted in 119 participants (cases = 51: controls = 68). Serum 25(OH)D levels were measured using ELISA. The VDR polymorphisms (Fok I and Taq I) were detected by polymerase chain reaction followed by restriction fragment length polymorphism. Results Findings indicated a significantly low (p = 0.000) 25(OH)D levels in cases (18.7±3.7 ng/mL) compared to controls(25.5±9.8 ng/mL) while 25(OH)D in both groups were below the reference range. Mean serum calcium levels in both groups were within normal reference range and was not significantly different among groups. Statistically significant association was not observed between VDR Fok I polymorphisms among cases and controls. Although Fok I polymorphism genotypes were in Hardy-Weinberg equilibrium (HWE), Taq I genotypes in controls violated HWE. Conclusion Present study confirms that insufficient serum 25(OH)D levels in cases have major contribution to LDH. VDR Fok I polymorphisms did not have any significant association with LDH in Sri Lankan ethnicity.
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Affiliation(s)
- Niroshima Dedunu Withanage
- Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugogoda, Sri Lanka
- * E-mail:
| | | | - Hemantha Peiris
- Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Diao N, Yang B, Yu F. Effect of vitamin D supplementation on knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. Clin Biochem 2017; 50:1312-1316. [DOI: 10.1016/j.clinbiochem.2017.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/30/2017] [Accepted: 09/03/2017] [Indexed: 10/18/2022]
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Gao XR, Chen YS, Deng W. The effect of vitamin D supplementation on knee osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg 2017; 46:14-20. [PMID: 28797917 DOI: 10.1016/j.ijsu.2017.08.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/02/2017] [Accepted: 08/03/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE We conducted a meta-analysis of RCTs to evaluate the effects of vitamin D supplementation in the prevention of symptom and structural progression of knee OA. METHODS PubMed, Embase, and Web of Science databases were searched to identify relevant studies. Outcomes included Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, function, stiffness, tibial cartilage volume, and serum vitamin D3 levels, and adverse events. Results were expressed as weight mean difference (WMD) with 95% confidence interval (CI), and risk ratio (RR) with 95%CI. RESULTS Four RCTs involving 1136 patients were included in this study. Pooled estimates suggested that vitamin D supplementation was associated with a significant reduction in WOMAC pain, and WOMAC function, but not in WOMAC stiffness. Vitamin D supplementation increased the serum vitamin D3 level, but had no effect on tibial cartilage volume. Subgroup analysis showed that, a daily supplement of more than 2000 IU vitamin D significantly decreased the WOMAC pain and WOMAC function. There was no significant difference in incidence of adverse events between the vitamin D and placebo groups. CONCLUSION Vitamin D supplementation was effective in improving the WOMAC pain and function in patients with knee OA. However, it had no beneficial effect on the prevention of tibial cartilage loss. Therefore, there is currently a lack of evidence to support the use of vitamin D supplementation in preventing the progression of knee OA.
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Affiliation(s)
- Xu-Ren Gao
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China.
| | - Ye-Shuai Chen
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Wei Deng
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
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Low Skeletal Muscle Mass in the Lower Limbs Is Independently Associated to Knee Osteoarthritis. PLoS One 2016; 11:e0166385. [PMID: 27832208 PMCID: PMC5104343 DOI: 10.1371/journal.pone.0166385] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/27/2016] [Indexed: 12/22/2022] Open
Abstract
Objectives It has been reported that low skeletal muscle mass correlates with knee osteoarthritis in obese individuals. This study aimed to investigate whether lower limb skeletal muscle mass is independently associated with knee osteoarthritis in the general population. Materials and Methods This cross-sectional study used public data from the Fourth and Fifth Korean National Health and Nutrition Examination Survey. Subjects included 4924 community-dwelling adults aged ≥50 years (821 subjects with knee osteoarthritis and 4,103 controls). Skeletal muscle mass index (SMI) was calculated from the appendicular skeletal muscle mass measured by dual energy X-ray absorptiometry. Independent effects of total and lower limb SMI values on knee osteoarthritis were determined using odds ratios (OR) adjusted for age, sex, obesity, total femur bone mineral density, serum vitamin D level, diabetes mellitus status, and physical activity on multivariate logistic regression analysis. Results The adjusted logistic regression model revealed that older age, female sex, and obesity were significantly associated with knee osteoarthritis. A higher serum vitamin D level was also positively correlated with knee osteoarthritis (OR, 1.015; 95% CI, 1.003–1.027; P = 0.010). Although total SMI was not significantly associated with knee osteoarthritis (OR, 0.976; 95% CI, 0.946–1.007; P = 0.127), a low lower limb SMI had an independent effect on knee osteoarthritis (OR, 0.941; 95% CI, 0.900–0.983; P = 0.006). Conclusions Low skeletal muscle mass in the lower limbs but not in the whole body was independently associated with knee osteoarthritis.
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Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther 2016; 33:1921-1946. [PMID: 27671326 PMCID: PMC5083776 DOI: 10.1007/s12325-016-0409-3] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Indexed: 01/05/2023]
Abstract
Highly prevalent among the elderly, hip osteoarthritis (OA) carries a heavy burden of disease. Guidelines for the management of hip OA are often extrapolated from knee OA research, despite clear differences in the etiopathogenesis and response to treatments of OA at these sites. We propose that hip OA requires specific attention separate from other OA phenotypes. Our understanding of the etiopathogenesis of hip OA has seen significant advance over the last 15 years, since Ganz and colleagues proposed femoroacetabular impingement (FAI) as an important etiological factor. This narrative review summarizes the current understanding of the etiopathogenesis of hip OA and identifies areas requiring further research. Therapeutic approaches for hip OA are considered in light of the condition’s etiopathogenesis. The evidence for currently adopted management strategies is considered, especially those approaches that may have disease-modifying potential. We propose that shifting the focus of hip OA research and public health intervention to primary prevention and early detection may greatly improve the current management paradigm.
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Affiliation(s)
- Nicholas J Murphy
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia
| | - Jillian P Eyles
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia.
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Arden NK, Cro S, Sheard S, Doré CJ, Bara A, Tebbs SA, Hunter DJ, James S, Cooper C, O’Neill TW, Macgregor A, Birrell F, Keen R. The effect of vitamin D supplementation on knee osteoarthritis, the VIDEO study: a randomised controlled trial. Osteoarthritis Cartilage 2016; 24:1858-1866. [PMID: 27264058 PMCID: PMC5045720 DOI: 10.1016/j.joca.2016.05.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 05/19/2016] [Accepted: 05/23/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Epidemiological data suggest low serum 25-hydroxyvitamin D3 (25-OH-D3) levels are associated with radiological progression of knee osteoarthritis (OA). This study aimed to assess whether vitamin D supplementation can slow the rate of progression. METHOD A 3-year, double-blind, randomised, placebo-controlled trial of 474 patients aged over 50 with radiographically evident knee OA comparing 800 IU cholecalciferol daily with placebo. Primary outcome was difference in rate of medial joint space narrowing (JSN). Secondary outcomes included lateral JSN, Kellgren & Lawrence grade, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function, stiffness and the Get up and Go test. RESULTS Vitamin D supplementation increased 25-OH-D3 from an average of 20.7 (standard deviation (SD) 8.9) μg/L to 30.4 (SD 7.7) μg/L, compared to 20.7 (SD 8.1) μg/L and 20.3 (SD 8.1) μg/L in the placebo group. There was no significant difference in the rate of JSN over 3 years in the medial compartment of the index knee between the treatment group (average -0.01 mm/year) and placebo group (-0.08 mm/year), average difference 0.08 mm/year (95% confidence interval (CI) [-0.14-0.29], P = 0.49). No significant interaction was found between baseline vitamin D levels and treatment effect. There were no significant differences for any of the secondary outcome measures. CONCLUSION Vitamin D supplementation did not slow the rate of JSN or lead to reduced pain, stiffness or functional loss over a 3-year period. On the basis of these findings we consider that vitamin D supplementation has no role in the management of knee OA.
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Affiliation(s)
- Nigel K Arden
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK,Arthritis Research UK Centre of Excellence for Sport, Injury, and Osteoarthritis
| | - Suzie Cro
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - Sally Sheard
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
| | - Caroline J Doré
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - Anna Bara
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - Susan A Tebbs
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - David J Hunter
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK,Chromatic Innovation Limited, Leamington Spa, UK
| | | | - Cyrus Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Terence W O’Neill
- Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | - Richard Keen
- Royal National Orthopaedic Hospital, Stanmore, Middlesex,Institute of Orthopaedics and Musculoskeletal Science, University College London, London
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Low Levels of Vitamin D have a Deleterious Effect on the Articular Cartilage in a Rat Model. HSS J 2016; 12:150-7. [PMID: 27385944 PMCID: PMC4916094 DOI: 10.1007/s11420-016-9492-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/14/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vitamin D appears to play an important role in bone and cartilage metabolism since its receptors are widely found in human articular chondrocytes. Thus, effects of variation of vitamin D may directly impact cartilage and bone biology. QUESTIONS/PURPOSES The aims of this study are to compare (1) articular cartilage structure and composition and (2) trabecular and cortical bone microstructure in rats with normal versus insufficient vitamin D levels. METHODS Twenty-five mature, male Sprague-Dawley rats were allocated to two groups: (1) control arm (vitamin D replete-12 rats) and (2) an experimental arm (vitamin D deficient-13 rats). Vitamin D deficiency was induced using a vitamin D-deficient diet and UV light restriction. Rats were sacrificed after 4 weeks vitamin D deficiency was confirmed. The right knee was harvested for analysis of both the medial (MFC) and lateral femoral condyles (LFC). A region of interest was established on both condyles to correlate subchondral bone architecture and the overlying cartilage. Histological analysis was performed and graded using the modified Mankin score. Subchondral and cortical bony architecture was evaluated with micro-CT. RESULTS After 4 weeks, the vitamin D-deficient group had statistically significant changes in cartilage structure in both the MFC and LFC [1.55 ± 0.6 vs. 4.23 ± 4.1 (p = 0.035) and 1.55 ± 0.6 vs. 3.53 ± 2.4 (p = 0.009), respectively]. Micro-CT analysis revealed no correlation between subchondral bone values and the overlying cartilage Mankin score (p = 0.460). No significant difference was evident between the subchondral bone of the control and study group. CONCLUSIONS Low levels of vitamin D have a deleterious effect on the cartilage. Given the high prevalence of vitamin D deficiency in the general population, these findings raise important questions about the potential role of vitamin D in articular cartilage health.
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Bergink AP, Zillikens MC, Van Leeuwen JP, Hofman A, Uitterlinden AG, van Meurs JB. 25-Hydroxyvitamin D and osteoarthritis: A meta-analysis including new data. Semin Arthritis Rheum 2016; 45:539-46. [DOI: 10.1016/j.semarthrit.2015.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 09/28/2015] [Accepted: 09/28/2015] [Indexed: 12/15/2022]
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Hussain SM, Daly RM, Wang Y, Shaw JE, Magliano DJ, Graves S, Ebeling PR, Wluka AE, Cicuttini FM. Association between serum concentration of 25-hydroxyvitamin D and the risk of hip arthroplasty for osteoarthritis: result from a prospective cohort study. Osteoarthritis Cartilage 2015; 23:2134-2140. [PMID: 26093211 DOI: 10.1016/j.joca.2015.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 06/03/2015] [Accepted: 06/09/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVES There is ongoing debate regarding the optimal serum concentrations of 25-hydroxy-vitamin D for musculoskeletal health, including osteoarthritis (OA). The aim of this prospective cohort study was to determine whether serum 25-hydroxy-vitamin D concentrations were associated with the risk of hip arthroplasty for OA. DESIGN This study examined 9135 participants from the Australian Diabetes, Obesity and Lifestyle Study who had serum 25-hydroxy-vitamin D measured in 1999-2000 and were aged ≥40 years at the commencement of arthroplasty data collection. The incidence of hip arthroplasty for OA during 2002-2011 was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry. RESULTS Over an average 9.1 (standard deviation (SD) 2.7) years of follow-up, 201 hip arthroplasties for OA were identified (males n = 90; females n = 111). In males, a one-standard-deviation increase in 25-hydroxy-vitamin D was associated with a 25% increased incidence (HR 1.25, 95% CI 1.02-1.56), with a dose response relationship evident by quartiles of 25-hydroxy-vitamin D concentration (P for trend 0.04). These results were independent of age, body mass index (BMI), ethnicity, smoking status, physical activity, season of blood collection, latitude, hypertension and diabetes, area level disadvantage or after excluding those with extreme low 25-hydroxy-vitamin D concentrations. No significant association was observed in women (HR 1.10, 95% CI 0.87, 1.39). CONCLUSIONS Increasing serum 25-hydroxy-vitamin D concentrations were associated with an increased risk of hip arthroplasty for OA in males, while no significant association was observed in females. The mechanism for the association warrants further investigation.
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Affiliation(s)
- S M Hussain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
| | - R M Daly
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; NorthWest Academic Centre, University of Melbourne, Western Health, St. Albans, VIC 3021, Australia.
| | - Y Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
| | - J E Shaw
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
| | - D J Magliano
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
| | - S Graves
- Australian Orthopaedic Association National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, SA 5005, Australia.
| | - P R Ebeling
- Department of Medicine, School of Clinical Science, Monash University, Melbourne, VIC 3168, Australia.
| | - A E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
| | - F M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
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Plotnikoff R, Karunamuni N, Lytvyak E, Penfold C, Schopflocher D, Imayama I, Johnson ST, Raine K. Osteoarthritis prevalence and modifiable factors: a population study. BMC Public Health 2015; 15:1195. [PMID: 26619838 PMCID: PMC4666016 DOI: 10.1186/s12889-015-2529-0] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 11/19/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This study's objectives were to investigate the prevalence of self-reported knee and hip osteoarthritis (OA) stratified by age and sex and to examine the association of modifiable factors with knee and hip OA prevalence. The study was conducted using randomly sampled data gathered from four communities in the province of Alberta, Canada. METHODS A large adult population sample (N = 4733) of individuals ≥18 years were selected. Health-related information was collected through telephone interviews and community measurement clinics for which a sub-sample (N = 1808) attended. Participants self-reported OA during telephone interviews. Clinic interviews further assessed if the diagnosis was made by a health care professional. Statistical analyses compared prevalence of OA between sexes and across age categories. Associations between modifiable factors for OA and the prevalence of knee and hip OA were assessed using binary logistic regression modelling. RESULTS Overall prevalence of self-reported OA in the total sample was 14.8 %, where 10.5 % of individuals reported having knee OA and 8.5 % reported having hip OA. Differences in prevalence were found for males and females across age categories for both knee and hip OA. In terms of modifiable factors, being obese (BMI >30 kg/m2) was significantly associated with the prevalence of knee (OR: 4.37; 95 % CI: 2.08,9.20) and hip (OR: 2.52; 95 % CI: 1.17,5.43) OA. Individuals who stand or walk a lot, but do not carry or lift things during their occupational activities were 2.0 times less likely to have hip OA (OR: 0.50; 95 % CI: 0.26,0.96). Individuals who usually lift or carry light loads or have to climb stairs or hills were 2.2 times less likely to have hip OA (OR: 0.45; 95 % CI: 0.21,0.95). The odds of having hip OA were 1.9 times lower in individuals consuming recommended or higher vitamin C intake (OR: 0.52; 95 % CI: 0.29,0.96). Significant differences in prevalence were found for both males and females across age categories. CONCLUSION The prevalence of knee and hip OA obtained in this study is comparable to other studies. Females have greater knee OA prevalence and a greater proportion of women have mobility limitations as well as hip and knee pain; it is important to target this sub-group.
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Affiliation(s)
- Ronald Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | | | - Ellina Lytvyak
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | - Christopher Penfold
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | | | - Ikuyo Imayama
- Fred Hutchinson Cancer Research Center Seattle, Washington, USA.
| | - Steven T Johnson
- Centre for Nursing and Health Studies, Athabasca University, Athabasca, AB, Canada.
| | - Kim Raine
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
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Veronese N, Maggi S, Noale M, De Rui M, Bolzetta F, Zambon S, Corti MC, Sartori L, Musacchio E, Baggio G, Perissinotto E, Crepaldi G, Manzato E, Sergi G. Serum 25-Hydroxyvitamin D and Osteoarthritis in Older People: The Progetto Veneto Anziani Study. Rejuvenation Res 2015; 18:543-53. [PMID: 26540555 DOI: 10.1089/rej.2015.1671] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Recent work has shown that low 25-hydroxyvitamin D (25OHD) levels are associated with the presence of osteoarthritis (OA), but these studies focused on radiographical changes of OA, investigated only one joint, and did not consider the association with OA-related pain. In this study, we aimed to examine the relationship between 25OHD levels and any presence of OA and pain in a cohort of older people. This study was part of the Progetto Veneto Anziani (Pro.V.A), a population-based cohort study in older people. In this cross-sectional work, we considered 2756 subjects (1102 males and 1654 females) with a mean age of 74.2 ± 7.1 years. OA and OA-related pain were defined using a standardized algorithm investigating disease history, medical documentation, symptoms, and physical examination of the joints. On logistic regression analysis, taking those in the highest 25OHD quartile for reference, those in the lowest quartile had significantly higher odds of OA involving the hands (odds ratio [OR] = 1.26, 95% confidence interval [CI] 1.15-1.38 in the sample as whole; 1.36, 95% CI 1.15-1.60 in men and 1.22, 95% CI 1.09-1.37 in women), and pain (OR = 1.18, 95% CI 1.06-1.32 in the sample as whole; 1.52, 95% CI 1.21-1.90 in men and 1.15, 95% CI 1.03-1.29 in women). Similar results were found for the hip. For the knee, low 25OHD levels were associated with the presence of OA in the sample as a whole, and in women, and with the presence of pain in the sample as a whole. In conclusion, low 25OHD levels are associated with the presence of OA and with OA-related pain, particularly when the hand and hip are involved.
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Affiliation(s)
- Nicola Veronese
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
| | - Stefania Maggi
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Marianna Noale
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Marina De Rui
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
| | - Francesco Bolzetta
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
| | - Sabina Zambon
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy .,3 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Italy
| | - Maria Chiara Corti
- 4 Division of Health Care Planning and Evaluation of the Regione Veneto , Venice, Italy
| | - Leonardo Sartori
- 3 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Italy
| | - Estella Musacchio
- 3 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Italy
| | | | - Egle Perissinotto
- 6 Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padova , Padova, Italy
| | - Gaetano Crepaldi
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Enzo Manzato
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy .,2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Giuseppe Sergi
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
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Barbour KE, Lui LY, Nevitt MC, Murphy LB, Helmick CG, Theis KA, Hochberg MC, Lane NE, Hootman JM, Cauley JA. Hip Osteoarthritis and the Risk of All-Cause and Disease-Specific Mortality in Older Women: A Population-Based Cohort Study. Arthritis Rheumatol 2015; 67:1798-805. [PMID: 25778744 DOI: 10.1002/art.39113] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/10/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine the risk of all-cause and disease-specific mortality among older women with hip osteoarthritis (OA) and to identify mediators in the causal pathway. METHODS Data were from the Study of Osteoporotic Fractures, a US population-based cohort study of 9,704 white women age ≥65 years. The analytic sample included women with hip radiographs at baseline (n = 7,889) and year 8 (n = 5,749). Mortality was confirmed through October 2013 by death certificates and hospital discharge summaries. Radiographic hip OA (RHOA) was defined as a Croft grade of ≥2 in at least 1 hip (definite joint space narrowing or osteophytes plus 1 other radiographic feature). RESULTS The mean ± SD followup time was 16.1 ± 6.2 years. The baseline and year 8 prevalence of RHOA were 8.0% and 11.0%, respectively. The cumulative incidence (proportion of deaths during the study period) was 67.7% for all-cause mortality, 26.3% for cardiovascular disease (CVD) mortality, 11.7% for cancer mortality, 1.9% for gastrointestinal disease mortality, and 27.8% for all other mortality causes. RHOA was associated with an increased risk of all-cause mortality (hazard ratio 1.14 [95% confidence interval 1.05-1.24]) and CVD mortality (hazard ratio 1.24 [95% confidence interval 1.09-1.41]) adjusted for age, body mass index, education, smoking, health status, diabetes, and stroke. These associations were partially explained by the mediating variable of physical function. CONCLUSION RHOA was associated with an increased risk of all-cause and CVD mortality among older white women followed up for 16 years. Dissemination of evidence-based physical activity and self-management interventions for hip OA in community and clinical settings can improve physical function and might also contribute to lower mortality.
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Affiliation(s)
| | - Li-Yung Lui
- California Pacific Medical Center, San Francisco
| | | | | | | | | | | | - Nancy E Lane
- University of California at Davis School of Medicine, Sacramento
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Hoxha F, Tafaj A, Roshi E, Burazeri G. Distribution of Risk Factors in Male and Female Primary Health Care Patients with Osteoarthritis in Albania. Med Arch 2015; 69:145-8. [PMID: 26261379 PMCID: PMC4500384 DOI: 10.5455/medarh.2015.69.145-148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/18/2015] [Indexed: 11/06/2022] Open
Abstract
Aim: We aimed to describe the distribution of the main risk factors among primary health care users diagnosed with osteoarthritis in Albania, a post-communist country in South Eastern Europe. Methods: Our study involved all individuals who were diagnosed with osteoarthritis over a two-year period (January 2013 – December 2014) in several primary health care centers in Tirana, the Albanian capital. On the whole, during this two-year period, 1179 adult individuals were diagnosed with osteoarthritis (521 men aged 60.1±10.6 years and 658 women aged 58.1±9.6 years). According to the criteria of the American College of Rheumatology, the diagnosis of osteoarthritis was based on the history of the disease, physical examination, laboratory findings and radiological findings. Binary logistic regression was used to assess the sex-differences regarding the major risk factors among individuals diagnosed with osteoarthritis. Results: In multivariable-adjusted logistic regression models, female gender was inversely associated with smoking (OR=0.39, 95%CI=0.27-0.56), alcohol intake (OR=0.08, 95%CI=0.06-0.10), overweight but not obesity (OR=0.65, 95%CI=0.46-0.91 and OR=0.74, 95%CI=0.46-1.18, respectively), weight lifting (OR=0.38, 95%CI=0.22-0.66) and heavy physical exercise (OR=0.69, 95%CI=0.46-1.03). Conversely, female gender was positively related to genetic factors (OR=2.17, 95%CI=1.55-3.04) and preexisting inflammatory diseases (OR=1.53, 95%CI=0.93-2.53). Conclusion: This study offers useful evidence about the distribution of the main risk factors for osteoarthritis in adult individuals diagnosed with osteoarthritis in Albania. This information may support health professionals and decision-makers in Albania for evidence-based health planning and policy formulation in order to control the toll of osteoarthritis in this transitional society.
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Affiliation(s)
| | | | | | - Genc Burazeri
- Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Nepple JJ, Thomason KM, An TW, Harris-Hayes M, Clohisy JC. What is the utility of biomarkers for assessing the pathophysiology of hip osteoarthritis? A systematic review. Clin Orthop Relat Res 2015; 473:1683-701. [PMID: 25623593 PMCID: PMC4385333 DOI: 10.1007/s11999-015-4148-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Innovations in biologics offer great promise in the treatment of patients with orthopaedic conditions and in advancing our ability to monitor underlying disease pathophysiology. Our understanding of the pathophysiology of hip osteoarthritis (OA) has improved significantly in the last decade. Femoroacetabular impingement (FAI) and hip dysplasia are increasingly recognized and treated as forms of prearthritic hip disease, yet the inability of radiographic and MR imaging to identify patients before the onset of irreversible articular cartilage injury limits their use for early diagnosis and treatment of patients with these conditions. Molecular biomarkers, as objectively measureable indicators of the pathophysiology of hip OA, have the potential to improve diagnosis, disease staging, and prognosis of hip OA and prearthritic hip disease. Although research into molecular biomarkers of hip OA has been conducted, investigations in prearthritic hip disease have only recently begun. QUESTIONS/PURPOSES The purpose of our review was to assess the use of molecular biomarkers in the pathophysiology of hip OA, including (1) diagnosis; (2) disease staging; and (3) prognosis. We additionally aimed to summarize the available literature investigating the use of biomarkers in (4) prearthritic hip disease, including FAI and hip dysplasia. METHODS We conducted a systematic review of molecular biomarkers associated with hip OA or prearthritic hip disease by searching four major electronic databases for keywords "hip", "osteoarthritis", "biomarker", and all synonyms. The search terms "femoroacetabular impingement" and "hip dysplasia" were also included. The biologic source of biomarkers was limited to serum, plasma, urine, and synovial fluid. The literature search yielded a total of 2740 results. Forty studies met all criteria and were included in our review. Studies were categorized regarding their relevance to (1) diagnosis; (2) disease staging; (3) prognosis; and/or (4) prearthritic hip disease. RESULTS Biomarker studies were characterized as relevant to diagnosis (16 studies), disease staging (15 studies), prognosis (11 studies), and prearthritic hip disease (three studies). Sixteen different biomarkers demonstrated associations relevant to the diagnosis of hip OA, 16 biomarkers demonstrated similar associations for disease staging, and six for prognosis. Six biomarkers seemed to be the most promising, demonstrating associations with hip OA in multiple studies, including: urinary level of type II collagen telopeptide (n = 5 studies), serum cartilage oligomeric protein (n = 4 studies), and serum C-reactive protein (n = 4 studies). Only three studies investigated the role of biomarkers in prearthritic hip disease, including two in FAI and one in unspecified etiology of pain. There were no studies about biomarkers in hip dysplasia. CONCLUSIONS Molecular biomarkers are increasingly investigated for their use in evaluating the pathophysiology of hip OA, but less so for prearthritic hip disease. Several biomarkers have demonstrated significant associations with hip OA across multiple studies. Further validation of these biomarkers is needed to assess their clinical use and potential application to prearthritic hip disease.
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Affiliation(s)
- Jeffrey J Nepple
- Department of Orthopaedic Surgery, Washington University School of Medicine, One Children's Place, Campus Box 8233, 4S60, St Louis, MO, 63110, USA,
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Musumeci G, Aiello FC, Szychlinska MA, Di Rosa M, Castrogiovanni P, Mobasheri A. Osteoarthritis in the XXIst century: risk factors and behaviours that influence disease onset and progression. Int J Mol Sci 2015; 16:6093-112. [PMID: 25785564 PMCID: PMC4394521 DOI: 10.3390/ijms16036093] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/06/2015] [Accepted: 03/12/2015] [Indexed: 12/24/2022] Open
Abstract
Osteoarthritis (OA) is a growing public health problem across the globe, affecting more than half of the over 65 population. In the past, OA was considered a wear and tear disease, leading to the loss of articular cartilage and joint disability. Nowadays, thanks to advancements in molecular biology, OA is believed to be a very complex multifactorial disease. OA is a degenerative disease characterized by “low-grade inflammation” in cartilage and synovium, resulting in the loss of joint structure and progressive deterioration of cartilage. Although the disease can be dependent on genetic and epigenetic factors, sex, ethnicity, and age (cellular senescence, apoptosis and lubricin), it is also associated with obesity and overweight, dietary factors, sedentary lifestyle and sport injuries. The aim of this review is to highlight how certain behaviors, habits and lifestyles may be involved in the onset and progression of OA and to summarize the principal risk factors involved in the development of this complicated joint disorder.
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Affiliation(s)
- Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
| | - Flavia Concetta Aiello
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
| | - Marta Anna Szychlinska
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
| | - Michelino Di Rosa
- Department of Biomedical and Biotechnological Sciences, Pathology Section, School of Medicine, University of Catania, 95123 Catania, Italy.
| | - Paola Castrogiovanni
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
| | - Ali Mobasheri
- The D-BOARD European Consortium for Biomarker Discovery, Department of Veterinary Preclinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK.
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Arthritis Research UK Pain Centre, Medical Research Council and Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK.
- Center of Excellence in Genomic Medicine Research (CEGMR), King Fahd Medical Research Center (KFMRC), King AbdulAziz University, Jeddah 21589, Saudi Arabia.
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Local and systemic risk factors for incidence and progression of osteoarthritis. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Yoshimura N, Muraki S, Oka H, Nakamura K, Kawaguchi H, Tanaka S, Akune T. Serum levels of 25-hydroxyvitamin D and the occurrence of musculoskeletal diseases: a 3-year follow-up to the road study. Osteoporos Int 2015; 26:151-61. [PMID: 25138262 DOI: 10.1007/s00198-014-2844-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 08/06/2014] [Indexed: 12/18/2022]
Abstract
UNLABELLED Assessment of serum 25-hydroxyvitamin D levels in association with the occurrence of musculoskeletal diseases using a population-based cohort study design revealed that serum 25-hydroxyvitamin D levels could predict the occurrence of osteoporosis at the femoral neck within 3 years, but not the occurrence of knee osteoarthritis or lumbar spondylosis. INTRODUCTION The aim of this study is to clarify the association between serum 25-hydroxyvitamin D (25D) levels and occurrence of osteoporosis and osteoarthritis in the general population. METHODS The Research on Osteoarthritis/Osteoporosis Against Disability study, a large-scale population-based cohort study, was performed during 2005-2007. Serum 25D levels were measured in 1,683 participants. Of these, 1,384 individuals (81.9%) completed a second follow-up survey 3 years later. Osteoporosis was defined according to World Health Organization criteria, in which osteoporosis is diagnosed by T-scores of bone mineral density (BMD) that are 2.5 standard deviations (SD) less than normal BMD. Knee osteoarthritis and lumbar spondylosis were defined as Kellgren-Lawrence grade ≥2, using paired X-ray films. Cumulative incidences were determined according to changes in measurements using World Health Organization criteria for osteoporosis or Kellgren-Lawrence grades for osteoarthritis between the baseline and second survey. RESULTS The mean (SD) serum 25D level of the 1,384 participants in both surveys was 23.4 ng/mL (6.5). The annual cumulative incidences of osteoporosis at L2-4 and the femoral neck were 0.76 and 1.83%/year, respectively. The incidences of knee osteoarthritis and lumbar spondylosis were 3.3 and 11.4%/year, respectively. After adjusting for potential associated factors, logistic regression analyses revealed that the odds ratio for the occurrence of femoral neck osteoporosis significantly decreased as serum 25D levels increased (+1 SD; odds ratio 0.67; 95% confidence interval 0.49-0.92; p = 0.014). CONCLUSIONS Higher serum 25D levels may prevent the occurrence of osteoporosis at the femoral neck, but not knee osteoarthritis, lumbar spondylosis, or osteoporosis at L2-4.
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Affiliation(s)
- N Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
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Mabey T, Honsawek S. Role of Vitamin D in Osteoarthritis: Molecular, Cellular, and Clinical Perspectives. Int J Endocrinol 2015; 2015:383918. [PMID: 26229532 PMCID: PMC4503574 DOI: 10.1155/2015/383918] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 05/28/2015] [Accepted: 06/09/2015] [Indexed: 12/11/2022] Open
Abstract
Osteoarthritis is a debilitating and degenerative disease which affects millions of people worldwide. The causes and mechanisms of osteoarthritis remain to be fully understood. Vitamin D has been hypothesised to play essential roles in a number of diseases including osteoarthritis. Many cell types within osteoarthritic joints appear to experience negative effects often at increased sensitivity to vitamin D. These findings contrast clinical research which has identified vitamin D deficiency to have a worryingly high prevalence among osteoarthritis patients. Randomised-controlled trial is considered to be the most rigorous way of determining the effects of vitamin D supplementation on the development of osteoarthritis. Studies into the effects of low vitamin D levels on pain and joint function have to date yielded controversial results. Due to the apparent conflicting effects of vitamin D in knee osteoarthritis, further research is required to fully elucidate its role in the development and progression of the disease as well as assess the efficacy and safety of vitamin D supplementation as a therapeutic strategy.
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Affiliation(s)
- Thomas Mabey
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Sittisak Honsawek
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
- *Sittisak Honsawek:
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Sanghi D, Mishra A, Sharma AC, Raj S, Mishra R, Kumari R, Natu SM, Agarwal S, Srivastava RN. Elucidation of dietary risk factors in osteoarthritis knee—a case-control study. J Am Coll Nutr 2014; 34:15-20. [PMID: 25387081 DOI: 10.1080/07315724.2013.875439] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Nutritional imbalance, combined with endocrine abnormalities, may be involved in the pathogenesis of osteoarthritis (OA). This study was conducted to determine the association of OA with dietary factors, such as quantity and quality of nutrient intake. METHODS This case-control study enrolled 180 knee osteoarthritis (KOA) subjects who met the American College of Rheumatology definition of KOA, with an equal number of matched controls. Outcome measures, such as dietary nutrient intake and its frequency, were recorded using a food frequency questionnaire. RESULTS Compared to controls, cases were older individuals with a higher body mass index (BMI). Physical activity scores were lower in female cases compared to male cases and controls. A significantly higher intake of phosphorus and fat was observed in overall cases (fat in females only). A significantly lower intake of vitamin C and vitamin D was observed in overall cases and the significance of vitamin D persisted on gender-wise bifurcation. On multiple logistic regression analysis, the intake of vitamin D (odds ratio [OR] = 0.79) and vitamin C (OR = 0.97) was inversely associated with the presence of KOA in the observation group, especially in females. Generally, the intake of food servings/day, green leafy vegetables (GLVs), and fats/oils was higher, whereas the intake of fruits, milk/milk products, and meat/poultry was lower in cases compared to controls. CONCLUSION Low intake of vitamin D and vitamin C is a possible risk factor for KOA. Certain food groups, such as fruits, milk/milk products, and meat/poultry are beneficial for KOA. Further studies are needed to elucidate the associations between diet and KOA.
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Affiliation(s)
- Divya Sanghi
- a Department of Orthopaedic Surgery , King George Medical University , Lucknow , INDIA
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Goula T, Kouskoukis A, Drosos G, Tselepis AS, Ververidis A, Valkanis C, Zisimopoulos A, Kazakos K. Vitamin D status in patients with knee or hip osteoarthritis in a Mediterranean country. J Orthop Traumatol 2014; 16:35-9. [PMID: 25736606 PMCID: PMC4348522 DOI: 10.1007/s10195-014-0322-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 09/21/2014] [Indexed: 11/25/2022] Open
Abstract
Background Vitamin D plays an important role in bone mineralization, remodeling, and maintenance and therefore its deficiency may be implicated in the pathogenesis of osteoarthritis (OA). Vitamin D status was evaluated in patients with knee or hip OA scheduled for joint replacement. The impact of anthropometric parameters such as gender, age, and body mass index on vitamin D levels was also examined. The study was conducted in a Mediterranean country (Greece). Materials and methods We included 164 patients with knee or hip OA scheduled for joint replacement in this study. Serum levels of 25-hydroxyvitamin D (vitamin D) were measured in routine blood samples taken from the patients at their pre-admission visit, a week before the operation, using radioimmunoassay. Results The majority of patients were vitamin D deficient (81.7 %); 15.2 % of them were vitamin D insufficient (hypovitaminosis). Only 3 % of patients were vitamin D sufficient. There was a significantly positive association between vitamin D levels and male gender. Conclusion These findings indicate a large percentage of vitamin D deficient patients with knee or hip OA, which is unexpected considering the high annual insolation in northern Greece. Many other possible predisposing factors for OA should be taken into consideration. Whether treatment with vitamin D supplements may provide beneficial effects to these patients and the stage of disease in which this treatment should commence remains an issue for further scientific investigation. Level of evidence Level IV.
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MESH Headings
- Aged
- Aged, 80 and over
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Female
- Greece/epidemiology
- Humans
- Male
- Middle Aged
- Osteoarthritis, Hip/blood
- Osteoarthritis, Hip/complications
- Osteoarthritis, Hip/surgery
- Osteoarthritis, Knee/blood
- Osteoarthritis, Knee/complications
- Osteoarthritis, Knee/surgery
- Prevalence
- Retrospective Studies
- Risk Factors
- Vitamin D/analogs & derivatives
- Vitamin D/blood
- Vitamin D Deficiency/blood
- Vitamin D Deficiency/complications
- Vitamin D Deficiency/epidemiology
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Affiliation(s)
- Thomais Goula
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | - Alexandros Kouskoukis
- Department of Nuclear Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Georgios Drosos
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | | | - Athanasios Ververidis
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | - Christos Valkanis
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | - Athanasios Zisimopoulos
- Department of Nuclear Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Konstantinos Kazakos
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
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La Porta C, Bura SA, Negrete R, Maldonado R. Involvement of the endocannabinoid system in osteoarthritis pain. Eur J Neurosci 2014; 39:485-500. [PMID: 24494687 DOI: 10.1111/ejn.12468] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/25/2013] [Accepted: 12/02/2013] [Indexed: 12/29/2022]
Abstract
Osteoarthritis is a degenerative joint disease associated with articular cartilage degradation. The major clinical outcome of osteoarthritis is a complex pain state that includes both nociceptive and neuropathic mechanisms. Currently, the therapeutic approaches for osteoarthritis are limited as no drugs are available to control the disease progression and the analgesic treatment has restricted efficacy. Increasing evidence from preclinical studies supports the interest of the endocannabinoid system as an emerging therapeutic target for osteoarthritis pain. Indeed, pharmacological studies have shown the anti-nociceptive effects of cannabinoids in different rodent models of osteoarthritis, and compelling evidence suggests an active participation of the endocannabinoid system in the pathophysiology of this disease. The ubiquitous distribution of cannabinoid receptors, together with the physiological role of the endocannabinoid system in the regulation of pain, inflammation and even joint function further support the therapeutic interest of cannabinoids for osteoarthritis. However, limited clinical evidence has been provided to support this therapeutic use of cannabinoids, despite the promising preclinical data. This review summarizes the promising results that have been recently obtained in support of the therapeutic value of cannabinoids for osteoarthritis management.
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Affiliation(s)
- Carmen La Porta
- Laboratori de Neurofarmacologia, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, C/Dr. Aiguader, 88, Barcelona, 08003, Spain
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Abu El Maaty MA, Hanafi RS, El-Badawy S, Gad MZ. Interplay of vitamin D and nitric oxide in post-menopausal knee osteoarthritis. Aging Clin Exp Res 2014; 26:363-8. [PMID: 24374888 DOI: 10.1007/s40520-013-0192-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 12/11/2013] [Indexed: 11/24/2022]
Abstract
AIM Mounting evidence has presented nitric oxide (NO) and vitamin D (vitD) as having independently complex roles in osteoarthritis (OA). However, a mechanistic or an observational connection between them has never been investigated in the disease. This study investigates the correlation between circulating 25-hydroxyvitamin D [25(OH)D] and total NO as nitrate/nitrite (NO x ) in patients with knee OA. METHODS The recruited subjects comprised 36 post-menopausal women with knee OA, ages 50-60 years, as well as 10 healthy males, 20-30 years of age. 25(OH)D and NO x levels were determined using high-performance liquid chromatography and spectrophotometrically using Griess reaction, respectively. RESULTS The mean (SEM) 25(OH)D and NO x concentrations of OA patients were 25.0 (1.6) ng/mL and 32.45 (2.18) μM, respectively, and 35.4 (2.1) ng/mL and 25.49 (2.23) μM, respectively, for controls. Comparison of mean 25(OH)D and NO x concentrations of OA patients and controls yielded significant results (P = 0.001 and 0.034, respectively). NO notably decreased with decreasing 25(OH)D concentration in patients. However, significant results in terms of mean NO x concentration were observed in the comparison of normal and deficient vitD OA groups (P = 0.048). CONCLUSION Results suggest that vitD increases NO production and inducible NO synthase expression in osteoarthritic chondrocytes possibly leading to a protective effect.
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Affiliation(s)
- Mohamed A Abu El Maaty
- Biochemistry Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Al Tagamoa Al Khames, New Cairo, 11835, Egypt
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Abstract
Osteoarthritis (OA) is a leading cause of disability and its incidence is rising due to increasing obesity and an ageing population. Risk factors can be divided into person-level factors, such as age, sex, obesity, genetics, race/ethnicity and diet, and joint-level factors including injury, malalignment and abnormal loading of the joints. The interaction of these risk factors is complex and provides a challenge to the managing physician. The purpose of this review is to illustrate how each of these factors interact together to instigate incident OA as well as to outline the need for ongoing epidemiologic studies for the future prevention of both incident and progressive OA. It is only by understanding the impact of this disease and the modifiable risk factors that we will be able to truly target public health prevention interventions appropriately.
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Affiliation(s)
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Kolling Institute, University of Sydney, Sydney, NSW, Australia.
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Konstari S, Kaila-Kangas L, Jääskeläinen T, Heliövaara M, Rissanen H, Marniemi J, Knekt P, Arokoski J, Karppinen J. Serum 25-hydroxyvitamin D and the risk of knee and hip osteoarthritis leading to hospitalization: a cohort study of 5274 Finns. Rheumatology (Oxford) 2014; 53:1778-82. [PMID: 24817700 DOI: 10.1093/rheumatology/keu178] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate whether low levels of serum 25-hydroxyvitamin D [25(OH)D] predicts the development of knee or hip OA. METHODS The cohort consisted of 5274 participants in a national health examination survey who had no knee or hip OA at baseline. Information about the incidence of OA was drawn from the National Health Care Register. During the follow-up of 10 years (50 134 person-years), 127 subjects developed incident, physician-diagnosed OA in the knee and 45 in the hip joint. The information on covariates, including age, sex, education, BMI, work load, leisure time physical activity, smoking history, knee or hip complaint during the past month and previous injuries, was gathered at baseline. Serum 25(OH)D concentrations were determined from baseline serum samples. RESULTS After adjustment for age and gender, serum 25(OH)D showed statistically significant associations with known risk factors for OA except injuries. In the fully adjusted model, low serum 25(OH)D concentration did not predict increased incidence of knee and hip OA. CONCLUSION The results do not support the hypothesis that low levels of serum 25(OH)D contribute to the development of knee or hip OA.
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Affiliation(s)
- Sanna Konstari
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
| | - Leena Kaila-Kangas
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tuija Jääskeläinen
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Heliövaara
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Harri Rissanen
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jukka Marniemi
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Paul Knekt
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jari Arokoski
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, Oulu University Hospital and University of Oulu, Oulu, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu and Helsinki, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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Al-Jarallah K, Shehab D, Abraham M, Mojiminiyi OA, Abdella NA. Musculoskeletal pain: should physicians test for vitamin D level? Int J Rheum Dis 2014; 16:193-7. [PMID: 23773644 DOI: 10.1111/1756-185x.12066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to evaluate vitamin D levels using a reliable method in patients with regional and generalized musculoskeletal (MSK) pain in comparison to healthy controls. METHODS A consecutive prospective case control cohort was recruited. Patients with generalized MSK pain, for example, fibromyalgia (FM), and regional MSK pain, for example, nonspecific low back pain (LBP) and knee osteoarthritis (OA) were screened for 25 hydroxy-vitamin D [25(OH)D₃ ] levels over a period of 9 months in a hospital-based setting. RESULTS One hundred and twenty-four patients and 82 age-sex matched controls were evaluated. The mean age for patients was 41.71 ± 13.86 years. Of the 124 patients, 118 (95%) were female, 77 (62.6%) had FM, 18 (14.6%) had LBP and 28 (22.8%) had knee OA. All patients had normal muscle power; 83.7% of females wore long garments, 11.4% wore veils, 95.5% had sun exposure < 10 min/day and 58.5% were multiparaous; 7.3% were strict vegetarians, 45.5% took inadequate dairy products. The mean calcium, parathyroid hormone, alkaline phosphatase and albumin levels were within normal limits for all study subjects. The vitamin D level was deficient in all patients. There was no statistical difference between the mean vitamin D values of the patients and controls, 27.61 ± 13.06 and 25.82 ± 15.06 nmol/L respectively, (P = 0.368). CONCLUSION Our findings suggest that it is unlikely that measuring vitamin D will be of diagnostic value in the routine assessment of regional and generalized MSK pain.
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Affiliation(s)
- Khaled Al-Jarallah
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait.
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Stoker GE, Buchowski JM, Chen CT, Kim HJ, Park MS, Riew KD. Hypovitaminosis D and Cervical Disk Herniation among Adults Undergoing Spine Surgery. Global Spine J 2013; 3:231-6. [PMID: 24436874 PMCID: PMC3854581 DOI: 10.1055/s-0033-1354252] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/14/2013] [Indexed: 12/12/2022] Open
Abstract
Study Design Single-center, retrospective study. Objective Suboptimal concentrations of vitamin D have been linked to hip and knee osteoarthritis in large, population-based cohort studies. We sought to examine the association of vitamin D levels with intervertebral disk disease. Methods From January 2010 through May 2011, 91 consecutive, eligible adult spine surgery patients who had undergone cervical magnetic resonance imaging (MRI) and preoperative serum 25-hydroxyvitamin D (s25D) measurement were retrospectively included. MRI was read for C2-T1 disk herniation and degeneration (grades I to V). Logistic regressions were performed. Results Compared with the 384 disks of nondeficient patients, 162 disks of vitamin D-deficient (< 20 ng/mL) patients were more frequently herniated (40% versus 27%, p = 0.004); deficiency was not predictive of individual disk grade (unadjusted odds ratio [uOR] = 0.98, p = 0.817). On regression analysis, deficiency was associated with increased number of herniations per patient (uOR = 2.17, 95% confidence interval [CI] = 1.22 to 3.87, p = 0.009; adjusted odds ratio [aOR] = 2.12, 95% CI = 1.11 to 4.03, p = 0.023). When disks were analyzed individually, and levels (e.g., C5 to C6), additionally controlled for, deficiency correlated with greater likelihood of herniation per disk (uOR = 1.81, 95% CI = 1.22 to 2.66, p = 0.003; aOR = 2.06, 95% CI = 1.25 to 3.41, p = 0.005). Conclusion Among adults undergoing spine surgery at our institution, vitamin D deficiency was associated with cervical disk herniation. Considering the current epidemics of vitamin D insufficiency and neck pain, further investigation is warranted, as these data were retrospectively collected and subject to sampling bias.
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Affiliation(s)
- Geoffrey E. Stoker
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Jacob M. Buchowski
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States,Address for correspondence Jacob M. Buchowski, MD, MS Washington University Orthopedics, BJC Institute of Health425 S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110United States
| | - Christopher T. Chen
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Han Jo Kim
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Moon Soo Park
- Department of Orthopaedic Surgery, Medical College of Hallym University, Gyeonggi-do, South Korea
| | - K. Daniel Riew
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
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Malas FU, Kara M, Aktekin L, Ersöz M, Ozçakar L. Does vitamin D affect femoral cartilage thickness? An ultrasonographic study. Clin Rheumatol 2013; 33:1331-4. [PMID: 24221506 DOI: 10.1007/s10067-013-2432-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 09/17/2013] [Accepted: 10/28/2013] [Indexed: 12/17/2022]
Abstract
This study aims to investigate the association between vitamin D levels and distal femoral cartilage thickness in healthy subjects. Eighty patients who were admitted to our outpatient clinic between May and July 2013 were classified into three subgroups according to their 25-OH vitamin D levels of <10, 10-20, and ≥20 ng/mL. Distal femoral cartilage thickness was measured from the midpoints of the right medial condyle (RMC), right lateral condyle (RLC), right intercondylar area (RIA), left medial condyle (LMC), left lateral condyle (LLC), and left intercondylar area (LIA) by using musculoskeletal ultrasound (US). The group with severe vitamin D deficiency (<10 ng/mL) had thinner femoral cartilage thickness at LMC (p = 0.005). Positive correlations were determined only between vitamin D levels and US measurements in the severe vitamin D deficiency group at RLC (r = 444, p = 0.020), LMC (r = 357, p = 0.067), and LLC (r = 568, p = 0.002). Low levels of vitamin D seem to affect the femoral cartilage thickness, adversely. Further studies are necessary to ascertain the clinical relevance of this change in cartilage thickness and whether vitamin D supplementation can reverse the cartilage thinning process or the allied clinical symptoms in the course of knee osteoarthritis.
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Affiliation(s)
- Fevziye Unsal Malas
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Sihhiye, Ankara, Turkey,
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Colombini A, Cauci S, Lombardi G, Lanteri P, Croiset S, Brayda-Bruno M, Banfi G. Relationship between vitamin D receptor gene (VDR) polymorphisms, vitamin D status, osteoarthritis and intervertebral disc degeneration. J Steroid Biochem Mol Biol 2013; 138:24-40. [PMID: 23500379 DOI: 10.1016/j.jsbmb.2013.03.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 02/26/2013] [Accepted: 03/01/2013] [Indexed: 02/07/2023]
Abstract
The vitamin D endocrine system is involved in bony and cartilaginous metabolisms and alterations in the homeostasis of this system could be associated to pathological conditions of cartilaginous tissue. In this context, the presence of polymorphisms in the vitamin D receptor gene (VDR), in association with the susceptibility to common osteochondral diseases, was largely investigated. The aim of this review was to summarize data present in literature, analyzing the association of the VDR polymorphisms, vitamin D status and knee cartilage and intervertebral disc pathologies, trying to suggest links between the different specific pathologies analyzed. Concerning the association between VDR polymorphisms and cartilaginous tissue diseases, we found controversial reports. However, the great majority of papers reported an association with lumbar disc degeneration, whereas about half of the studies found an association with osteoarthritis. A further association between VDR polymorphisms (in linkage disequilibrium) and the presence of specific characteristics of these diseases, in particular the formation of osteophytes, was evidenced. Finally, the influence of vitamin D status on these pathologies was evaluated, trying to evidence the relation between the presence of particular genetic variants in the VDR and vitamin D levels or to show whether a particular vitamin D status could predispose to the development or progression of such diseases, however, no significant associations were found. In the future, given the role of vitamin D system in the cartilaginous tissue metabolism, it could be interesting to perform functional and tissue specific studies to analyze the interplay between the different VDR variants and its ligand.
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Affiliation(s)
- Alessandra Colombini
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy.
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