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Chopp-Hurley JN, Wiebenga EG, Keller HH, Maly MR. Nutrition risk, physical activity and fibre intake are associated with body composition in OA: analysis of the Canadian Longitudinal Study on Aging. BMJ Nutr Prev Health 2022; 5:191-200. [PMID: 36619336 PMCID: PMC9813624 DOI: 10.1136/bmjnph-2021-000319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/31/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Sarcopenic obesity is a key feature in osteoarthritis (OA). While ideal OA treatment involves physical activity and diet, how diet influences OA pathophysiology is unclear. We explored the associations between diet, nutrition risk and physical activity with body composition in older adults with OA. Methods Baseline data from the Canadian Longitudinal Study on Aging data set were analysed. Participants with hip, knee, hand or multiple forms of OA were included in this cross-sectional analysis. Body composition measures (lean, fat and total masses (kg) and body fat percentage) were separate dependent variables. Regression analyses were conducted to explore associations between body composition with dietary intake (high calorie snack, fibre), nutrition risk (SCREEN II) and physical activity (Physical Activity Scale for the Elderly). Results 1596 participants were 66.5 (9.0) years old with a body mass index of 28.2 (5.3) kg/m2. Higher fibre cereal intake was associated with higher lean mass (unstandardised beta coefficient 0.5 (0.1, 0.9), p=0.02) and lower body fat percentage (-0.3 (-0.6, 0.0), p=0.046). Lower nutrition risk was associated with higher lean mass (0.1 (0.0, 0.1), p=0.03), lower fat mass (-0.05 (-0.1, 0.0), p=0.009) and lower body fat percentage (-0.1 (-0.1, 0.0), p<0.001). Higher physical activity was associated with higher lean mass (0.01 (0.01, 0.02), p<0.001), lower fat mass (-0.01 (0.0, 0.0), p=0.005) and lower body fat percentage (-0.01 (0.0, 0.0), p<0.001). Conclusion Greater physical activity and lower nutrition risk were associated with better body composition. While fibre intake was also associated body composition, the CIs were wide suggesting weak associations.
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Affiliation(s)
- Jaclyn N Chopp-Hurley
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Emily G Wiebenga
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Heather H Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada,Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada
| | - Monica R Maly
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada,Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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2
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Webb EJ, Osmotherly PG, Baines SK. Effect of Dietary Weight Loss and Macronutrient Intake on Body Composition and Physical Function in Adults with Knee Osteoarthritis: A Systematic Review. J Nutr Gerontol Geriatr 2022; 41:103-125. [PMID: 35642456 DOI: 10.1080/21551197.2022.2063219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Overweight and obesity increase the risk of development and progression of knee osteoarthritis (OA), with higher levels of fat mass and lower levels of lean mass associated with poorer functional status. The aim was to assess changes in weight, body composition and physical function following weight loss or weight maintenance interventions in knee OA. A comprehensive search of four databases was conducted. The risk of bias was assessed using the Quality Criteria Checklist for primary research. Primary outcomes included weight, body composition and physical function; secondary outcomes were lipids, inflammatory biomarkers and muscle strength. Eleven studies were included utilizing diet and exercise (n = 4) or diet-only (n = 7) interventions, two of which were weight maintenance studies. Most studies (n = 10) reported improvements in physical function with significant weight loss, while the change in strength reported in three studies was variable. The diet and exercise studies reported an average reduction in weight of 6.7% and lean mass of 1.6 kg, with greater improvements in physical function. The diet-only studies, including weight maintenance interventions, reported greater average weight loss (7.8%) and reduction in LM (2.0 kg). Overall, better retention of lean mass and muscle strength was observed in participants with higher protein intake (≥37% of energy) and subsequently improved physical function.
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Affiliation(s)
- Emily J Webb
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Peter G Osmotherly
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Surinder K Baines
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
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3
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He J, Ba H, Feng J, Peng C, Liao Y, Li L, Cao X, Wang Z, Shen M, Wu S. Increased signal intensity, not volume variation of infrapatellar fat pad in knee osteoarthritis: A cross-sectional study based on high-resolution magnetic resonance imaging. J Orthop Surg (Hong Kong) 2022; 30:10225536221092215. [PMID: 35422165 DOI: 10.1177/10225536221092215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Infrapatellar fat pad (IPFP) is regarded as an essential knee tissue involved in osteoarthritis (OA) for its potential structural-related or metabolism-related function. This cross-sectional study aims to identify which part is more related to OA. METHODS Patients with knee OA (n = 53) and healthy controls (n = 54) were prospectively recruited. Based on high-resolution magnetic resonance imaging with a slice thickness of only 0.35 mm, IPFP structural-related parameters (volume and maximal area), metabolism-related parameter (signal), degeneration indicators, and patellar maltracking indicators (patellar translation, patellofemoral angle, and Insall-Salvati ratio) were measured. IPFP volume (maximal area, and signal) was compared between healthy controls and OA patients. The level of significance for all comparisons was set as .05. RESULTS OA patients had higher IPFP signal (672.9 ± 136.9 vs 567.3 ± 63.6, p = .009), but no significant difference in IPFP volume or maximal area compared with healthy controls. In healthy controls, IPFP signal was positively associated with age (β = 1.481; 95% CI: 0.286-2.676; p = .018); IPFP maximal area was positively related to Insall-Salvati ratio (β = 0.001; 95% CI: 0.0003-0.0017; p = .039), but not associated with patellar translation and patellofemoral angle. In OA patients, IPFP signal was positively associated with cartilage loss (β = 0.005; 95% CI: 0.003-0.007; p = .013); no correlation between knee pain and IPFP volume or maximal area was observed. CONCLUSIONS The metabolism-related function of IPFP, which can be reflected by the IPFP signal, might play a more critical role in OA progression than its structural function.
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Affiliation(s)
- Jinshen He
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Hongliang Ba
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Jing Feng
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Cheng Peng
- Department of Burns, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Yunjie Liao
- Department of Radiology, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Lifeng Li
- Department of Radiology, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Xu Cao
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Zili Wang
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Minren Shen
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Song Wu
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
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Go DJ, Kim DH, Guermazi A, Crema MD, Hunter DJ, Hwang HS, Kim HA. Metabolic obesity and the risk of knee osteoarthritis progression in elderly community residents: A 3-year longitudinal cohort study. Int J Rheum Dis 2021; 25:192-200. [PMID: 34877797 DOI: 10.1111/1756-185x.14255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/29/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Metabolic syndrome is a major health problem worldwide associated with obesity, thus drawing attention to its relation to osteoarthritis (OA). However, it is still uncertain whether metabolic syndrome or body fat distribution is associated with knee OA. The aim of this longitudinal study was to elucidate the association between metabolic obesity and adverse structural changes of knee OA assessed by magnetic resonance imaging (MRI). METHODS Participants were recruited from the Hallym Aging Study cohort in Korea. Knee MRI scans, along with dual-energy X-ray absorptiometry, were assessed in 226 participants at baseline and after 3 years. The structural progression in the tibiofemoral joint was evaluated using the semi-quantitative Whole-Organ MRI Score (WORMS) for cartilage morphology and bone marrow lesions (BML). Logistic regression with generalized estimating equation was performed for associations of metabolic risk factors with worsening of WORMS scores at the subregional level. RESULTS In the medial compartment, fat mass in women was associated with cartilage loss, but the statistical significance disappeared after adjusting for body mass index. Metabolic syndrome and each of its components were not associated with cartilage loss or increase of BML. On the other hand, the interaction effects of metabolic syndrome on the association between obesity and knee OA progression were not significant. CONCLUSION In this cohort, metabolic effects of obesity on knee cartilage damage and BML were not demonstrated. Further large-scale studies are required to prove the causal relationship between metabolic obesity and knee OA.
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Affiliation(s)
- Dong Jin Go
- Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea
| | - Dong Hyun Kim
- Department of Social and Preventive Medicine, Hallym Research Institute of Clinical Epidemiology, Hallym University, Chuncheon, Korea
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michel Daoud Crema
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - Hyun Sook Hwang
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.,Institute for Skeletal Aging, Hallym University, Chuncheon, Korea
| | - Hyun Ah Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.,Institute for Skeletal Aging, Hallym University, Chuncheon, Korea
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5
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Chopp-Hurley JN, Wiebenga EG, Bulbrook BD, Keir PJ, Maly MR. Evaluating the relationship between quadriceps muscle quality captured using ultrasound with clinical severity in women with knee osteoarthritis. Clin Biomech (Bristol, Avon) 2020; 80:105165. [PMID: 32906002 DOI: 10.1016/j.clinbiomech.2020.105165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 04/21/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Infiltration of muscle with non-lean tissue, such as fat, reduces muscle quality. Ultrasound captures muscle quality through measurement of echogenicity. Given the potential implications of quadriceps muscle quality on physical function, particularly in knee osteoarthritis, the purpose of this study was to investigate the relationship between echogenicity, muscle thickness and subcutaneous fat thickness with the clinical severity of osteoarthritis. METHODS Thirty-one women with clinical knee osteoarthritis participated. Rectus femoris and vastus lateralis echogenicity, muscle thickness and subcutaneous fat thickness were measured from ultrasound images of the most symptomatic knee. Clinical severity of osteoarthritis was characterized with pain, self-reported function, six-minute walk test, and knee extensor strength. Correlation coefficients were calculated between muscle and fat architecture outcomes (muscle quality, muscle and fat thicknesses) and osteoarthritis clinical severity outcomes. FINDINGS Data from 25 women were of sufficient quality for analysis. Echogenicity (muscle quality) related to the six-minute walk test for both rectus femoris (r = -0.52, p = 0.02) and vastus lateralis (r = -0.74, p = 0.004), with poorer muscle quality related to lower mobility. Subcutaneous fat thickness was related to the six-minute walk test (rectus femoris, r = -0.61, p = 0.0012; vastus lateralis, r = -0.73, p = 0.003) and strength (rectus femoris, r = -0.46, p = 0.02; vastus lateralis, r = -0.59, p = 0.03). Muscle thickness was not related to any severity outcomes. INTERPRETATION Muscle quality, rather than thickness, is associated with mobility performance in women with knee osteoarthritis. Thus, interventions for osteoarthritis that specifically target muscle quality, rather than size, should be explored.
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Affiliation(s)
- Jaclyn N Chopp-Hurley
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Emily G Wiebenga
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | | | - Peter J Keir
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Monica R Maly
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada; Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
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6
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Meng T, Antony B, Venn A, Eckstein F, Cicuttini F, March L, Cross M, Dwyer T, Blizzard L, Jones G, Laslett LL, Ding C. Association of body composition, physical activity and physical performance with knee cartilage thickness and bone area in young adults. Rheumatology (Oxford) 2020; 59:1607-1616. [PMID: 31652312 DOI: 10.1093/rheumatology/kez498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/25/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe associations of body composition, physical activity and physical performance with knee cartilage thickness and subchondral bone area in young adults. METHODS Body composition, physical activity and physical performance were measured 4-5 years prior to knee MRI. Cartilage thickness and bone area were measured quantitatively from MRI. Associations were assessed using linear regression analysis, with mediators being identified using mediation analysis. RESULTS Participants (n = 186) were 31-41 years of age when the MRI was acquired and 48% were female. Greater lean mass was positively associated with cartilage thickness [β = 6.52 μm/kg (95% CI 0.86, 12.18)] and bone area [β = 13.37 mm2/kg (95% CI 5.43, 21.31)]. Physical performance measures were positively associated with cartilage thickness [long jump: β = 2.44 μm/cm (95% CI 0.70, 4.18); hand grip strength: 7.74 μm/kg (95% CI 1.50, 13.98); physical work capacity: 1.07 μm/W (95% CI 0.29, 1.85)] and bone area [long jump: β = 3.99 mm2/cm (95% CI 0.64, 7.34); hand grip strength: 19.06 mm2/kg (95% CI 7.21, 30.92); leg strength: 3.18 mm2/kg (95% CI 1.09, 5.28); physical work capacity: 3.15 mm2/W (95% CI 1.70, 4.60)]. Mediation analysis suggested these associations were mediated by lean mass (effect mediated: 27-95%). CONCLUSION Greater lean mass and better physical performance measured 4-5 years prior were associated with greater knee cartilage thickness and subchondral bone area in young adults, and the associations of physical performance were largely mediated by lean mass. These findings suggest lean mass may play an important role in maintaining knee joint health in young adults.
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Affiliation(s)
- Tao Meng
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Medical University, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lyn March
- Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - Marita Cross
- Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,George Institute for Global Health, University of Oxford, Oxford, UK
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Laura L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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7
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Identifying effector molecules, cells, and cytokines of innate immunity in OA. Osteoarthritis Cartilage 2020; 28:532-543. [PMID: 32044352 DOI: 10.1016/j.joca.2020.01.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 02/06/2023]
Abstract
Inflammatory changes are observed in affected joints of osteoarthritis (OA) patients and are thought to be involved in the pathology that develops along OA progression. This narrative review provides an overview of the various cell types that are present in the joint during OA and which alarmins, cytokines, chemokines, growth factors, and other mediators they produce. Moreover, the involvement of more systemic processes like inflammaging and its associated cellular senescence in the context of OA are discussed.
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8
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Alissa EM, Alzughaibi LS, Marzouki ZM. Relationship between serum resistin, body fat and inflammatory markers in females with clinical knee osteoarthritis. Knee 2020; 27:45-50. [PMID: 31926675 DOI: 10.1016/j.knee.2019.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/21/2019] [Accepted: 12/17/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Adipokines have gained much interest in osteoarthritis (OA) pathogenesis studies over the past years in that they play crucial roles in bone and cartilage homeostasis. Obesity is known to be one of the well-recognized and modifiable causes of OA burden. Key mediators in this metabolic link between obesity and OA could be resistin, among other cytokines secreted by the adipose tissue. We aimed to evaluate the association of serum resistin with obesity, and inflammation in female patients with knee OA. METHODS One hundred female participants, aged above 40 years, with symptomatic primary knee OA were matched for age with 100 apparently healthy females in a case-control study design. All study participants were subjected to clinical examination, laboratory investigations and radiological examination. RESULTS Patients with primary knee OA had elevated levels of serum resistin compared with healthy controls. We demonstrated that elevated serum resistin positively correlated with adiposity measures, inflammatory markers and WOMAC index. High sensitivity C reactive protein was found to be an independent predictor of serum resistin levels after adjustment for confounder factors. CONCLUSIONS These results indicate that resistin may play an important role in the progression of knee OA and may serve as a novel and reliable biomarker for reflecting disease severity, with the potential to contribute to the fundamental processes underlying the pathogenesis of knee OA.
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Affiliation(s)
- Eman M Alissa
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Elemental Spectroscopy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
| | | | - Zuhair M Marzouki
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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9
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Bratke G, Bruggemann GP, Willwacher S, Mählich D, Trudeau MB, Rohr E, Weir G, Maintz D, Hamill J. Does footwear affect articular cartilage volume change after a prolonged run? Scand J Med Sci Sports 2019; 30:332-338. [PMID: 31605631 DOI: 10.1111/sms.13576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/25/2019] [Accepted: 10/08/2019] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate knee intra-articular cartilage volume changes after a prolonged running bout in three footwear conditions. Twelve participants performed 75-minute running bouts in the three footwear conditions. Before and after each running bout, magnetic resonance imaging (MRI) scans were obtained using a high-resolution 3.0 Tesla MRI. Three-dimensional reconstruction of the cartilage plates of the patella, the femur, and the tibia was created to quantify cartilage volume change due to the 75-minute running bout. Three-dimensional biomechanical data were also collected using an integrated motion capture and force treadmill system. There were no statistically significant differences among shoe conditions for all anatomical regions. However, significant cartilage volume reductions at all anatomical sites were observed after the 75-minute running bout in each footwear condition. These data suggest that the intra-articular knee cartilage undergoes a significant reduction in cartilage volume during a prolonged run that may indicate an increase in joint loading. There was a considerable variation in cartilage volume between participants across footwear conditions indicating an individual cartilage volume response to footwear. An individualistic approach to footwear recommendations may help in minimizing this change in cartilage.
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Affiliation(s)
- Grischa Bratke
- Institute for Diagnostic and Interventional Radiology, University Hospital, Cologne, Germany
| | - Gert-Peter Bruggemann
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | - Steffen Willwacher
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | - Daniela Mählich
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | | | - Eric Rohr
- Brooks Running Inc, Seattle, WA, USA
| | - Gillian Weir
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, University Hospital, Cologne, Germany
| | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
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10
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Jiang LF, Fang JH, Wu LD. Role of infrapatellar fat pad in pathological process of knee osteoarthritis: Future applications in treatment. World J Clin Cases 2019; 7:2134-2142. [PMID: 31531309 PMCID: PMC6718789 DOI: 10.12998/wjcc.v7.i16.2134] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/11/2019] [Accepted: 06/27/2019] [Indexed: 02/05/2023] Open
Abstract
It has been found that obese people have a higher proportion in suffering from osteoarthritis (OA), not only in the weight-bearing joints like knee and hip joints, even in non-weight-bearing joints such as hand joints. One of the reasons is because the large amount of adipose tissue secretes some factors, which can promote the occurrence of arthritis. As an important structure of the knee joint, the infrapatellar fat pad (IPFP) is actually a piece of adipose tissue. The aim of this review is to offer a comprehensive view of the anatomy and physiological characteristics of IPFP and its relationship with the pathological process of OA, indicating the important function of IPFP in OA. At the same time, with the development of adipose derived stem cells in the treatment of OA, owing to its special advantages, the IPFP is becoming a kind of important, minimally invasive fat stem cell source, providing a new approach for the treatment of OA. We hope that this review will offer an overview of all published data regarding the IPFP and will indicate novel directions for future research.
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Affiliation(s)
- Li-Feng Jiang
- Department of Orthopedics Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Jing-Hua Fang
- Department of Orthopedics Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Li-Dong Wu
- Department of Orthopedics Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
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Abstract
The classification and monitoring of individuals with early knee osteoarthritis (OA) are important considerations for the design and evaluation of therapeutic interventions and require the identification of appropriate outcome measures. Potential outcome domains to assess for early OA include patient-reported outcomes (such as pain, function and quality of life), features of clinical examination (such as joint line tenderness and crepitus), objective measures of physical function, levels of physical activity, features of imaging modalities (such as of magnetic resonance imaging) and biochemical markers in body fluid. Patient characteristics such as adiposity and biomechanics of the knee could also have relevance to the assessment of early OA. Importantly, research is needed to enable the selection of outcome measures that are feasible, reliable and validated in individuals at risk of knee OA or with early knee OA. In this Perspectives article, potential outcome measures for early symptomatic knee OA are discussed, including those measures that could be of use in clinical practice and/or the research setting.
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Herrero-Beaumont G, Pérez-Baos S, Sánchez-Pernaute O, Roman-Blas JA, Lamuedra A, Largo R. Targeting chronic innate inflammatory pathways, the main road to prevention of osteoarthritis progression. Biochem Pharmacol 2019; 165:24-32. [PMID: 30825432 DOI: 10.1016/j.bcp.2019.02.030] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/26/2019] [Indexed: 12/15/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disease characterized by cartilage degradation, osteophyte formation, subchondral bone sclerosis, and synovitis. Systemic factors such as obesity and the components of the metabolic syndrome seem to contribute to its progression. Breakdown of cartilage ensues from an altered balance between mechanical overload and its absorption by this tissue. There is in this context a status of persistent local inflammation by means of the chronic activation of innate immunity. A broad variety of danger-associated molecular patterns inside OA joint are able to activate pattern recognition receptors, mainly TLR (toll-like receptor) 2 and 4, which are overexpressed in the OA cartilage. Chronic activation of innate immune responses in chondrocytes results in a robust production of pro-inflammatory cytokines and chemokines, as well as of tissue-destructive enzymes, downstream of NF-κB and MAPK (mitogen activated protein kinase) dependent pathways. Besides, the toxic effects of an excess of glucose and/or fatty acids, which share the same pro-inflammatory intracellular signalling pathways, may add fuel to the fire. Not only high concentrations of glucose can render cells prone to inflammation, but also AGEs (advanced glycation end products) are integrated into the TLR signalling network through their own innate immune receptors. Considering these mechanisms, we argue for the control of both primary inflammation and proteolytic catabolism as a preventive strategy in OA, instead of focusing treatment on the enhancement of anabolic responses. Even though this approach would not return to normal already degraded cartilage, it nonetheless might avoid damage extension to the surrounding tissue.
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Affiliation(s)
| | - Sandra Pérez-Baos
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | | | - Jorge A Roman-Blas
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | - Ana Lamuedra
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | - Raquel Largo
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain.
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13
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Body Composition Is Associated With Physical Performance in Individuals With Knee Osteoarthritis. ACTA ACUST UNITED AC 2019; 26:109-114. [DOI: 10.1097/rhu.0000000000000967] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Collins KH, Sharif B, Reimer RA, Sanmartin C, Herzog W, Chin R, Marshall DA. Association of Metabolic Markers with self-reported osteoarthritis among middle-aged BMI-defined non-obese individuals: a cross-sectional study. BMC OBESITY 2018; 5:23. [PMID: 30186613 PMCID: PMC6120068 DOI: 10.1186/s40608-018-0201-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 05/24/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic degenerative joint disease. While it is well-established that obesity affects OA through increased axial loading on the joint cartilage, the indirect effect of obesity through metabolic processes among the body mass index (BMI)-defined non-obese population, i.e., BMI < 30 kg/m2, is less known. Our goal was to evaluate the association of metabolic markers including body fat percentage (BF%), waist circumference, maximum weight gain during adulthood and serum creatinine with self-reported OA to establish if such measures offer additional information over BMI among the non-obese population between 40 and 65 years of age. METHODS Cross-sectional data from two cycles of the Canadian Health Measures Survey (CHMS) in 2007-2009 and 2009-2011 were analyzed. Sex-specific logistic regression models were developed to evaluate the association of self-reported OA with metabolic markers. Models were separately adjusted for age, BMI categories and serum creatinine, and a stratified analysis across BM categories was performed. In a secondary analysis, we evaluated the association of self-reported OA, cardiovascular diseases and hypertension across BF% categories. RESULTS Of 2462 individuals, 217 (8.8%) self-reported OA. After adjusting for age and BMI, those within BF%-defined overweight/obese category had 2.67 (95% CI: 1.32-3.51) and 2.11(95% CI: 1.38-3.21) times higher odds of reporting self-reported OA compared to those within BF%-defined athletic/acceptable category for females and males, respectively. BF% was also significantly associated with self-reported OA after adjusting for age and serum creatinine only among females (OR: 1.47, 95%CI: 1.12-1.84). Furthermore, among the BMI-defined overweight group, the age-adjusted odds of self-reported OA was significantly higher for overweight/obese BF% compared to athletic/acceptable BF% in both females and males. In a secondary analysis, we showed that the association of self-reported OA and hypertension/cardiovascular diseases is significantly higher among BF% overweight/obese (OR: 1.37, 95%CI: 1.19-3.09) compared to BF% athletic/acceptable (OR: 1.13, 95%CI: 0.87-2.82). CONCLUSION Our results provide corroborating evidence for a relationship between body fat and OA in a population-based study, while no significant independent correlates were found between other metabolic markers and OA prevalence. Future investigation on the longitudinal relationship between BF and OA among this sub-population may inform targeted prevention opportunities.
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Affiliation(s)
- Kelsey H. Collins
- Human Performance Laboratory, University of Calgary, Calgary, AB Canada
| | - Behnam Sharif
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Raylene A. Reimer
- Faculty of Kinesiology and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB Canada
| | | | - Walter Herzog
- Human Performance Laboratory, University of Calgary, Calgary, AB Canada
| | - Rick Chin
- Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Deborah A. Marshall
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
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Chang J, Liao Z, Lu M, Meng T, Han W, Ding C. Systemic and local adipose tissue in knee osteoarthritis. Osteoarthritis Cartilage 2018; 26:864-871. [PMID: 29578044 DOI: 10.1016/j.joca.2018.03.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/28/2018] [Accepted: 03/15/2018] [Indexed: 02/08/2023]
Abstract
Knee osteoarthritis (OA) is the most common joint disease. Body adipose tissue has been shown to be related to the development and progression of knee OA. Among systemic adipose tissues, subcutaneous adipose tissue is significantly and negatively associated with muscle mass and forces, and could be related to the presence and progression of knee OA. Visceral adipose tissue is associated with increased cartilage loss and production of pro-inflammatory cytokines. Intra-muscular adipose tissue is associated with knee osteoarthritic changes, but it remains controversial if inter-muscular adipose tissue has a role to play in the pathogenesis for knee OA. Knee local adipose tissue such as infrapatellar fat pad (IPFP) can interact with neighbouring tissues, and may have a biphasic effect in knee OA. The underlying mechanisms for the roles of the systemic and local fat in knee OA could be related to biomechanical, metabolic, inflammatory factors and fat fibrosis, which may have a separated or combined effect on OA. Tissue engineering from systemic or local adipose tissue is a new research direction, and adipose tissue-derived stem cells from systemic or local adipose tissue may be beneficial for OA cartilage repair. Research on systemic and local adipose tissue would provide novel approaches for prevention and treatment of knee OA, but further studies are required to explore the roles of different adipose tissues in knee OA and the effects of stem cells derived from different adipose tissues on knee OA.
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Affiliation(s)
- J Chang
- Department of Orthopaedics, 4th Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Z Liao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Rheumatology and Immunology Division, 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - M Lu
- Department of Orthopaedics, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - T Meng
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - W Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - C Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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16
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Abstract
Osteoarthritis (OA) is the most prevalent joint disease characterized by pain and degenerative lesions of the cartilage, subchondral bone, and other joint tissues. The causes of OA remain incompletely understood. Over the years, it has become recognized that OA is a multifactorial disease. In particular, aging and trauma are the main risk factors identified for the development of OA; however, other factors such as genetic predisposition, obesity, inflammation, gender and hormones, or metabolic syndrome contribute to OA development and lead to a more severe outcome. While this disease mainly affects people older than 60 years, OA developed after joint trauma affects all range ages and has a particular impact on young individuals and people who have highest levels of physical activity such as athletes. Traumatic injury to the joint often results in joint instability or intra-articular fractures which lead to posttraumatic osteoarthritis (PTOA). In response to injury, several molecular mechanisms are activated, increasing the production and activation of different factors that contribute to the progression of OA.In this chapter, we have focused on the interactions and contribution of the multiple factors involved in joint destruction and progression of OA. In addition, we overview the main changes and molecular mechanisms related to OA pathogenesis.
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17
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Waller B, Munukka M, Rantalainen T, Lammentausta E, Nieminen MT, Kiviranta I, Kautiainen H, Häkkinen A, Kujala UM, Heinonen A. Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up. Osteoarthritis Cartilage 2017; 25:1238-1246. [PMID: 28263901 DOI: 10.1016/j.joca.2017.02.800] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/31/2017] [Accepted: 02/21/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the effects of 4-months intensive aquatic resistance training on body composition and walking speed in post-menopausal women with mild knee osteoarthritis (OA), immediately after intervention and after 12-months follow-up. Additionally, influence of leisure time physical activity (LTPA) will be investigated. DESIGN This randomised clinical trial assigned eighty-seven volunteer postmenopausal women into two study arms. The intervention group (n = 43) participated in 48 supervised intensive aquatic resistance training sessions over 4-months while the control group (n = 44) maintained normal physical activity. Eighty four participants continued into the 12-months' follow-up period. Body composition was measured with dual-energy X-ray absorptiometry (DXA). Walking speed over 2 km and the knee injury and osteoarthritis outcome score (KOOS) were measured. LTPA was recorded with self-reported diaries. RESULTS After the 4-month intervention there was a significant decrease (P = 0.002) in fat mass (mean change: -1.17 kg; 95% CI: -2.00 to -0.43) and increase (P = 0.002) in walking speed (0.052 m/s; 95% CI: 0.018 to 0.086) in favour of the intervention group. Body composition returned to baseline after 12-months. In contrast, increased walking speed was maintained (0.046 m/s; 95% CI 0.006 to 0.086, P = 0.032). No change was seen in lean mass or KOOS. Daily LTPA over the 16-months had a significant effect (P = 0.007) on fat mass loss (f2 = 0.05) but no effect on walking speed. CONCLUSIONS Our findings show that high intensity aquatic resistance training decreases fat mass and improves walking speed in post-menopausal women with mild knee OA. Only improvements in walking speed were maintained at 12-months follow-up. Higher levels of LTPA were associated with fat mass loss. TRIAL REGISTRATION NUMBER ISRCTN65346593.
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Affiliation(s)
- B Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - M Munukka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - T Rantalainen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
| | - E Lammentausta
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
| | - M T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland.
| | - I Kiviranta
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - H Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
| | - A Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - U M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - A Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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18
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Abstract
Osteoarthritis (OA) is the most common joint disorder, is associated with an increasing socioeconomic impact owing to the ageing population and mainly affects the diarthrodial joints. Primary OA results from a combination of risk factors, with increasing age and obesity being the most prominent. The concept of the pathophysiology is still evolving, from being viewed as cartilage-limited to a multifactorial disease that affects the whole joint. An intricate relationship between local and systemic factors modulates its clinical and structural presentations, leading to a common final pathway of joint destruction. Pharmacological treatments are mostly related to relief of symptoms and there is no disease-modifying OA drug (that is, treatment that will reduce symptoms in addition to slowing or stopping the disease progression) yet approved by the regulatory agencies. Identifying phenotypes of patients will enable the detection of the disease in its early stages as well as distinguish individuals who are at higher risk of progression, which in turn could be used to guide clinical decision making and allow more effective and specific therapeutic interventions to be designed. This Primer is an update on the progress made in the field of OA epidemiology, quality of life, pathophysiological mechanisms, diagnosis, screening, prevention and disease management.
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Runhaar J, de Vos BC, van Middelkoop M, Vroegindeweij D, Oei EHG, Bierma-Zeinstra SMA. Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females. Arthritis Care Res (Hoboken) 2016; 68:1428-33. [PMID: 26866630 DOI: 10.1002/acr.22854] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/12/2016] [Accepted: 01/26/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This study evaluated the effect of moderate weight loss on the incidence of knee osteoarthritis (OA) in middle-aged overweight and obese women, without clinical and radiologic knee OA at baseline. METHODS A total of 353 women (87%) with followup data available were selected from the Prevention of Knee Osteoarthritis in Overweight Females study, which evaluated the preventive effect of a diet and exercise intervention and of oral glucosamine sulfate on the incidence of knee OA. This was an exploratory proof-of-concept analysis, which compared the incidence of knee OA between women who reached the clinically relevant weight loss target of 5 kg or 5% of body weight after 30 months and those who did not reach this target. RESULTS The weight loss group showed a significantly lower incidence of knee OA according to the primary outcome measure, which was composed of the American College of Rheumatology criteria (clinical and radiographic), Kellgren/Lawrence grade ≥2, and joint space narrowing ≥1.0 mm (15% versus 20%; odds ratio 0.5, 95% confidence interval 0.3-0.9). Moreover, the weight loss also positively affected several health measures, such as blood glucose level, body fat percentage, and blood pressure. CONCLUSION A reduction of ≥5 kg or 5% of body weight over a 30-month period reduces the risk for the onset of radiographic knee OA in middle-aged overweight and obese women. Because of the slow progression of the disease, a longer followup period will be necessary before the number of prevented cases of knee OA by moderate weight loss becomes clinically more relevant.
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Affiliation(s)
- Jos Runhaar
- Erasmus Medical Center, Rotterdam, The Netherlands.
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20
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Antony B, Venn A, Cicuttini F, March L, Blizzard L, Dwyer T, Cross M, Jones G, Ding C. Association of Body Composition and Hormonal and Inflammatory Factors With Tibial Cartilage Volume and Sex Difference in Cartilage Volume in Young Adults. Arthritis Care Res (Hoboken) 2016; 68:517-25. [PMID: 26386243 DOI: 10.1002/acr.22715] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 08/11/2015] [Accepted: 08/18/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe the associations between body composition and hormonal and inflammatory factors measured 5 years prior and tibial cartilage volume in young adults, and to explore if these factors contribute to the sex difference in tibial cartilage volume. METHODS Subjects broadly representative of the young adult Australian population (n = 328, ages 31-41 years, 47.3% women) were selected. They underwent T1-weighted fat-suppressed magnetic resonance imaging (MRI) of their knees. Tibial cartilage volume was measured from MRI. Sex hormone binding globulin (SHBG) and testosterone in a subset of women and C-reactive protein (CRP) level and fibrinogen in both sexes were measured 5 years prior. Body mass index (BMI), fat mass, and lean mass were calculated from height, weight, and skinfolds. RESULTS In multivariable analyses, correlates of tibial cartilage volume included lean body mass (β = 26.4 mm(3) ; 95% confidence interval [95% CI] 13.6, 39.1), fat mass (β = -11.8 mm(3) ; 95% CI -22.2, -1.4), and fibrinogen (β = -146.4 mm(3) ; 95% CI -276.4, -16.4), but not BMI, testosterone, or CRP level. In women, SHBG was positively associated with tibial cartilage volume (β = 0.67 mm(3) ; 95% CI 0.14, 1.20) and Free Androgen Index was negatively associated with lateral tibial cartilage volume (β = -0.04 mm(3) ; 95% CI -0.07, 0.00). Men had 13% more tibial cartilage volume (500 mm(3) ) than women. The magnitude of this association decreased by 38%, 20%, and 37% after adjustment for lean body mass, fat mass, and fibrinogen, respectively. CONCLUSION Body composition, sex hormones, and fibrinogen correlate with knee cartilage volume in young adult life. Sex difference in knee cartilage volume is contributed largely by variations in body composition and/or fibrinogen.
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Affiliation(s)
- Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Lyn March
- Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Terence Dwyer
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Marita Cross
- Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, Tasmania, Hobart, Australia, and Monash University, Melbourne, Australia
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21
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Nguyen TG, McKelvey KJ, March LM, Hunter DJ, Xue M, Jackson CJ, Morris JM. Aberrant levels of natural IgM antibodies in osteoarthritis and rheumatoid arthritis patients in comparison to healthy controls. Immunol Lett 2015; 170:27-36. [PMID: 26744098 DOI: 10.1016/j.imlet.2015.12.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/19/2015] [Accepted: 12/23/2015] [Indexed: 01/05/2023]
Abstract
Natural IgM antibodies (nIgM) are polyreactive autoantibodies that have diverse roles in regulating autoimmunity, systemic inflammation and removal of oxidized low-density lipoproteins (oxLDL). We hypothesized that aberrant states of nIgM may exist in persons with osteoarthritis (OA) and rheumatoid arthritis (RA). Herein, we characterized and compared the levels of nIgM specific for phosphorylcholine (anti-PC), double-stranded DNA (anti-dsDNA), and galactosyl (anti-Gal) in persons with OA, RA and healthy controls (HC). Levels of anti-PC nIgM in OA patients were significantly lower than both HC and RA patients in an age-adjusted analysis (P<0.05). In contrast, anti-Gal nIgM levels were significantly higher in RA patients than OA patients (P<0.05) and markedly increased in comparison to HC. Anti-PC nIgM significantly correlated with anti-dsDNA and anti-Gal nIgM levels in HC and RA (P<0.05) but not in OA patients. Elevated CRP levels were associated with RA conditions and old ages in general. There was no significant correlation between anti-PC nIgM and CRP or oxLDL levels. Our study highlights for the first time the evidence of aberrant state of nIgM in human OA compared to healthy individuals that implicates a deficiency in immune responses to oxLDL which may contribute to the metabolic syndromes in the development of OA.
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Affiliation(s)
- Tue G Nguyen
- Autoimmunity and Immunotherapy Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Perinatal Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia.
| | - Kelly J McKelvey
- Perinatal Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Sutton Arthritis Research Laboratory, Kolling Institute, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Lyn M March
- Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - David J Hunter
- Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Meilang Xue
- Sutton Arthritis Research Laboratory, Kolling Institute, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Christopher J Jackson
- Sutton Arthritis Research Laboratory, Kolling Institute, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Jonathan M Morris
- Perinatal Research, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Northern Clinical School, University of Sydney, Royal North Shore Hospital, Sydney, NSW 2065, Australia
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22
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Cai J, Xu J, Wang K, Zheng S, He F, Huan S, Xu S, Zhang H, Laslett L, Ding C. Association Between Infrapatellar Fat Pad Volume and Knee Structural Changes in Patients with Knee Osteoarthritis. J Rheumatol 2015; 42:1878-84. [PMID: 26276969 DOI: 10.3899/jrheum.150175] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The function of the infrapatellar fat pad (IPFP) in knee osteoarthritis (OA) remains uncertain. This study aimed to examine cross-sectional associations between IPFP volume and knee structures in patients with knee OA. METHODS The study included 174 patients with clinical knee OA (mean age, 55.5 yrs). Fat-suppressed 3-D T1-weighted spoiled gradient recall magnetic resonance imaging (MRI) was used to measure the IPFP and cartilage volume. T2-weighted fast spin echo MRI was used to assess cartilage defects and bone marrow lesions (BML). Radiographic knee osteophytes and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas. RESULTS After adjustment for potential confounders, greater IPFP volume was associated with greater tibial and patellar cartilage volume (all p < 0.05), and fewer cartilage defects at all sites (OR 0.88-0.91, all p < 0.05). IPFP volume was associated with presence of BML at lateral tibial and medial femoral sites (OR 0.88-0.91, all p < 0.05) and osteophytes at lateral tibiofemoral compartment (OR 0.88, p < 0.05). IPFP volume was not significantly associated with JSN. CONCLUSION Greater IPFP volume was associated with greater knee cartilage volume and fewer structural abnormalities, suggesting a protective role of IPFP size in knee OA.
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Affiliation(s)
- Jingyu Cai
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Jianhua Xu
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Kang Wang
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Shuang Zheng
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Fan He
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Shuting Huan
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Shengqing Xu
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Hui Zhang
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Laura Laslett
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania
| | - Changhai Ding
- From the Department of Rheumatology and Immunology, Arthritis Research Institute, and the Department of Medical Images, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.J. Cai, MMed; J. Xu, MD; K. Wang, MD; S. Zheng, MMed; F. He, MMed; S. Huan, MMed; S. Xu, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; H. Zhang, MMed, Department of Medical Image, the First Affiliated Hospital of Anhui Medical University; L. Laslett, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University; C. Ding, MD, Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, and Menzies Institute for Medical Research, University of Tasmania.
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23
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Hunter D, Beavers D, Eckstein F, Guermazi A, Loeser R, Nicklas B, Mihalko S, Miller G, Lyles M, DeVita P, Legault C, Carr J, Williamson J, Messier S. The Intensive Diet and Exercise for Arthritis (IDEA) trial: 18-month radiographic and MRI outcomes. Osteoarthritis Cartilage 2015; 23:1090-8. [PMID: 25887362 PMCID: PMC9178604 DOI: 10.1016/j.joca.2015.03.034] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 02/22/2015] [Accepted: 03/15/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE Report the radiographic and magnetic resonance imaging (MRI) structural outcomes of an 18-month study of diet-induced weight loss, with or without exercise, compared to exercise alone in older, overweight and obese adults with symptomatic knee osteoarthritis (OA). METHODS Prospective, single-blind, randomized controlled trial that enrolled 454 overweight and obese (body mass index, BMI = 27-41 kg m(-2)) older (age ≥ 55 yrs) adults with knee pain and radiographic evidence of femorotibial OA. Participants were randomized to one of three 18-month interventions: diet-induced weight loss only (D); diet-induced weight loss plus exercise (D + E); or exercise-only control (E). X-rays (N = 325) and MRIs (N = 105) were acquired at baseline and 18 months follow-up. X-ray and MRI (cartilage thickness and semi-quantitative (SQ)) results were analyzed to compare change between groups at 18-month follow-up using analysis of covariance (ANCOVA) adjusted for baseline values, baseline BMI, and gender. RESULTS Mean baseline descriptive characteristics of the cohort included: age, 65.6 yrs; BMI 33.6 kg m(-2); 72% female; 81% white. There was no significant difference between groups in joint space width (JSW) loss; D -0.07 (SE 0.22) mm, D + E -0.27 (SE 0.22) mm and E -0.16 (SE 0.24) mm (P = 0.79). There was also no significant difference in MRI cartilage loss between groups; D -0.10(0.05) mm, D + E -0.13(0.04) mm and E -0.05(0.04) mm (P = 0.42). CONCLUSION Despite the potent effects of weight loss in this study on symptoms as well as mechanistic outcomes (such as joint compressive force and markers of inflammation), there was no statistically significant difference between the three active interventions on the rate of structural progression either on X-ray or MRI over 18-months.
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Affiliation(s)
- D.J. Hunter
- Rheumatology Department, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW Australia,Address correspondence and reprint requests to: D.J. Hunter, Rheumatology Department, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW Australia. Tel: 61-2-9463-1887; Fax: 61-2-9463-1077. (D.J. Hunter)
| | - D.P. Beavers
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - F. Eckstein
- Institute of Anatomy, Paracelsus Medical University, Salzburg, Austria,Chondrometrics GmbH, Ainring, Germany
| | - A. Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - R.F. Loeser
- Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA,Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - B.J. Nicklas
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA,Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - S.L. Mihalko
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA,Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - G.D. Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - M. Lyles
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - P. DeVita
- Department of Kinesiology, East Carolina University, Greenville, NC, USA
| | - C. Legault
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - J.J. Carr
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - J.D. Williamson
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - S.P. Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA,Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA,Section on Rheumatology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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24
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Wang X, Hunter D, Xu J, Ding C. Metabolic triggered inflammation in osteoarthritis. Osteoarthritis Cartilage 2015; 23:22-30. [PMID: 25452156 DOI: 10.1016/j.joca.2014.10.002] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/23/2014] [Accepted: 10/06/2014] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is a common chronic joint disorder with a multifactorial etiology including genetic and environmental factors. Metabolic triggered inflammation, induced by nutrient overload and metabolic surplus, consists of components such as obesity, pro-inflammatory cytokines and adipokines, abnormal metabolites, acute phase proteins, vitamin D deficiency, and deregulated microRNAs that may play a role in OA pathophysiology. Obesity-related metabolic factors, especially adipokines, contribute to OA development by inducing pro-inflammatory cytokines and degradative enzymes, leading to cartilage matrix impairment and subchondral bone remodeling. Ectopic metabolite deposition and low-grade systemic inflammation can contribute to a toxic internal environment that exacerbates OA. Complement components highly expressed in osteoarthritic joints have also been proposed as causative factors. Vitamin D deficiency has been associated with obesity and is implicated to be associated with cartilage loss in OA. Metabolic microRNAs may explain the inflammatory link between obesity and OA. Therapies targeting metabolic-triggered inflammation and its components are anticipated to have potential for the treatment of OA.
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Affiliation(s)
- X Wang
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - D Hunter
- Institute of Bone and Joint Research, Kolling Institute and Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia
| | - J Xu
- Department of Rheumatology and Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, China
| | - C Ding
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia; Institute of Bone and Joint Research, Kolling Institute and Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia; Department of Rheumatology and Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, China.
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25
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Abstract
PURPOSE OF REVIEW There is an increasing number of reports suggesting that indicators of obesity for the general adult population may need to be modified; that the magnitude of risk is attenuated or that adiposity may even be protective; and that additional adverse outcomes specific to older persons need to be considered. Finally, there are benefits and adverse effects of weight loss programmes for older persons. This article reviews publications addressing these issues from 2013 to March 2014. RECENT FINDINGS BMI was not considered to be as good an indicator of obesity because of loss of muscle mass with age. Higher body weight seems to be protective among older persons with chronic diseases or geriatric syndromes. Increased adiposity together with decreased muscle mass (sarcopenic obesity) is associated with adverse outcomes, although there is no consensus regarding the definition. Intentional weight loss has health benefits but is accompanied by muscle and bone loss, and therefore programmes should include components to counteract these changes. SUMMARY The magnitude of health risk associated with obesity is attenuated with age, and mild increase in adiposity may be beneficial for those who are frail and/or with chronic diseases. Weight loss programmes should include resistance exercises to counteract muscle loss.
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Affiliation(s)
- J Woo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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26
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Han W, Cai S, Liu Z, Jin X, Wang X, Antony B, Cao Y, Aitken D, Cicuttini F, Jones G, Ding C. Infrapatellar fat pad in the knee: is local fat good or bad for knee osteoarthritis? Arthritis Res Ther 2014; 16:R145. [PMID: 25008048 PMCID: PMC4227074 DOI: 10.1186/ar4607] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 06/25/2014] [Indexed: 12/30/2022] Open
Abstract
Introduction Recent studies regarding the infrapatellar fat pad (IPFP) mainly focus on the roles of the cells derived from the IPFP. There have been few clinical or epidemiological studies reporting on the association between the IPFP and knee osteoarthritis (OA). Our objective is to generate hypotheses regarding the associations between IPFP maximum area and knee OA measures in older adults. Methods A total of 977 subjects between 50 and 80 years of age (mean, 62.4 years) participated in the study. Radiographic knee osteophyte and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas. T1- or T2-weighted fat suppressed magnetic resonance imaging (MRI) was utilized to assess IPFP maximum area, cartilage volume, cartilage defects, and bone marrow lesions (BMLs). Knee pain was assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Results After adjustment for potential confounders, IPFP maximum area was significantly associated with joint space narrowing (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.62 to 0.91 (medial), 0.77, 95% CI: 0.62 to 0.96 (lateral)) and medial osteophytes (OR: 0.52, 95% CI: 0.35 to 0.76), knee tibial and patellar cartilage volume (β: 56.9 to 164.9 mm3/cm2, all P <0.001), tibial cartilage defects (OR: 0.58, 95% CI: 0.41 to 0.81 (medial), 0.53, 95% CI: 0.40-0.71 (lateral)), any BMLs (OR: 0.77, 95% CI: 0.63 to 0.94), and knee pain on a flat surface (OR: 0.79, 95% CI: 0.63 to 0.98). IPFP maximum area was negatively, but not significantly, associated with femoral cartilage defects, lateral tibiofemoral BMLs, and total knee pain or other knee pain subscales. Conclusion IPFP maximum area is beneficially associated with radiographic OA, MRI structural pathology and knee pain on a flat surface suggesting a protective role for IPFP possibly through shock absorption. Consequently, we must pay special attention to IPFP in the clinical settings, avoiding resection of normal IPFP in knee surgery.
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27
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Pan F, Han W, Wang X, Liu Z, Jin X, Antony B, Cicuttini F, Jones G, Ding C. A longitudinal study of the association between infrapatellar fat pad maximal area and changes in knee symptoms and structure in older adults. Ann Rheum Dis 2014; 74:1818-24. [PMID: 24833783 DOI: 10.1136/annrheumdis-2013-205108] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 04/16/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND The infrapatellar fat pad (IPFP) is of uncertain significance for knee osteoarthritis. The aim of this study was to describe the longitudinal associations between baseline IPFP maximal area and changes in knee pain, knee cartilage volume and cartilage defects in older adults. METHODS 356 community-dwelling male and female adults aged 50-80 years were measured at baseline and approximately 2.6 years later. T1-weighted or T2-weighted fat-suppressed MRI was used to assess maximal IPFP area, cartilage volume and cartilage defects at baseline and/or follow-up. Knee pain was assessed by the self-administered Western Ontario McMaster Osteoarthritis Index questionnaire. RESULTS After adjustment for confounders, IPFP maximal area in women was significantly and negatively associated with changes in knee pain (β: -0.18 to -0.86 for total knee pain, pain at night while in bed, pain when sitting/lying and pain when standing upright, all p<0.05) but not with other knee pain subscales. IPFP maximal area in women was beneficially associated with change in tibial cartilage volume per annum (β: +1.56% per cm(2) at medial site; +0.86% per cm(2) at lateral site, both p<0.05), but not with change in patellar cartilage volume. Further, it was significantly associated with reduced risks of increases in medial cartilage defects (relative risk: 0·46 at tibial site, relative risk: 0.59 at femoral site; both p<0.05) but not with increases at other sites in women. No significant associations were found in men. CONCLUSIONS While the associations are not fully consistent, IPFP maximal area appears to have a protective role for knee symptoms and cartilage damage in older female adults.
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Affiliation(s)
- Faming Pan
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Weiyu Han
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia Department of Orthopedics, 3rd Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xia Wang
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Zhenhua Liu
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia Department of Orthopedics, 3rd Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xingzhong Jin
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Benny Antony
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Graeme Jones
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Changhai Ding
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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28
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Abstract
Osteoarthritis (OA) is the most common form of arthritis in the United States and is a leading cause of disability. It is typically defined in epidemiologic studies by radiographic findings and consideration of symptoms. Its incidence and prevalence are rising, likely related to the aging of the population and increasing obesity. Risk factors for OA include numerous person-level factors, such as age, sex, obesity, and genetics, as well as joint-specific factors that are likely reflective of abnormal loading of the joints. In studying OA, several methodologic challenges exist that can hamper our ability to identify pertinent relationships.
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Affiliation(s)
- Tuhina Neogi
- Sections of Clinical Epidemiology Research, Training Unit and Rheumatology, Boston University School of Medicine, Boston, MA 02118, USA.
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