膝关节骨性关节炎和骨质疏松症患者是一个独特的亚群体,其症状源于软骨下骨而非软骨的差异。

IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Andy K O Wong, Ali M Naraghi, Linda Probyn
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引用次数: 0

摘要

研究假设:患有骨质疏松症的膝骨关节炎患者是一个具有不同疾病特征和症状起源的亚群。使用 DXA(股骨颈 T 评分≤-2.5)对骨关节炎倡议(OAI)中第 5 次就诊(36 个月)的男性和女性骨质疏松症患者(N = 1483)、使用双膦酸盐或发生过骨折的患者进行检查。根据软骨下骨质量、骨髓病变(BML)特性和核磁共振成像软骨厚度,采用一般线性模型对有骨质疏松症和无骨质疏松症的患者进行比较。在骨质疏松症状态的条件下,对症状(12 个月后)与软骨或软骨下骨特征之间的关系进行了研究。总体而言,在 1246 名患有膝关节 OA 的参与者(825 名女性,658 名男性,平均年龄:64.4 ± 8.9 岁,体重指数:30.1 ± 4.9 kg/m2)中,有 15.2% 的人可能患有骨质疏松症,并表现出较低的内侧和外侧软骨下骨密度、较小的骨小梁数量和较大的骨小梁分离度(所有 p 值均为 0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Individuals with Knee Osteoarthritis and Osteoporosis Represent a Distinctive Subgroup Whose Symptoms Originate from Differences in Subchondral Bone Rather than Cartilage.

To explore the hypothesis that knee osteoarthritis patients with osteoporosis represent a sub-cohort with different disease characteristics and origin of symptoms. Men and women in the Osteoarthritis Initiative (OAI) at visit 5 (36 months) were examined for osteoporosis (N = 1483) using DXA (T-score at femoral neck ≤ -2.5), use of bisphosphonates, or having experienced a fracture. Those with and without osteoporosis were compared by subchondral bone quality, bone marrow lesion (BML) properties, and cartilage thickness from MRI, with general linear modeling. Relationships between symptoms (12 months later) and each of cartilage or subchondral bone features were examined conditional on osteoporosis status. Overall, 15.2% of 1246 participants (825 women, 658 men, mean age: 64.4 ± 8.9yrs, BMI: 30.1 ± 4.9 kg/m2) with knee OA likely had osteoporosis and showed lower medial and lateral subchondral bone density, smaller trabecular number and larger trabecular separation (all p < 0.01) compared to those without. Cartilage thickness appeared lower in this group (p = 0.04) but only by a small amount. Knee symptoms correlated with both BML properties and cartilage thickness; the latter but not the former being moderated by osteoporosis status. Those with osteoporosis showed no relationship between cartilage and knee symptoms, but demonstrated bone-related associations with symptoms. Osteoporosis affects the pattern of subchondral bone and cartilage properties in individuals with knee osteoarthritis. Knee symptoms in this subgroup likely originates in bone instead of cartilage. Osteoporosis screening may help identify knee osteoarthritis patients at further risk of subchondral bone damage leading to pain.

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来源期刊
Calcified Tissue International
Calcified Tissue International 医学-内分泌学与代谢
CiteScore
8.00
自引率
2.40%
发文量
112
审稿时长
4-8 weeks
期刊介绍: Calcified Tissue International and Musculoskeletal Research publishes original research and reviews concerning the structure and function of bone, and other musculoskeletal tissues in living organisms and clinical studies of musculoskeletal disease. It includes studies of cell biology, molecular biology, intracellular signalling, and physiology, as well as research into the hormones, cytokines and other mediators that influence the musculoskeletal system. The journal also publishes clinical studies of relevance to bone disease, mineral metabolism, muscle function, and musculoskeletal interactions.
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