Nan Hu1, Jing Zhang1, Jing Wang2, Pei Wang1, Jing Wang2, Yongqian Qiang2, Zicheng Li3, Tianming Wu4, Xing Wang5, Yahong Wang5, Jiao Li3, Xiaoping Liu6, Jirong Zhang3, Xiuyuan Feng1, Bomiao Ju1, Zhiming Hao1, Dan Pu1, Xiaohong Lu1, Qiang Wang7, Lan He8. 1. Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China. 2. Department of Radiography, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 3. Department of Radiography, Shenmu Hospital, Shenmu, China. 4. Clinical Laboratory, Shenmu Hospital, Shenmu, China. 5. Physical Examination Center, Shenmu Hospital, Shenmu, China. 6. Department of Orthopaedics, Shenmu Hospital, Middle Section of Guangming Road, Shenmu, 719300, Shaanxi, China. 7. Department of Orthopaedics, Shenmu Hospital, Middle Section of Guangming Road, Shenmu, 719300, Shaanxi, China. 13509129505@163.com. 8. Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China. xajdhl87@mail.xjtu.edu.cn.
Abstract
INTRODUCTION: Biomarkers of bone and cartilage metabolism were proposed as early diagnosis indicators for knee osteoarthritis (OA), however, which were influenced by disease stage, age, and menopause state. Accurate diagnosis indicators are eagerly awaited. The current study aims to investigate associations of joint metabolism biomarkers and bone mineral density (BMD) with early knee OA in males and premenopausal females before age 50 years. METHOD: A total of 189 patients aged before 50 years with early knee OA and 152 healthy participants were enrolled. Levels of bone biomarkers (PINP, OC, and CTX-I) and cartilage biomarkers (PIIANP, COMP, CTX-II, and MMP-3) were assessed. BMD was measured at the lumbar, femoral neck, and hip. Multivariate regression analyses were performed to evaluate the relationship between biomarkers, BMD, and early knee OA. RESULTS: Serum COMP, urine CTX-II and BMD at femoral neck and hip were increased in premenopausal patients as compared to control; with serum PINP and OC reduced. Meanwhile, serum COMP, urine CTX-II, and BMD at femoral neck and hip showed positive associations with premenopausal early knee OA, while serum PINP had negative association. However, in male patients, only serum COMP was higher than control, and no association of biomarkers or BMD was found with early knee OA. CONCLUSIONS: The joint metabolism biomarkers and BMD showed multiple associations with early knee OA in premenopausal females, but not in males aged before 50 years. It was suggested that sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA. Key Points • The joint metabolism biomarkers and BMD are associated with early knee OA in premenopausal females, but not in males aged before 50 years. • Sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA.
INTRODUCTION: Biomarkers of bone and cartilage metabolism were proposed as early diagnosis indicators for knee osteoarthritis (OA), however, which were influenced by disease stage, age, and menopause state. Accurate diagnosis indicators are eagerly awaited. The current study aims to investigate associations of joint metabolism biomarkers and bone mineral density (BMD) with early knee OA in males and premenopausal females before age 50 years. METHOD: A total of 189 patients aged before 50 years with early knee OA and 152 healthy participants were enrolled. Levels of bone biomarkers (PINP, OC, and CTX-I) and cartilage biomarkers (PIIANP, COMP, CTX-II, and MMP-3) were assessed. BMD was measured at the lumbar, femoral neck, and hip. Multivariate regression analyses were performed to evaluate the relationship between biomarkers, BMD, and early knee OA. RESULTS: Serum COMP, urine CTX-II and BMD at femoral neck and hip were increased in premenopausal patients as compared to control; with serum PINP and OC reduced. Meanwhile, serum COMP, urine CTX-II, and BMD at femoral neck and hip showed positive associations with premenopausal early knee OA, while serum PINP had negative association. However, in male patients, only serum COMP was higher than control, and no association of biomarkers or BMD was found with early knee OA. CONCLUSIONS: The joint metabolism biomarkers and BMD showed multiple associations with early knee OA in premenopausal females, but not in males aged before 50 years. It was suggested that sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA. Key Points • The joint metabolism biomarkers and BMD are associated with early knee OA in premenopausal females, but not in males aged before 50 years. • Sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA.
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