Abstract
BackgroundAdipokines secreted by adipose tissue create a low grade systemic inflammatory state that could contribute to the pathogenesis of knee OA (KOA). Previous studies of association between adipokines and radiographic KOA represented late-stage disease shown as bony changes. Magnetic Resonance Imaging (MRI) has the advantage of showing early changes of KOA in all joint structures.ObjectivesWe aimed to evaluate the association between the adipokines: Leptin, Adiponectin, Resistin, and hs-CRP with clinical, radiographical and MRI assessment of KOA severity.MethodsWe performed a cross-sectional study in participants with early KOA. Demographics, clinical (WOMAC), and MRI (BLOKS scoring) KOA severity were assessed. Serum leptin, adipokines, resistin and hs-CRP were measured. Association of adipokines with clinical and MRI severity outcomes were evaluated using regression models with adjustment with age, sex, and body mass index (BMI).Results139 participants with early KOA (82% women, mean ± SD age: 55.5 ± 7.8 years) were included. Participants had moderate KOA symptoms, mean WOMAC pain and function were 31.1 ± 18.4, and 32.0 ± 19.9 respectively. Mean BMI was 26.0 ± 5.9 kg/m2. After adjustment with age, sex and BMI, Leptin (p=0.001) and hs-CRP (p=0.03) were positively associated, while adiponectin (p=0.02) and resistin (p=0.03) were negatively associated with osteophyte size (Table 1). In addition, leptin was statistically significantly associated with cartilage loss, synovitis, and effusion, while hs-CRP was associated with meniscus extrusion. As for WOMAC assessed severity, only adiponectin was statistical significantly associated with WOMAC function.Table 1.Association of adipokines with MRI features and clinical symptoms, adjusted with age, sex and BMIKOA severityβ (95% confidence intervals)leptinAdiponectinResistinhs-CRPOST Size1.11 (0.5, 1.7)**-1.86 (-3.53, -0.18)*-2.12 (-3.95, -0.30)*0.17 (0.02, 0.31)*% Cart Loss0.37 (0.04, 0.71)*-0.45 (-1.32, 0.42)-0.72 (-1.67, 0.23)0.02 (-0.06, 0.10)BML Size0.24 (-0.02,0.50)-0.03 (-0.70,0.65)-0.15 (-0.92,0.56)0.02 (-0.04, 0.08)Synovitis0.24 (0.08, 0.40)**-0.21 (-0.63, 0.22)-0.33 (-0.79, 0.13)0.03 (-0.01, 0.07)Effusion0.21 (0.07, 0.35)**-0.25 (-0.62, 0.12)-0.09 (-0.49, 0.32)0.02 (-0.02, 0.05)Meniscus Extrusion0.09 (-0.06, 0.24)0.01 (-0.39, 0.40)-0.08 (-0.51, 0.35)0.04 (0.00, 0.07)*WOMAC pain1.72 (-1.45, 4.89)7.07 (-0.98, 15.1)-2.61 (-11.4, 6.14)0.04 (-0.68, 0.76)WOMAC function0.01 (-3.34,3.35)13.2 (5.0, 21.5)**-0.07 (-9.26, 9.12)-0.22 (-0.97, 0.54)*p<0.05, **p<0.01, Bold: statistically significant.ConclusionAdipokines, particularly leptin was associated with severity of various structural defects of the knee joint beyond age, sex and BMI in early KOA.MRI: Magnetic Resonance Imaging; %: percentage; BML: Bone Marrow Lesion; Cart: Cartilage; OST: Osteophyte; KL: Kellgren and Lawrence grading; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index.AcknowledgementsThis study is funded by the National Medical Research Council of Singapore (NMRCDisclosure of InterestsTimothy Chong: None declared, Jin-Rong Tan: None declared, Cheryl Ma: None declared, Steven Bak-Siew Wong: None declared, Ying Ying Leung Speakers bureau: Honorarium from Abbvie, DKSH, Janssen, Novartis and Pfizer.
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