POS1128 SERUM MARKERS OF GUT PERMEABILITY AND ENDOTOXEMIA IN PATIENTS WITH METABOLIC SYNDROME-ASSOCIATED KNEE OSTEOARTHRITIS: AN EXPLORATORY STUDY

Abstract

BackgroundMetabolic syndrome (MetS)-related osteoarthritis (OA) has been proposed as a distinct phenotype of OA (1). One of the many putative pathways linking MetS with OA is increased gut permeability resulting in endotoxemia, systemic inflammation, and cartilage damage. There is a lack of studies evaluating markers of gut permeability and endotoxemia in patients with MetS-associated OA.ObjectivesIn this exploratory study we aimed to: a. compare serum markers of gut permeability and endotoxemia in patients with knee OA and concomitant MetS vs patients with knee OA b. evaluate possible associations between the studied biomarkers, knee pain, function and body mass index (BMI) in patients with MetS plus OA.MethodsIn this cross-sectional study, we evaluated consecutive patients diagnosed with knee OA according to ACR criteria and willing to participate in the study. MetS was defined in accordance with NCEP ATP III criteria. Knee pain and function were assessed using the WOMAC scale. Serum concentrations of gut permeability marker zonulin, lipopolysaccharide (LPS), and soluble LPS receptor (sCD14) were measured using commercial ELISA kits.ResultsForty patients (19 with OA plus MetS, 21 with OA), all women, mean age 65.5 years, were included in the study. The participants in the compared groups were of similar age. Patients with MetS had significantly higher BMI, increased knee pain, impaired knee function, and elevated serum C-reactive protein levels. Serum LPS, sCD14, and zonulin concentrations were significantly higher (1.5 fold, 2 fold, and 3.5 fold, respectively) in patients with OA+MetS. In the latter group, serum zonulin, sCD14, and LPS concentrations were moderately positively correlated with BMI. There were no correlations between the studied serum biomarkers and WOMAC knee pain, only zonulin was moderately positively associated with WOMAC knee function (Figure 1)Figure 1.Spearman correlation between serum gut permeability markers, BMI, knee pain and function. * - p<0.95, ** - p<0.01ConclusionThese findings suggest that while associated with MetS, increased gut permeability may not play a significant role in OA clinical manifestations.