Abstract
IntroductionSerum hyaluronic acid (sHA) is a serum biomarker for knee osteoarthritis (OA). Although sHA concentration is elevated in patients with knee OA, the relationship between serum concentration and disease progression remains unclear. We examined the relationship between sHA concentration and radiographic progression of knee OA in a cohort of individuals followed for 5 years.MethodsWe prospectively enrolled 444 individuals and measured their sHA concentrations at baseline. Anterior-posterior weight bearing knee radiographs were obtained at baseline and the 5-year endpoint. Osteoarthritic knee changes were classified according to Kellgren–Lawrence (KL) grade, and joint space narrowing (JSN) was measured using a Knee Osteoarthritis Computer-Aided Diagnosis (KOACAD) system. Correlations between sHA concentration, progression in KL grade, and JSN were assessed using regression models, taking into account potentially confounding factors.ResultsOA progressed from KL grades 0 or 1 in 129 of the 323 knees, and from KL grades 2 or 3 in 61 of the 119 knees. Higher sHA concentrations were correlated with KL grade progression (p = 0.004). The mean JSN, as assessed by KOACAD over 5 years, was 0.23 ± 0.55 mm, and sHA concentration was positively correlated with progression of JSN in KL grades 0 or 1 (p = 0.021) and KL grades 2 or 3 (p = 0.008) knees.ConclusionSerum HA concentration was positively correlated with progression of KL grade. sHA was also positively correlated with progression of JSN in knees with and without OA, suggesting that sHA concentration may be a useful predictor of knee OA progression.
Highlights
Serum hyaluronic acid is a serum biomarker for knee osteoarthritis (OA)
No significant differences were found for gender (p = 0.76), body mass index (BMI) (p = 0.97), serum hyaluronic acid (sHA) concentration (p = 0.35), KL grade (p = 0.13), or lifestyle habits between the followed subjects and those who dropped out (Table 1)
SHA concentration at baseline was correlated with joint space narrowing (JSN) in both normal and severely osteoarthritic knees, as assessed by radiograph
Summary
Serum hyaluronic acid (sHA) is a serum biomarker for knee osteoarthritis (OA). SHA concentration is elevated in patients with knee OA, the relationship between serum concentration and disease progression remains unclear. We examined the relationship between sHA concentration and radiographic progression of knee OA in a cohort of individuals followed for 5 years. Osteoarthritis (OA) is a common cause of pain and disability in elderly people [1]. Knee OA imposes a heavy burden of pain and disability, including high costs of treatments, decreased productivity, and absence from work. Magnetic resonance imaging (MRI) may allow for earlier OA diagnosis because it is capable of detecting cartilage damage, small osteophytes, subchondral bone changes, and synovitis in the presence or absence of symptoms [4,5,6]. MRI is expensive, time consuming, and contraindicated in some patients
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