High Risk Of Knee Osteoarthritis Research Articles

Ultra-processed food consumption, genetic susceptibility, and the risk of hip/knee osteoarthritis

The associations between ultra-processed food (UPF) consumption, genetic susceptibility, and the risk of osteoarthritis (OA) remain unknown. This study was to examine the effect of UPF consumption, genetic susceptibility, and their interactions on hip/knee OA. Cohort analyses included 163,987 participants from the UK Biobank. Participants' UPF consumption was derived from their 24-h dietary recall using a questionnaire. Genetic risk scores (GRSs) of 70 and 83 single nucleotide polymorphisms (SNPs) for hip and knee OA were constructed. After 1,461,447 person-years of follow-up, 11,540 patients developed OA. After adjustments, compared to participants in the low quartile of UPF consumption, those in the high quartile had a 10 % (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.03-1.18) increased risk of knee OA. No significant association was found between UPF consumption and hip OA. Replacing 20% of UPF diet weight with an equivalent proportion of unprocessed or minimally processed food caused a 6% (HR, 0.94; 95% CI, 0.89-0.98) decreased risk of knee OA, respectively. A significant interaction was found between UPF consumption, genetic predisposition, and the risk of knee OA (P=0.01). Participants with lower OA-GRS scores experienced higher knee OA risks due to UPF consumption. UPF consumption was associated with a higher risk of knee OA but not hip OA, particularly in those with lower genetic susceptibility. These results highlight the importance of reducing UPF consumption to prevent knee OA.

Analysis on the risk of degenerative knee arthritis in the elderly during regular exercise

<p>目的：經由退化性膝關節炎 (knee osteoarthritis, KOA) 風險角度檢測，探討規律參與運動的中年人與中老年人是否有較高的 KOA 罹患風險。方法：招募規律運動習慣的實驗參與者共 14 位，分為中年組 7 位 (年齡為44.1 ± 4.7歲)，以及中老年組 7 位 (年齡為59.0 ± 8.8歲)。使用 2 台高速攝影機拍攝膝關節內外翻角度，以及Noraxon無線肌電感測系統分析股內側肌與股外側肌之肌肉活化特徵，使用描述性統計分析兩組實驗參與者是否有 KOA 風險的角度特徵，以及經由獨立樣本 t-test 比較中年組與中老年組在膝關節內外翻角度與肌肉活化特徵之差異，顯著水準設 α = .05。結果：中年組膝內翻角度為 0.71 ± 2.9˚，中老年組為 2.14 ± 4.4˚，以上皆小於罹患 KOA 之風險角度 (內翻 3˚)，兩組間無顯著差異。兩組實驗參與者在步行時，股內側肌與股外側肌的活化程度相似，無顯著差異。股內側肌與股外側肌之活化比例與活化時間差值，在兩組之間皆未達顯著差異。結論：在本研究中未發現長期規律運動的中年人與中老年人有較高的退化性膝關節炎罹患風險，膝內翻角度皆未超過罹患 KOA 的風險角度值，平均年齡接近 60 歲的中老年組，KOA 風險角度的平均值仍低於 3°，因此適度的運動對膝關節健康應有正面的效益。</p><p>Purpose: Through detecting Knee Osteoarthritis (KOA) risk perspective, to explore whether middle-aged and middle-aged people who regularly participate in sports have a higher risk of KOA. Methods: Fourteen participants with regular exercise habits were recruited and divided into the middle-aged group (seven participants aged 44.1 ± 4.7 years old) and the pre-elderly group (59.0 ± 8.8 years old). Two high-speed cameras were used to capture the varus and valgus angles of the knee joint, and the Noraxon wireless electromyography system was used to analyze the muscle activation characteristics of the vastus medialis and vastus lateralis muscles. Descriptive statistics were used to analyze the angle characteristics of whether the two groups of experiment participants were at risk of KOA. And through the independent sample t-test to compare the differences between the middle-aged group and the pre-elderly group in the varus angle and muscle activation characteristics of the middle-aged group, the significance level was set at α = .05. Results: The knee varus angle was 0.71 ± 2.9° in the middle-aged group, and 2.14 ± 4.4° in the middle-aged and elderly group, all of which were smaller than the risk angle of KOA (varus 3°) and there was no significant difference between the two groups. The activation of the vastus medialis and vastus lateralis was similar between the two groups of participants during walking, with no significant difference. There was no significant difference between the two groups in the activation ratio and activation time difference of vastus medialis and vastus lateralis. Conclusion: In this study, it was not found that middle-aged people and pre-elderly people who exercise regularly for a long time have a higher risk of degenerative knee arthritis, and the angle of knee varus does not exceed the risk angle value of KOA, and the average age is close to 60 years old in the pre-elderly group, the average KOA risk angle was still lower than 3°; therefore moderate exercise should have a positive effect on knee joint health.</p> <p> </p>

Association between Cardiovascular Diseases and Knee Osteoarthritis

CONTEXT: Cardiovascular diseases (CVDs) such as ischemic heart diseases, heart failure, and stroke are the leading causes of morbidity and mortality (almost 30% of deaths) worldwide. Sociodemographic and clinical factors, such as obesity, diabetes, depressive symptoms, and physical inactivity, as factors behind the risk of CVDs.
 
 AIMS: This study aims to identify the factors behind the risk of CVDs in people with or at high risk for Knee Osteoarthritis (OA).
 
 SETTINGS & DESIGN: The baseline data (2004–2006) of a total of 4674 persons with or at high risk for knee OA aged 45–79 years from the Osteoarthritis Initiative (OAI).
 
 METHODS & MATERIAL: This study adopted a cross-sectional study. Baseline data (2004–2006) from the Osteoarthritis Initiative were analyzed to determine the sociodemographic and clinical factors behind CVDs in 4674 persons.
 
 STATISTICAL ANALYSIS USED: The Kolmogorov-Smirnov test was used to assess the data normality for continuous parameters.
 
 RESULTS: The results indicate 178 (62%) participants with age ≥65 years also had CVDs (p <.0001). Male gender had OR = 2.97 for heart attack and OR = 2.53 for heart failure making the implied probability of 33.7% and 39.5% respectively (p < 0.05). The OR and implied probability of diabetes and obesity for heart failure were 1.81 (55.2%) and 2.20 (45.5%) respectively (p<0.05). 
 
 CONCLUSIONS: These findings provide a rationale for further investigation of those factors behind the risk of CVDs in cross-sectional studies among this population.

The Natural History of Knee Osteoarthritis Pain Experience and Risk Profiles

The study aimed to characterize the natural history of the pain experience, concurrently considering intermittent and constant pain over 4 years, and determine baseline factors associated with unfavorable trajectories in individuals with chronic knee pain. The Osteoarthritis Initiative (OAI) is a prospective, observational study of people with or at higher risk for knee osteoarthritis. The Intermittent and Constant Osteoarthritis Pain (ICOAP) was assessed annually at 48-to-96-month OAI visits. Twenty-eight baseline sociodemographic, knee-specific, and health-related characteristics were assessed. Group-based dual-trajectory modeling identified pain experience patterns indicated by ICOAP intermittent and constant pain scores over 4 years. Multivariable multinomial logistic regression models determined baseline factors associated with membership in each dual-trajectory group. Four longitudinal pain experience patterns were identified (n = 3,584, mean age = 64.8 [standard deviation 9.0] years, BMI = 28.6 [5.0] kg/m2; 57.9% women). Group 1 (37.7%) had minimal intermittent and no constant pain; Group 2 (35.1%) had mild intermittent and no constant pain; Group 3 (18.5%) had mild intermittent and low-grade constant pain; and Group 4 (8.7%) had moderate intermittent and constant pain. Baseline widespread pain, knee stiffness, back pain, hip pain, ankle pain, obesity, depressive symptoms, more advanced radiographic disease, and analgesic use were each associated with an increased risk of membership in less favorable Groups 2, 3, and 4. These distinct courses of pain experience may be driven by different underlying pain mechanisms. The benchmarked ICOAP scores could be used to stratify patients and tailor management. Addressing and preventing the development of modifiable risks (eg, widespread pain and knee joint stiffness) may reduce the chance of belonging to unfavorable dual-trajectory groups. PerspectiveConcurrently tracking intermittent versus constant pain experience, group-based dual-trajectory modeling identified 4 distinct pain experience patterns over 4 years. The benchmarked ICOAP scores in these dual trajectories could aid in stratifying patients for tailored management strategies and intensity of care.

Sitting may increase risk for radiographic incidence and progression of knee osteoarthritis over 2years: Data from alarge cohort study.

To examine the association of leisure-time sitting with radiographic incidence and progression of knee osteoarthritis (OA) over 2years, and to determine whether worktime sitting modifies this association. We included adults with or at high risk for knee OA who enroled in the Osteoarthritis Initiative (OAI). Participants reported leisure-time sitting (≤4 vs. >4h/day) and worktime sitting (frequent vs. infrequent) at enrolment, and had bilateral knee radiographs at enrolment and 2years later. Our outcome, radiographic knee OA incidence/progression (yes/no), was defined as any increase in Kellgren-Lawrence grade over 2years. We examined the association of leisure-time sitting (≤4 vs. >4h/day) with risk of radiographic knee OA incidence/progression using binary linear regression, adjusting for potential confounders. We stratified by worktime sitting (frequent vs. infrequent) and repeated our analysis. We included 4254 adults (mean age 61years; 58% women; mean body mass index 29kg/m2 ) who contributed a total of 8127 knees. Adults with >4h/day of leisure-time sitting had 25% higher risk (adjusted risk ratio [RR] 1.25, 95% confidence interval [95% CI] 1.08-1.50) for radiographic knee OA incidence/progression compared with adults with ≤4h/day of leisure-time sitting (referent group). Importantly, this association was intensified (RR 1.60, 95% CI 1.19-2.33) among adults with frequent worktime sitting, but was attenuated (RR 1.11, 95% CI 0.89-1.39) among adults with infrequent worktime sitting. Higher leisure-time sitting (>4h/day) may be associated with greater risk for radiographic knee OA incidence/progression over 2years. Furthermore, this association was intensified among adults who also reported frequent worktime sitting.

Prevalence and factors associated with knee osteoarthritis among middle-aged and elderly individuals in rural Tianjin: a population-based cross-sectional study

BackgroundThe prevalence of osteoarthritis has been investigated in many countries and regions. Considering the wide differences in ethnicity, socioeconomic status, environmental factors, and lifestyle patterns, our study aimed to report the prevalence of knee osteoarthritis (KOA) and its associated factors in rural areas of Tianjin.MethodsThis population-based cross-sectional study was conducted between June and August 2020. KOA was diagnosed according to the 1995 American College of Rheumatology criteria. Information on participants’ age, years of education, BMI, smoking and drinking status, sleep quality, and frequency of walking were collected. Multivariate logistic regression analysis was used to analyze factors influencing KOA.ResultsThis study included 3924 participants (1950 male and 1974 female); the mean age of all participants was 58.53 years. In total, 404 patients were diagnosed with KOA, and the overall prevalence of KOA was 10.3%. The prevalence of KOA was higher in women than in men (14.1% vs. 6.5%). The risk of KOA in women was 1.764 times higher than that in men. The risk of KOA increased following the increasement of age. There was higher risk of KOA in participants who walked frequently than in participants who walked infrequently (OR = 1.572); in participants with overweight than in participants with normal weight (OR = 1.509), in participants with average sleep quality (OR = 1.677) and those with perceived poor sleep quality (OR = 1.978), respectively, than participants with satisfactory sleep quality, and in postmenopausal women than in non-menopausal women (OR = 4.12). The risk of KOA in participants with an elementary level was lower (0.619 times) than participants with illiteracy. In addition, the results of gender subgroup analysis showed that in male, age, obesity, frequent walking and sleep quality were independent factors associated with KOA; while in female, age, BMI, education level, sleep quality, frequent walking and whether menopausal were independent factors associated with KOA (P < 0.05).ConclusionThe results of our population-based cross-sectional study showed that sex, age, educational level, BMI, sleep quality, and frequent walking were independent influencing factors for KOA, and the influencing factors for KOA differed between the sexes. In order to reduce the disease burden of KOA and the harm to the health of middle-aged and elderly people, the risk factors related to the control of KOA should be identified as much as possible.Trial registration: ChiCTR2100050140.

Effects of Running on the Development of Knee Osteoarthritis: An Updated Systematic Review at Short-Term Follow-up.

Some studies have suggested that running increases the risk of knee osteoarthritis (OA), while others believe it serves a protective function. To perform an updated systematic review of the literature to determine the effects of running on the development of knee OA. Systematic review; Level of evidence, 4. A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify studies evaluating the effect of cumulative running on the development of knee OA or chondral damage based on imaging and/or patient-reported outcomes (PROs). The search terms used were "knee AND osteoarthritis AND (run OR running OR runner)." Patients were evaluated based on plain radiographs, magnetic resonance imaging (MRI), and PROs (presence of knee pain, Health Assessment Questionnaire-Disability Index, and the Knee injury and Osteoarthritis Outcome Score). Seventeen studies (6 level 2 studies, 9 level 3 studies, and 2 level 4 studies), with 7194 runners and 6947 nonrunners, met the inclusion criteria. The mean follow-up time was 55.8 months in the runner group and 99.7 months in the nonrunner group. The mean age was 56.2 years in the runner group and 61.6 years in the nonrunner group. The overall percentage of men was 58.5%. There was a significantly higher prevalence of knee pain in the nonrunner group (P < .0001). Although 1 study found a significantly higher prevalence of osteophytes in the tibiofemoral (TF) and patellofemoral (PF) joints within the runner group, multiple studies found no significant differences in the prevalence of radiographic knee OA (based on TF/PF joint-space narrowing or Kellgren-Lawrence grade) or cartilage thickness on MRI between runners and nonrunners (P > .05). One study found a significantly higher risk of knee OA progressing to total knee replacement among nonrunners (4.6% vs 2.6%; P = .014). In the short term, running is not associated with worsening PROs or radiological signs of knee OA and may be protective against generalized knee pain.

Annual income, age, marital status, and smoking influence healthcare access among American minorities and Caucasians with knee osteoarthritis

ABSTRACT This study examined the associations between annual income, age, marital status, smoking status, and healthcare access in American minority and Caucasian populations with or at high risk for knee osteoarthritis (KOA). The Osteoarthritis Initiative provided data on 4674 Americans aged between 45 and 79 years with or at increased risk for KOA. We categorized the participants into American minorities (such as African Americans, Asians, or other non-whites) and Caucasians based on racial and ethnic backgrounds. A multinomial regression analysis revealed that American minorities having an annual income of <$50,000 and who were single, divorced, or widowed were 3.82- and 2.19-times more likely not to have healthcare access, respectively. For Caucasians, age ≥65, annual household income <$50,000, and present or past smoking habit were 2.34-, 1.93-, and 1.50-times more likely not to access healthcare, respectively. American minorities and Caucasians who either had KOA or were at high risk for developing it and had lower annual income had a greater likelihood of not accessing healthcare. Age ≥65 years and smoking history impacted healthcare access in Caucasians, whereas American minorities were more affected by being single, divorced, or widowed.

Automated machine learning-based prediction of the progression of knee pain, functional decline, and incidence of knee osteoarthritis in individuals at high risk of knee osteoarthritis: Data from the osteoarthritis initiative study.

This study aimed to examine the performance of machine learning models in predicting the progression of knee pain, functional decline, and incidence of knee osteoarthritis (OA) in high-risk individuals, with automated machine learning (AutoML) being used to automate the prediction process. There were four stages in the process of our AutoML-integrated prediction. Stage 1-Data preparation: The data of 3200 eligible individuals in the Osteoarthritis Initiative (OAI) study who were considered at high risk of knee OA at the baseline visit were extracted and used. Specifically, 1094 variables from the OAI study were used to predict the changes in knee pain, physical function, and incidence of knee OA (i.e. the first occurrence of frequent knee symptoms and definite tibial osteophytes (Kellgren and Lawrence grade ≥2)) over a 9-year period. Stage 2-Model training: The AutoML approach was used to automatically train nine widely used machine learning (ML) models. Stage 3-Model testing: The AutoML approach was used to automatically test the performance of the ML models. Stage 4-Selection of important input variables: The AutoML approach automated the process of computing the importance scores of all input variables and identifying the most important ones, using the technique of permutation feature importance. Using the AutoML approach, the weighted ensemble model and the CatBoost model showed the best performance among all nine ML models. For the prediction of each outcome in each year, the five most important input variables were identified, most of which were obtained from self-reported questionnaire surveys and radiographic imaging reports. The AutoML approach has shown potential in automating the process of using ML models to predict long-term changes in knee OA-related outcomes. Its use could support the deployment of ML solutions, facilitating the provision of personalized interventions to prevent the deterioration of knee health and incident knee OA.

Passive stiffness of the quadriceps predicts the incidence of clinical knee osteoarthritis in twelve months.

Quadriceps weakness is a known risk factor for the onset of knee osteoarthritis (OA). In addition to muscle weakness, increased passive stiffness of the quadriceps may affect knee biomechanics and hence contribute to the pathogenesis of knee OA. However, the association between quadriceps stiffness and the risk of knee OA development has not been prospectively investigated. The aim of this study was to investigate how baseline quadriceps passive stiffness predicts the incidence of clinical knee OA at the 12-month follow-up. Prospective cohort study. University laboratory. Community-dwelling adults aged 60-80 years were recruited. We excluded participants with: 1) knee pain or known arthritis; 2) knee injury; 3) knee or hip joint replacement, 4) cognitive impairment; or 5) neurological conditions. At baseline, passive stiffness of the three superficial quadriceps muscle heads (rectus femoris [RF], vastus lateralis [VL], and vastus medialis oblique [VMO]) was evaluated using shear-wave ultrasound elastography. Knee muscle (quadriceps and hamstrings) strength was tested using a Cybex dynamometer. Knee OA was defined based on clinical criteria 12 months after baseline measurements. Generalized estimating equations were used to examine the associations of quadriceps stiffness and knee muscle strength with the risk of knee OA, controlling for age, sex, Body Mass Index, comorbidities, and activity level. The analyses included 158 knees (58.2% females, age: 65.6±4.1 years). Twenty-eight knees (17.7%) were classified as having clinical OA at 12 months. Compared with the lowest stiffness tertiles, the highest stiffness tertiles of the RF (relative risk =5.31, 95% CI: 1.34-21.0), VMO (4.15, 1.04-16.6), and total superficial quadriceps (6.35, 1.48-27.3) at baseline were significantly associated with a higher risk of knee OA at the follow-up. The highest strength tertile of quadriceps has a trend of association with a lower risk of knee OA than the lowest tertile (0.18, 0.03-1.25, P=0.083). Greater passive stiffness of the quadriceps at baseline was associated with a higher risk of clinical knee OA incidence at the 12-month follow-up. Interventions for reducing the passive stiffness of the quadriceps should be included in preventative training programs for older adults.

Knee Confidence Trajectories Over Eight Years and Factors Associated With Poor Trajectories in Individuals With or at Risk for Knee Osteoarthritis.

To identify distinct trajectories of lack of knee confidence over an 8-year follow-up period and to examine baseline factors associated with poor trajectories in individuals with or at risk for knee osteoarthritis (OA). The Osteoarthritis Initiative is a prospective cohort study of individuals with or at high risk for knee OA. Confidence in the knees was assessed within the Knee Injury and Osteoarthritis Outcome Score instrument querying how much the individual is troubled by lack of confidence in his/her knee(s), rated as not-at-all (score=0), mildly (score=1), moderately (score=2), severely (score=3), and extremely (score=4) troubled, reported annually from baseline to 96 months. Lack of knee confidence was defined as a score of ≥2. We used latent class models to identify subgroups that share similar underlying knee confidence trajectories over an 8-year period and multivariable multinomial logistic regression models to examine baseline factors associated with poor trajectories. Among 4,515 participants (mean ± SD age 61.2 ± 9.2 years, mean ± SD BMI 28.6 ± 4.8 kg/m2 ; 2,640 [58.5%] women), 4 distinct knee confidence trajectories were identified: persistently good (65.6%); declining (9.1%); poor, improving (13.9%); and persistently poor (11.4%). Baseline predictors associated with persistently poor confidence (reference: persistently good) were younger age, male sex, higher body mass index (BMI), depressive symptoms, more advanced radiographic disease, worse knee pain, weaker knee extensors, history of knee injury and surgery, and reported hip and/or ankle pain. Findings suggest the dynamic nature of self-reported knee confidence and that addressing modifiable factors (e.g., BMI, knee strength, depressive symptoms, and lower extremity pain) may improve its long-term course.

Knee joint osteoarthritis in obese subjects, effects of diet and exercise on knee-joint loading: a review of literature

The incidence of osteoarthritis (OA) is greater in the knee than in other joints and is increasing. This could be because of an increase in the applied loads on this joint or because of a change in the alignment of the knee joint. The aim of this review was to determine the effects of being overweight on knee joint OA. Moreover, it aimed to determine whether a change in body weight by diet or exercise influenced the loads applied on the knee joint and decreased the incidence of knee OA. A systematic literature search was carried out to find the literature published on the effects of joint loading and being overweight on knee OA in databases such as Medline, PubMed, Embase, Web of Sciences, Scopus, and Google Scholar. The key words such as knee OA and loading, knee OA and joint contact forces, knee OA and body weight were used to determine the effects of joint loading on knee OA. The quality of the studies was evaluated by use of Downs and Black tool. There were 15 studies on the effects of joint loading, overweight, and obesity on joint contact force and knee OA symptoms and three studies on the effects of weight loss, exercise, and intensive diet intervention on joint loading. The quality of these papers varied between 9 and 20. The results of this review showed that obese subjects are at high risk of knee OA because of change in alignment of the knee joint and also overloading of the joint. Use of approaches such as diet and exercise may decrease the loads applied on the joint and decrease the incidence of knee OA.

High Estimated 24-Hour Urinary Sodium Excretion Is Related to Symptomatic Knee Osteoarthritis: A Nationwide Cross-Sectional Population-Based Study.

High salt intake results in various harmful effects on human health including hypertension, cardiovascular disease, and reduced bone density. Despite this, there are very few studies in the literature that have investigated the association between sodium intake and osteoarthritis (OA). Therefore, we aimed to explore these associations in a Korean population. This study used cross-sectional data from adult subjects aged 50-75 years from two consecutive periods of the Korean National Health and Nutrition Examination Survey V-VII (2010-2011 and 2014-2016). The estimated 24-hour urinary sodium excretion (24HUNa) was used as a surrogate marker of salt intake. In the 2010-2011 dataset, knee OA (KOA) was defined as the presence of the radiographic features of OA and knee pain. The association between KOA and salt intake was analysed using univariable and multivariable logistic regression methods. For the sensitivity analysis, the same procedures were conducted on subjects with self-reported OA (SR-OA) with knee pain in the 2010-2011 dataset and any site SR-OA in the 2014-2016 dataset. Subjects with KOA had significantly lower energy intake, but higher 24HUNa than those without KOA. The restricted cubic spline plots demonstrated a J-shaped distribution between 24HUNa and prevalent KOA. When 24HUNa was stratified into five groups (<2, 2-3, 3-4, 4-5 and ≥5 g/day), subjects with high sodium intake (≥5 g/day) had a higher risk of KOA (odds ratio [OR] = 1.64, 95% confidence interval [CI] 1.03-2.62) compared to the reference group (3-4 g/day) after adjusting for covariates. The sensitivity analysis based on SR-OA with knee pain showed that high sodium intake was also significantly associated with increased prevalence of OA (OR = 1.84, 95% CI 1.10-3.10) compared with the reference group. Regarding SR-OA at any site in the 2014-2016 dataset, estimated 24HUNa showed a significantly positive association with the presence of SR-OA after adjusting for potential confounders. This nationwide Korean representative study showed a significant association between symptomatic KOA and high sodium intake (≥5 g/day). Avoidance of a diet high in salt might be beneficial as a non-pharmacologic therapy for OA.

Sarcopenia, sarcopenic obesity and osteoarthritis

Sarcopenia is considered an important geriatric syndrome, the manifestations of which lead to impaired quality of life and increased mortality. Sarcopenia is a disease associated with decreased muscle mass and strength. Sarcopenic obesity is manifested by an increase in subcutaneous or visceral fat, fatty degeneration of muscles, and is also accompanied by impaired muscle function. After the age of 40, an average of 8 % loss of muscle mass is noted, and by the age of 80 this value can reach 50 %. The review examined the relationship between sarcopenia, sarcopenic obesity, and osteoarthritis (OA).Many exogenous and endogenous factors influence the development and course of OA. Based on the study of mechanisms of cellular and molecular profiles, the specific features for these frequently coexisting pathologies have been identified. The review presents the molecular mechanisms in the development of sarcopenia, sarcopenic obesity and osteoarthritis. Increased fat mass is manifested by increased adipogenesis, expression of inflammatory molecules (leptin, adiponectin, interleukin-1 (IL-1), IL-1b, IL-6 and tumor necrosis factor α) that contribute to chronic low-grade systemic inflammationand negatively affect muscle and joint quality. The relationship between elevated levels of myostatin and muscle weakness as well as myostatin accumulation in synovial fluid and severity of osteoarthritis was considered. Some common mechanisms in the development of sarcopenia and OA were noted: the influence of oxidative stress, systemic chronic inflammation, and disruption of the signaling pathway of bone morphogenetic proteins. Based on the analysis of associations between sarcopenia, sarcopenic obesity, and OA, population-based studies have revealed a high prevalence of knee OA with an increased risk among men with sarcopenic obesity. Women with sarcopenia and sarcopenic obesity had a high risk of knee OA in both groups. The review reviewed the prevention and treatment of the combined pathology, in particular the effect of sarcopenia on the results of total joint а rthroplasty in patients with OA. In general, sarcopenia, sarcopenic obesity, and OA can be considered as concomitant age-associated diseases that jointly affect quality of life and life expectancy.

Association of Matrix Metalloproteinase (MMP) Gene Polymorphisms With Knee Osteoarthritis: A Review of the Literature.

Progressive matrix metalloproteinase (MMP)-induced degradation of the extracellular matrix (ECM) of the articular cartilage is one of the major pathogenic osteoarthritis (OA) events. Several single nucleotide polymorphisms (SNPs) in genes encoding MMPs have been identified as affecting MMP expression, production, and enzymatic activity. This study systematically reviews the literature regarding the association between the SNPs of genes encoding MMPs and the risk of knee OA. An electronic search in the PubMed and Web of Science databases from conception to January 2021 was performed addressing studies relating MMPs genetic polymorphisms with the risk of knee OA. We included case-control studies that used validated genotyping methods to detect the SNPs’ association in MMP genes with primary knee OA risk. Ten studies were finally included in this systematic review, evaluating different SNPs in six MMP genes in terms of knee OA pathogenesis: MMP-1 (3 SNPs), MMP-2 (1 SNP), MMP-3 (9 SNPs), MMP-8 (10 SNPs), MMP-9 (6 SNPs), and MMP-13 (1 SNP). Among them, nine SNPs of four MMP genes have been associated with knee OA: (a) MMP-1 -1607 1G/2G (Turkish, Chinese), (b) MMP-3 rs650108, rs650108, rs520540, rs602128, rs679620 (Chinese), (c) MMP-8 rs1940475 and rs376520 (Finnish), and (d) MMP-13 77A/ (rs2252070) (Chinese). The present review summarizes all known SNPs of MMP genes related to a higher risk of knee OA. There are at least nine SNPs in four MMP genes associated with knee OA. No solid correlation between MMP genotype and knee OA phenotype exists. More high-quality studies and modern genetic testing methods are needed to fully elucidate the role of polymorphisms of MMP genes in knee OA pathogenesis.

Weight-bearing CT for Knee Osteoarthritis Assessment: A Story Unfolds

Weight-bearing CT for Knee Osteoarthritis Assessment: A Story Unfolds

Vitamin D receptor gene variants contribute to hip and knee osteoarthritis susceptibility

Vitamin D receptor (VDR) gene polymorphisms could play a significant role in the susceptibility and pathogenesis of osteoarthritis (OA), the most common degenerative joint disorder in humans. The current study involved 94 OA patients and 100 healthy, asymptomatic controls. VDR variants FokI (rs2228570), TaqI (rs731236), ApaI (rs7975232) and EcoRV (rs4516035) were genotyped using TaqMan-based real-time PCR. Adjusted odds ratio (OR) analysis showed that VDR TaqI and FokI polymorphisms are significantly associated with susceptibility to OA (OR=1.986, P=0.001 and OR=1.561, P=0.017, respectively). Joint-specific analysis showed that the VDR TaqI polymorphism was associated with risk of hip OA (OR=1.930, P=0.005) and knee OA (OR=1.916, P=0.028), while the VDR FokI polymorphism was associated with higher risk of knee OA (OR=2.117, P=0.012). VDR TaqI and FokI polymorphisms are associated with the occurrence of persistent pain (P=0.005 and P=0.027, respectively), while ApaI was associated with a family history of OA (p=0.004). The VDR FokI and TaqI genetic variants significantly contribute to osteoarthritis susceptibility, the occurrence of persistent pain, and potentially to joint-specific OA risk.

Associations between social determinants and the presence of chronic diseases: data from the osteoarthritis Initiative

BackgroundSome studies investigated the relationship between musculoskeletal conditions and chronic diseases. However, no study examined the association between social determinants and chronic diseases among people at high risk for knee osteoarthritis. Thus, the current study was aimed to address this gap.MethodsA secondary data analysis was conducted on a total of 3280 men and women aged 45 to 79 who were recruited in the Osteoarthritis Initiative.ResultsMultivariable logistic regression analyses show that age ≥ 65 years was associated with 1.98, 1.96, and 1.46 times odds of the presence of diabetes, heart attack, and multi-morbidity, respectively than age ≤ 64 years. Men were associated with 1.39, 1.41, 1.76, and 2.24 times odds of the presence of arthritis, cancer, diabetes, and heart attack, respectively than women. African American/Asian/ non-Caucasian was associated with 2.71, 2.56, and 1.93 times odds of the presence of arthritis, diabetes, and heart attack, respectively than Caucasian. Primary school/less education was associated with twice or more times the odds of arthritis and chronic obstructive pulmonary disease (COPD) than ≥high school education. Unemployment was associated with 1.41-, 1.73-, 1.58-, and 1.70-time odds of the presence of arthritis, cancer, COPD, and heart attack, respectively, then employed. Unmarried/widowed/separated was associated with 1.41, 1.75, 2.77, 2.76, 1.86, and 3.34 times odds of the presence of arthritis, asthma, cancer, COPD, diabetes, and heart attack, respectively than married. Annual income < 50,000 was associated with 1.33-, 1.44-, and 1.38-time odds of the presence of arthritis, diabetes, and multi-morbidity, respectively, then annual income ≥50,000. Overweight/obese was associated with 2.28 times the odds of the presence of diabetes than healthy weight. Current/former smoker was associated with 1.57, 2.47, 2.53, 1.63, and 1.24 times odds of the presence of arthritis, cancer, COPD, heart attack, and multi-morbidity, respectively than a nonsmoker. Consuming alcohol was associated with 1.32-, 1.65-, 1.50-, and 1.24-time odds of the presence of arthritis, COPD, diabetes, and multi-morbidity, respectively, then nonalcoholic.ConclusionsSocial determinants are associated with the presence of chronic diseases. Some of the social determinants are modifiable or treatable. Thus, these findings can inform public health strategies in the United States.

Sleep Disturbance Trajectories in Osteoarthritis.

Sleep disturbance is common among adults with osteoarthritis (OA), but little is known about patterns over time. In this cohort study, we identified restless sleep trajectories and associated factors in adults with or at high risk for knee OA. Longitudinal (2004-2014) restless sleep (≥3 nights/week) annual reports over 8 years from 4359 Osteoarthritis Initiative participants were analyzed. Group-based trajectory modeling identified heterogeneous temporal patterns. Logistic regression identified baseline health and behavioral predictors of trajectory membership. Four restless sleep trajectory groups were identified: good (69.7%, persistently low restless sleep probabilities), worsening (9.1%), improving (11.7%), and poor (9.5%, persistently high). Among 2 groups initially having low restless sleep prevalence, the worsening trajectory group had an increased likelihood of baseline cardiovascular disease (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.01-2.33), pulmonary disease (OR, 1.48; 95% CI, 1.07-2.05), lower physical activity (OR, 1.29; 95% CI, 1.03-1.61), knee pain (OR, 1.04; 95% CI, 1.00-1.07), depressive symptoms (OR, 1.03; 95% CI, 1.01-1.06), and a decreased likelihood of better mental health (OR, 0.97; 95% CI, 0.95-0.98) at baseline. Among 2 groups initially having high restless sleep prevalence, the poor group had an increased likelihood of baseline depressive symptoms (OR, 1.03; 95% CI, 1.00-1.05). Four trajectories of restless sleep over 8 years were identified using data collected from over 4000 older adults aged 45 to 79 years with or at higher risk for knee OA. The presence of depressive symptoms, less physical activity, knee pain, poor mental health, cardiovascular disease, or pulmonary disease was each associated with unfavorable trajectories.

Increased risk of knee osteoarthritis in patients using oral N-acetylcysteine: a nationwide cohort study

BackgroundKnee osteoarthritis (OA) is known to be a progressive degenerative disorder; however, recent evidence suggests that inflammatory mediators contribute to cartilage degradation. Studies have reported that N-acetylcysteine (NAC) had a promising effect on the reduction of the synthesis of proinflammatory and structural mediators by synovial cells. Given the lack of relevant clinical trials, we conducted this study to determine the relationship between NAC use and risk of knee OA.MethodsWe designed a retrospective cohort study from 2000 to 2013. Patients who received oral NAC over 28 days within 1 year after the first prescription were defined as the case group, whereas those without NAC use were considered as candidates of the control group. We adopted 1:4 propensity-score matching by age, sex, index year, and comorbidities to obtain the control group. The primary outcome was a new diagnosis of knee OA during the follow-up period.ResultsOur study sample comprised 12,928 people who used NAC and 51,715 NAC nonusers. NAC users had a significantly higher incidence of osteoarthritis (adjusted hazard ratio: 1.42, P < .001) than did NAC nonusers. Also, in analyses stratified by age group and sex, all subgroups exhibited a significantly higher incidence of knee osteoarthritis (P < .0001) among NAC users than among NAC nonusers. The use of oral NAC was associated with nearly four-fold increased the risk of knee OA in the young age group.ConclusionsLong-term use of oral NAC is associated with a higher risk of knee OA.