Osteoarthritis In Postmenopausal Women Research Articles

Effect of spinal and lower limb re-alignment protocol on bilateral medial compartment Osteoarthritis of knee in postmenopausal women

Objective:The alignment of spine-pelvis-lower extremity axis is significantly influenced by knee osteoarthritis. Joint alignment is the main bio-mechanical risk factor for progression of knee osteoarthritis. The purpose of this study was to find out the effect of spinal and lower limb realignment protocol on bilateral medial compartment knee osteoarthritis in postmenopausal women and to compare it with the conventional method of treatment for osteoarthritis of knee.Method: A study sample of 98 post-menopausal subjects having bilateral knee osteoarthritis with medial compartment involvement were selected and equally divided into two groups as the control group and the experimental group. Assessment of pain, knee range of motion, quadriceps and hip abductor strength, and posture for spinal and lower limb malalignment was taken before and after giving the treatment regime to both the groups. Comparison was carried out between the results of the two groups. Results:The results showed how significantly the mal-aligned structures were re-aligned after giving 8 weeks of realignment protocol and how significantly this resulted in better reduction of pain intensity and improvement in knee range of motion and strength of quadriceps and hip abductor muscles in experimental group as compared to the control group. Conclusion:Re-aligning the spinal and lower limb malalignment present in postmenopausal women with bilateral medial compartment knee osteoarthritis results in pain reduction associated with knee joint and improved knee range of motion and strength of quadriceps and hip abductor muscles in these individuals as compared to the ones receiving conventional physiotherapy.

Osteoprotegerin gene polymorphisms in postmenopausal women with knee osteoarthritis

Aim – to investigate the associations of rs3134069, rs4355801 and rs3102735 polymorphisms in the TNFRSF11B gene with knee osteoarthritis in postmenopausal women.
 Material and methods. 483 postmenopausal women were examined, including 157 patients with knee osteoarthritis. The remaining 326 women had no signs of joint disease and formed the control group. All examined women were tested using real-time polymerase chain reaction for single nucleotide polymorphisms rs3134069, rs4355801 and rs3102735 in the TNFRSF11B gene.
 Results. It was found that genotypes distribution of polymorphisms rs3134069, rs4355801 and rs3102735 in the TNFRSF11B gene in the total group of examined women (n=483) corresponded to the Hardy-Weinberg law (p0,05). Analysis of the polymorphic variants frequency in the TNFRSF11B gene revealed an increased frequency of AC or CC genotypes of rs3134069 polymorphism in patients with knee osteoarthritis (OR=1,91; 95% CI: 1,10–3,32; p=0,030). Also, among patients with osteoarthritis, the allele C registration frequency of the above polymorphism was increased (OR=1,78; 95% CI: 1,06–2,99; p=0,040). For two other studied polymorphisms in the TNFRSF11B gene (rs4355801 and rs3102735) no association with knee osteoarthritis was found (p0,05).
 Conclusion. The increased frequency of genotypes AC or CC registration, as well as allele C of rs3134069 polymorphism in the TNFRSF11B gene in postmenopausal women with knee osteoarthritis indicates the important role of TNFRSF11B gene mutations in the osteoarthritis development and progression. Further research in this direction is of great interest both for a deeper understanding of the disease pathogenesis and for the development of personalized approach criteria in the prevention and treatment of knee osteoarthritis in postmenopausal women.

Polymorphisms of genes of interleukin-6 and alpha-1 chain of collagen type 1 in postmenopausal women with knee osteoarthritis

BACKGROUND: To date in the Russian Federation insufficient attention has been paid to the study of IL6 and COL1A1 gene polymorphisms role in the development of knee osteoarthritis. And the results of the single carried out to date studies, devoted to the research of polymorphic variants of the above genes influence on the osteoarthritis development, are insufficient for substantiated conclusions.
 AIM: To study the frequency of alleles and genotypes of the IL6 gene rs1800795 polymorphism and COL1A1 gene rs1107946 and rs1800012 polymorphisms in postmenopausal women with knee osteoarthritis.
 MATERIALS AND METHODS: The results of 157 postmenopausal women survey with knee osteoarthritis were selected and analyzed. The control group consisted of 326 women of the same age without signs of joint disease. The study of polymorphisms rs1800795, rs1107946 and rs1800012 was performed by real-time polymerase chain reaction.
 RESULTS: The conducted studies showed that in the general group of examined women the frequency of all three studied polymorphisms genotypes registration corresponded to the Hardy-Weinberg law. An uneven (p = 0.043) distribution of rs1800795 polymorphism genotypes was found in the group of women with osteoarthritis and in the control group in the study of the IL6 gene polymorphic variants frequency detection. This difference was due to more frequent GG genotype registration of the above polymorphism (odds ratio = 1.75; 95% confidence interval: 1.12–2.72; p = 0.021) among women with knee osteoarthritis. Associations of rs1107946 and rs1800012 COL1A1 gene polymorphisms were not found (p 0.05).
 CONCLUSIONS: An association between GG genotype of the IL6 gene rs1800795 polymorphism and knee osteoarthritis in postmenopausal women has been established. Genotypes and alleles of COL1A1 gene rs1107946 and rs1800012 polymorphisms were not associated with joint disease.

Could sex-specific subtypes of hand osteoarthritis exist? A retrospective study in women presenting to secondary care.

Hand osteoarthritis is more common in women, and its risk increases around the time of the menopause. We set out to describe the timing between menopause and the onset of symptomatic hand osteoarthritis (OA), and associations with the use of hormone replacement therapy (HRT) or its discontinuation, describing any identifiable subgroups of women. Retrospective healthcare-records study of sequential women referred to a specialist hand OA clinic, 2007-2015. Confirmation of hand OA diagnosis was by clinican, by accepted criteria. Demographics and clinical variables were from healthcare-records, recorded by standardised proforma. Outcomes of interest were reported age of onset of hand symptoms, reported age at final menstrual period (FMP), time from FMP to reported onset of hand symptoms and time from cessation of HRT to reported onset of hand symptoms. Exposure categories for systemic HRT use were never users, current users, previous users. Analysis of Variance compared groups; linear regression analysed associations of exposure with outcome. 82/92(89%) of eligible women were post-menopausal, mean age at FMP 49.9 years (SD5.4). In these post-menopausal women, median time from FMP to hand symptom onset was 3 years. 48/82 (59%) developed hand symptoms within the defined peri-menopausal period (FMP ± 4 years), whilst some women developed their symptoms before or after (range -25, 30 years). In women who discontinued HRT prior to symptom onset, the median time from HRT cessation to onset of hand symptoms was 6 months. Past HRT users were older at hand symptom onset than women who had not taken HRT [coeff.4.7 years (0.92, 8.39); P = 0.015]. This study adds to evidence associating the menopause/sex hormone deficiency with hand OA symptom onset in a sizeable subgroup of women (but not all). HRT use/cessation appears to influence the timing of onset of hand OA symptoms. It is not possible to interpret from this type of study whether sex hormone deficiency is causative of disease or modulates its symptoms. It is also not possible to judge whether painful hand osteoarthritis in post-menopausal women is a subtype of disease. Further investigation is indicated of sex-specific subtypes and potential for personalised medicine for post-menopausal women with hand osteoarthritis, as a clearly definable high-risk subgroup.

The relationship between fat mass, muscle mass, and BMI with severity degrees of knee joint osteoarthritis in postmenopausal women

The relationship between fat mass, muscle mass, and BMI with severity degrees of knee joint osteoarthritis in postmenopausal women

Plasma Cartilage Acidic Protein 1 Measured by ELISA Is Associated With the Progression to Total Joint Replacement in Postmenopausal Women.

To investigate the association of plasma cartilage acidic protein 1 (CRTAC1), a novel biochemical marker of osteoarthritis (OA), and total joint replacement (TJR) in postmenopausal women. The association of plasma CRTAC1 with the incidence of TJR was investigated in a prospective cohort including 478 postmenopausal women. A total of 38 women underwent a TJR for OA during a median follow-up of 18 years. Every one of the TJR cases were age- and BMI (kg/m2)-matched with 2 controls with no TJR from the same cohort. Plasma CRTAC1 was measured before TJR. The association between CRTAC1 and TJR incidence was investigated by conditional logistic regression. Increased CRTAC1 was associated with a higher risk of TJR with an odds ratio (OR) of 1.80 (95% CI 1.11-2.92) for 1 SD increase, which remained significant after adjusting for Western Ontario and McMaster Universities Osteoarthritis Index, knee OA baseline severity (Kellgren-Lawrence grade), hip OA, and hip bone mineral density. Urinary crosslinked C-telopeptide of type II collagen (CTX-II) was also associated with a higher risk of TJR with an adjusted OR of 1.83 (95% CI 1.11-3.00). When CRTAC1 and CTX-II were included in the same model, both markers were significantly associated with TJR with similar ORs. CRTAC1 is a new risk indicator of TJR for OA in postmenopausal women. Combined with knee and hip OA and CTX-II, it may help to identify subjects at risk for TJR.

Development of Osteoarthritis in Post-menopausal Women and Different Ways to Manage it

Menopause is a natural, gradual transition between active and inactive ovarian functions that last several years in women's lives and involves changes in both the body and the mind. Women enter an estrogen-deficient phase during menopause, which speeds up the ageing process. They are more likely to develop osteoarthritis compared to men, and the prevalence of the condition rises dramatically during menopause for women. As a result, this article aims to understand the connection between menopause and osteoarthritis, followed by various strategies for managing arthritis symptoms in postmenopausal women.

Effects of sarcopenia and sarcopenic obesity on joint pain and degenerative osteoarthritis in postmenopausal women

This study aimed to identify the prevalence of sarcopenia, obesity, and sarcopenic obesity and examine their association with radiographic knee osteoarthritis (OA) and knee pain in Korean postmenopausal women. This cross-sectional study utilized the data from Korean National Health and Nutrition Examination Surveys 2009–2011. The participants were categorized into 4 groups based on body composition: either sarcopenic (appendicular skeletal muscle < 23%) or not, either obese (body mass index ≥ 25.0 kg/m2) or not. The prevalence of radiographic knee OA and knee pain was calculated. The effect of hormone replacement therapy (HRT) was also evaluated. The prevalence of radiographic knee OA, knee pain, and both were all highest in the sarcopenic obese group and lowest in the control group (61.49% vs. 41.54%, 39.11% vs. 27.55%, 32.04% vs. 17.82%, all p < 0.001). Without sarcopenia, obese women showed significantly higher ratio of radiographic knee OA only (57.64% vs. 41.54%, p < 0.001). With sarcopenia, the coexistence of obesity presented higher ratio of radiographic knee OA, knee pain, and both compared to sarcopenia without obesity (61.49% vs. 41.82%, 39.11% vs. 27.61%, 32.04% vs. 17.60%, all p < 0.001). The use of HRT for more than 1 year was not associated with radiographic knee OA, knee pain, or both (p = 0.147, 0.689 and 0.649, respectively). Obesity with sarcopenia had greater effect on knee OA compared to obesity without sarcopenia. Moreover, HRT use for more than 1 year was not associated with the prevalence of knee OA. Therefore, more efforts should focus on reducing body fat and increasing muscle in postmenopausal women with knee OA.

Zoledronic acid does not slow spinal radiographic progression of osteoarthritis in postmenopausal women with osteoporosis and radiographic osteoarthritis.

Introduction:Post hoc analyses of osteoporosis trials have suggested that alendronate and strontium ranelate may be associated with a reduction in the progression of spinal radiographic osteoarthritis (OA). We performed an analysis on a subgroup of participants in the horizon PFT trial (a 3-year randomized controlled trial (RCT) of yearly zoledronic acid (ZA) in postmenopausal women with osteoporosis), to evaluate the effect of ZA on the structural progression of spinal osteophytes (OPh) and disk space narrowing (DN).Methods:Paired lateral spinal X-rays (baseline and 36 months) were selected from the horizon PFT trial records restricted to those with radiographic OA at baseline. The X-rays were analyzed by two readers blinded to the treatment allocation. OPh and DN were scored separately using the Lane atlas (0–3 for increasing severity at each vertebral level) at all evaluable levels from T4–12 and L1–5.Results:A total of 504 sets of paired radiographs were included in the analysis, 245 in the ZA group and 259 in the placebo group. Overall, the rates of change of OPh and DN scores were low, and they were not statistically different between the groups (change in the whole spine OPh ZA 1.0 ± 1.6, placebo 0.8 ± 1.3, p = 0.1; DN ZA 0.3 ± 1.0, placebo 0.3 ± 0.8, p = 0.7).Conclusion:Yearly ZA for 3 years was not associated with a slowing of progression of OPh or DN in the thoracolumbar spine in patients with pre-existing radiographic OA.

Female reproductive factors and risk of joint replacement arthroplasty of the knee and hip due to osteoarthritis in postmenopausal women: a nationwide cohort study of 1.13 million women

Previous studies of the relationships between female reproductive factors and osteoarthritis (OA) have shown conflicting results. In this study, we aimed to explore the relationships between reproductive factors and joint replacement arthroplasty of the knee (TKRA) and hip (THRA) in a large nationwide population-based cohort of postmenopausal Korean women. We included 1,134,680 subjects who participated in national health examinations in 2009 in the study. The study outcomes were incident THRA or TKRA due to severe hip or knee OA. The relationships between reproductive factors and THRA or TKRA were evaluated using a multivariable-adjusted proportional hazards model. During a mean follow-up duration of 8.2 years, 1,610 incident THRA cases and 60,670 incident TKRA cases were observed. Later age at menarche, longer breastfeeding, HRT and OC use were associated with increased risk of TKRA for severe knee OA, while later age at menopause and longer reproductive span were associated with decreased risk. With regard to THRA for severe hip OA, later menarche, longer breastfeeding, HRT more than 5 years, and OC use more than 1 year were associated with higher risk. The associations between reproductive factors and severe OA were more pronounced in underweight and younger subjects. We found that shorter estrogen exposure was associated with higher risk of TKRA due to severe knee OA, and such associations were more pronounced in underweight and younger subjects. The association between shorter estrogen exposure and THRA was not robust.

STUDY TO EVALUATE THE ROLE OF HIGH TIBIAL OSTEOTOMY (HTO) FIXED WITH ANGLE STABLE PLATE IN TREATMENT OF OSTEOARTHRITIS OF KNEE AT NMCH, ROHTAS, BIHAR

Background: Osteoarthritis is more common in females. It is because osteoarthritis in post-menopausal women is associated with higher body weight, higher subcutaneous fat, calcium deficiency and weaker muscles linked to hormonal changes. The purpose of this study was to evaluate the role of high tibial osteotomy fixed with angle stable plate in treatment of osteoarthritis of knee. Material and Methods: In our study 10 cases were operated by modified coventry technique, 10 cases were operated by open wedge osteotomy with non locking plates and bone graft and 104 cases were operated by medial open wedge osteotomy and iliac graft secured by locking plate. In these cases full weight bearing was allowed at 8 week, 6 week and 3rd post operative day respectively. Radiographical analysis include post operatively change in tibio-femoral angle. Mean follow up of these cases was 2 year. Results: In our study thee knee pain and function score were significantly improved (p value &lt;0.001). The average pain score preoperatively was 1 8± 7(the maximum pain score for pain is 50) and post-operatively was 44±5. According to the grading used for functional assessment in knee scores there was definite improvement in the function of cases 122 (98.38%) at 2 yrs. The preoperatively mean functional knee score in of 110 cases (88.7%) cases was 28.86 (the maximum functional knee score is 100) and postoperatively was 70.45. There is correction in tibiofemoral angle (mean preoperative and postoperative tibiofemoral angle was 5.2±1.5 degrees varus and 5.8±1.3 degrees valgus respectively). Conclusion: There was definite improvement in the pain and function of the knee after the correction of the deformity (P value &lt;0.001). The results of high tibial osteotomy in 88.23 percentage knees were rated as excellent. 104 out of these 124 cases were fix by locking plates. 2 cases had poor results due to excessive over correction and associated comorbidities. There is a definite correlation between the postoperative valgus obtained and relief in the pain.

High follicle-stimulating hormone levels accelerate cartilage damage of knee osteoarthritis in postmenopausal women through the PI3K/AKT/NF-κB pathway.

Osteoarthritis is the main cause of pain and disability in the elderly, with the most commonly affected joint being the knee. The prevalence of knee osteoarthritis (KOA) is significantly increased in postmenopausal women, although the mechanisms underlying KOA remain unclear. The present study aimed to investigate the association between follicle-stimulating hormone (FSH) and postmenopausal women with KOA aged between 50 and > 70 years, as well as explore its underlying molecular mechanisms. Here, we report that the 50-60 years age group had the highest level of serum FSH. Compared to the low FSH group (< 40 mIU·mL-1 ) in the same age group, the high FSH group (> 40 mIU·mL-1 ) showed more severe cartilage damage. Furthermore, phosphorylated (p)-phosphoinositide 3-kinase (PI3K)/PI3K, p-AKT/AKT and p-nuclear factor kappa B (NF-κB)/NF-κB levels were significantly higher in the high FSH group compared to the low FSH group. Immunofluorescence experiments showed that FSH stimulation promoted the translocation of NF-κB p65 into the nucleus, and decreased type II collagen and aggrecan in ATDC5 cells. Moreover, we used western blotting in ATDC5 cells to demonstrate that FSH decreased type II collagen and increased p-PI3K/PI3K, p-AKT/AKT, p-NF-κB/NF-κB and p-IKB/IKB in a concentration-dependent manner. Our results suggest that increased FSH levels are associated with KOA for postmenopausal women aged 50-60 years and that high FSH levels might damage the cartilage tissues through the PI3K/AKT/NF-κB pathway.

High-Impact Exercise Increased Femoral Neck Bone Density With No Adverse Effects on Imaging Markers of Knee Osteoarthritis in Postmenopausal Women.

High-impact exercise can improve femoral neck bone mass but findings in postmenopausal women have been inconsistent and there may be concern at the effects of high-impact exercise on joint health. We investigated the effects of a high-impact exercise intervention on bone mineral density (BMD), bone mineral content (BMC), and section modulus (Z) as well as imaging biomarkers of osteoarthritis (OA) in healthy postmenopausal women. Forty-two women aged 55 to 70 years who were at least 12 months postmenopausal were recruited. The 6-month intervention consisted of progressive, unilateral, high-impact exercise incorporating multidirectional hops on one randomly assigned exercise leg (EL) for comparison with the contralateral control leg (CL). Dual-energy X-ray absorptiometry (DXA) was used to measure BMD, BMC, and Z of the femoral neck. Magnetic resonance imaging (MRI) of the knee joint was used to analyze the biochemical composition of articular cartilage using T2 relaxometry and to analyze joint pathology associated with OA using semiquantitative analysis. Thirty-five participants (61.7 ± 4.3 years) completed the intervention with a mean adherence of 76.8% ± 22.5%. Femoral neck BMD, BMC, and Z all increased in the EL (+0.81%, +0.69%, and +3.18%, respectively) compared to decreases in the CL (-0.57%, -0.71%, and -0.75%: all interaction effects p < 0.05). There was a significant increase in mean T2 relaxation times (main effect of time p = 0.011) but this did not differ between the EL and CL, indicating no global effect. Semiquantitative analysis showed high prevalence of bone marrow lesions (BML) and cartilage defects, especially in the patellofemoral joint (PFJ), with no indication that the intervention caused pathology progression. In conclusion, a high-impact exercise intervention that requires little time, cost, or specialist equipment improved femoral neck BMD with no negative effects on knee OA imaging biomarkers. Unilateral high-impact exercise is a feasible intervention to reduce hip fracture risk in healthy postmenopausal women. © 2019 American Society for Bone and Mineral Research.

The relationships of blood lead level, body mass index, and osteoarthritis in postmenopausal women

ObjectivesIt is unclear whether blood lead level (BLL) is associated with osteoarthritis (OA). The objectives of this study were to address the relationship between BLL and OA and to assess whether degree of obesity, evaluated as body mass index (BMI), mediates BLL-related OA. Study designThis study was performed using data obtained from 884 postmenopausal women (≥55 years old) in the Korea National Health and Nutrition Examination Survey 2010-2012. OA in back, hip, and knee was assessed by radiographic examination (rOA) and radiographic examination and symptoms (sxOA). Multivariable logistic regression analyses were performed to investigate the BLL–OA relationship. Mediation analyses were performed to address the contribution of BMI to BLL-related OA. ResultsOdds ratio (OR) for knee rOA with the highest tertile of BLL was 1.56 [95% confidence interval (CI) = 1.08–2.25] compared with the lowest tertile; there were significant linear trends across tertiles. With adjustments for confounders without BMI, continuous BLL was significantly associated with rOA (OR = 1.89, 95% CI = 1.27–2.80) and sxOA (OR = 1.69, 95% CI = 1.03–2.80) in the knee. After further adjusting for BMI, however, these significances were attenuated or disappeared. BMI was significantly associated with BLL, rOA of knee, and sxOA of knee and back. BMI significantly mediated the BLL–rOA association of the knee (21.1%) and back (46.5%) and the BLL–sxOA association of the knee (22.0%). The population-attributable fraction of rOA caused by BLL greater than the median (2.216 μg/dL) was 8.7% (95% CI = 1.1%–16.2%, P value = 0.024). ConclusionsBLL was significantly associated with knee OA in Korean postmenopausal women. BMI considerably mediated the effects of BLL on knee OA.

Elevated High-Sensitivity C-Reactive Protein And Interleukin-6 Plasma As Risk Factors For Symptomatic Lumbar Osteoarthritis In Postmenopausal Women.

AIM:To determine whether elevated high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR), as risk factors of symptomatic lumbar osteoarthritis (OA) in estrogen deficiency postmenopausal women.METHODS:A case-control study was conducted between January and June 2017. The inclusion criteria include post-menopausal women with estrogen deficiency with low back pain. Exclusion criteria were: patients with a history of undergoing bilateral oophorectomy, taking hormonal replacement therapy or corticosteroid, malignancies, and lumbosacral spine trauma. The blood examinations were taken to measure IL-6 level by ELISA, hs-CRP level by spectrophotometry and ESR by modified Westergren method.RESULTS:A group of 44 pairs of subjects were divided equally into case and control groups showed that in estrogen deficiency postmenopausal women, an increased level of hs-CRP increased the risk for symptomatic lumbar OA (OR = 2.83, CI95% = 1.065-8.776, p = 0.034). Also, a high level of IL-6 increased the risk of symptomatic lumbar OA (OR = 2.7, CI95% = 0.991-8.320, p = 0.033). No such significant findings were found for an increased ESR level.CONCLUSION:Elevated level of plasma hs-CRP and IL-6 were concluded as risk factors for symptomatic lumbar OA in post-menopausal women.

Possible association between circulating CTRP3 and knee osteoarthritis in postmenopausal women.

Osteoarthritis (OA) is considered as one of the most common cause of chronic pain and functional disabilities in the elderly. Toexamine serum levels of complement-C1q TNF-related protein 3 (CTRP3) in postmenopausal women with knee OA. A population-based cross-sectional study was performed in women who complained of chronic knee pain. All subjects were followed by clinical and weight-bearing bilateral anteroposterior radiographical examinations. The Kellgren and Lawrence (K&L) score was used for knee OA classification. Two groups of postmenopausal women were chosen to investigate CTRP3 as an OA marker who had the K&L score ≥ 3 as a case group and K&L ≤ 1 as a control group. Serum levels of CTRP3 were measured in two groups. According to K&L classification, 36 subjects with knee OA and 54 age-matched without or mild OA were selected. After adjusting the obtained data for taking NSAID drugs, the concentration of Ln CTRP3 in serum of patients with OA was lower compared to control group [mean ± SE, (0.39 ± 0.05ng/ml vs. 0.48 ± 0.03ng/ml, respectively, p = 0.04)]. There is a possible role for CTRP3 as an anti-inflammatory mediator in knee OA in postmenopausal women. Our results indicate an association between CTRP3 and knee OA. However, a much more robust study is required to draw that circulating CTRP3 could be a clinical marker for osteoarthritis.

The relationship between body composition and knee osteoarthritis in postmenopausal women.

The aim of this study was to examine the relationship between the body composition measures and knee osteoarthritis (OA) in postmenopausal women to determine whether the fat mass or the lean mass was closely associated with knee OA. This retrospective, cross-sectional study included a total of 212 postmenopausal women (mean age 59.9±6.2 years; range, 46 to 76 years). Descriptive characteristics were recorded and height was measured using a stadiometer. Body weight, fat mass, and lean mass were estimated using bioelectrical impedance analysis. X-rays of the knees were obtained. Knee OA was radiographically diagnosed according to the Kellgren-Lawrence criteria. Based on the radiographic knee OA diagnosis the women were divided into two groups. Logistic regression analyses were used to examine the associations between the body composition measures and knee OA. Knee OA was present in 117 women. Body Mass Index, body weight, fat mass, and lean mass were all significantly associated with knee OA after adjusting for confounding factors such as age, height, and physical activity (p<0.001). When assessed together with lean mass in a multivariate regression model, fat mass was closely and significantly found to be related to knee OA, compared to lean mass (p<0.001, OR: 1.17). Furthermore the fat mass/lean mass ratio was positively associated with knee OA (p<0.001). In postmenopausal women body weight was significantly and positively associated with knee OA and among the components that constitute body weight, fat mass was closely and significantly associated with knee OA compared to lean mass. This result suggests that the relationship between obesity and knee OA is mainly based on the fat mass, and supports the importance of systemic metabolic effects of adiposity in this relationship.

Study the relevance between inflammatory factors and estradiol and their association with knee osteoarthritis in postmenopausal women.

To investigate whether serum levels of inflammatory factors and estradiol (E2) are involved in the pathogenesis of postmenopausal women with knee osteoarthritis (OA). 58 randomly patients diagnosed with postmenopausal knee OA that underwent orthopedic surgery from October 2013 to October 2016 in our hospital were selected. These patients, considered as the experimental group, according to the degree of cartilage damage, were divided into light, medium and heavy groups. 58 patients with menstrual disorders without knee OA were in the control group. 35 cases without osteoarthritis were included in the normal control group. Serum levels of interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), erythrocyte sedimentation rate (ESR), high sensitive C- reactive protein (CRP), estradiol (E2) and IL-1, IL-6 and TNF-α levels in the synovial fluid of the experimental group were measured. The serum levels of IL-1, IL-6, TNF-α, and CRP in the normal control group, the control group and the experimental group were gradually increasing, the difference was statistically significant (p<0.05). The level of serum E2 was gradually decreasing (p<0.05); the difference of ESR between normal control group and control group had no significant difference (p>0.05), but the level of ESR in experimental group was higher than the normal control group and the control group (p<0.05). The serum levels of IL-1, TNF-α in experimental group of mild, moderate and severe sub-group were gradually increasing, the difference was statistically significant (p<0.05); while the level of IL-6 in the early, middle stage of OA increased significantly, and the late was reduced (p<0.05). The level of E2 was gradually decreased in the mild, moderate and severe sub-group of the experimental group, which had statistically significant difference (p<0.05). The level of serum E2 in the experimental group was positively correlated with the levels of IL-1, IL-6 and TNF-α in synovial fluid (p<0.05). The lack of estradiol is associated with the pathogenesis of OA in postmenopausal women, the inflammatory factors of IL-1, IL-6, TNF-α in postmenopausal increased in serum and synovial fluid may promote and aggravate the OA.

Interleukin-6 and ratio of plasma interleukin-6/interleukin-10 as risk factors of symptomatic lumbar osteoarthritis.

AIMTo determine the role of cartilage oligomeric matrix protein (COMP), interleukin (IL)-6, IL-10 and ratio of IL-6/IL-10 as risk factors of symptomatic lumbar osteoarthritis (OA) in postmenopausal women with estrogen deficiency.METHODSCase-control study had been conducted in Sanglah General Hospital from October 2015 until March 2016. The blood samples were obtained and analyzed by enzyme-linked immunosorbent assay (ELISA).RESULTSFrom 44 pairs of samples which divided into 44 samples as case group and 44 samples as control group showed that high level of COMP in estrogen deficiency postmenopausal women were not at risk (OR = 0.7; 95%CI: 0.261-1.751; P = 0.393) for symptomatic lumbar OA (cut-off point 0.946). Estrogen deficiency in postmenopausal women with the high level of IL-6 had 2.7 times risk (OR = 2.7; 95%CI: 0.991-8.320; P = 0.033) for symptomatic lumbar OA from the low level of IL-6 (cut-off point 2.264). At lower level of IL-10, there was no risk for symptomatic lumbar OA (OR = 0.6; 95%CI: 0.209-1.798; P = 0.345) than with the higher level of IL-10 (cut-off point 6.049). While the high ratio of IL-6/IL-10 level in estrogen deficiency postmenopausal women gave 3.4 times risk (OR = 3.4; 95%CI: 1.204-11.787; P = 0.011) for symptomatic lumbar OA than the low ratio of IL-6/IL-10 level (cut-off point 0.364).CONCLUSIONHigh ratio of IL-6/IL-10 plasma level was the highest risk factor for causing symptomatic lumbar OA in postmenopausal women with estrogen deficiency.

Relationship of Thyroid and Sex Hormones With Osteoarthritis in Postmenopausal Indian Women

Background: Osteoarthritis (OA) is the most frequent joint disease encountered in the clinical practice and is the most common cause of movement disability in the elderly. Females are found to have more severe OA, and prevalence and incidence increase after menopause. OA affects all articular tissues and finally leads to joint failure. Many experimental and clinical studies suggest that loss of hormone especially estrogen at the time of menopause increases a woman’s risk of getting OA and use of hormone replacement therapy (HRT) did seem to be associated with not only relieving of symptoms but also reduced rate of progression of OA. The aim of this case-control study was to investigate whether the thyroid and sex hormones are associated with OA in postmenopausal Indian women. Methods: One hundred twenty-five patients suffering from OA and 82 control subjects, all aged 45 - 65 years, were included in this study. Thyroid and sex hormones were measured in the serum by ELISA and chemiluminescent immunoassay technique. Results: Mean serum estrogen levels in the OA and control samples were 29.53 ± 3.27 and 49.21 ± 2.18 (P < 0.0001) which were significantly lower in OA patients compared with controls. Also these patients show significant change in thyroid hormones and progesterone hormone levels when compared with control subjects. Conclusion: The findings suggest that estrogen deficiency after menopause may contribute to developing OA in postmenopausal women. Estrogen can render help in such patients but with the current level of evidence, it cannot be recommended as a first-line treatment. J Clin Gynecol Obstet. 2016;5(4):117-120 doi: https://doi.org/10.14740/jcgo410e