Severity Of Hand Osteoarthritis Research Articles

Gender and age differences in the associations between cortical thickness and hand osteoarthritis severity: data from the Osteoarthritis Initiative

ObjectiveTo evaluate gender differences in the association between metacarpal cortical thickness - a surrogate for bone density - and severity of radiographic hand osteoarthritis (HOA) in a longitudinal observational study. MethodHand radiographs of 3,575 participants (2039 F/1536 M) from the Osteoarthritis Initiative were assessed at baseline and 48 months. A reader used a semi-automated software tool to calculate Tcort, a measurement of the cortical thickness, for metacarpals 2-4. Average Tcort at baseline and change in Tcort from baseline to 48 months was determined and stratified by gender and age for 7 5-year age groups. Spearman’s rank correlation coefficients were calculated for the association of baseline Tcort and 2 measures of baseline HOA severity: the sum of Kellgren and Lawrence (KL) grade and total number of joints with radiographic HOA. Longitudinally, logistic regression was used to assess the relationship of Tcort loss to new finger joint radiographic HOA, increase in KL grades, and incident hand pain. ResultsMale Tcort was higher than females. Significant correlations between Tcort and radiographic severity were noted for women but not men, with stronger associations among women >60 years (rho=-0.25; 95% CI= -0.31- -0.19). Statistically significant associations were seen between Tcort change and radiographic osteoarthritis change among women but not men, with substantial gender differences for Tcort change, particularly ages 50 to 70 years (p<0.01; e.g.Tcort change ages 55 to <60: Males=-0.182(0.118), Females=-0.219(0.124). ConclusionWe found significant HOA-related gender differences in cortical thickness, suggesting the involvement of female bone loss during and after menopause.

Exploring Talarozole as a Novel Therapeutic Approach for Osteoarthritis: Insights From Experimental Studies.

Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by the slow degeneration of joint components that primarily affects the elderly. There is currently no cure for OA; thus, treatment focuses on symptom reduction. This article investigates the potential of talarozole, a retinoic acid metabolism-blocking agent (RAMBA), as a new treatment for hand OA. Talarozole showed promising results by inhibiting retinoic acid degradation and increasing its levels in the body. Six hours after destabilization of the medial meniscus, talarozole significantly reduced inflammation in mice's cartilage. The findings underscore the importance of the protein encoded by the ALDH1A2 gene in retinoic acid metabolism, shedding light on its potential implications for the management of OA. Maintaining adequate retinoic acid levels may help to reduce mechano-inflammatory gene regulation. Furthermore, RAMBAs like talarozole may emerge as disease-modifying OA therapies, promising improved symptom control and slower disease progression. In conclusion, this research provides critical genetic insights into severe hand OA and promotes talarozole as a prospective therapy option. These findings pave the door for additional research that could revolutionize OA treatment by targeting retinoic acid metabolism to reduce symptoms and slow disease progression.

Subluxation of the first carpometacarpal joint and age are important factors in reduced hand strength in patients with hand osteoarthritis

Objective To investigate the determinants of hand strength in patients with hand osteoarthritis (OA). Method Pinch and cylinder grip strength were measured in 527 patients with hand OA diagnosed by their treating rheumatologist from the Hand OSTeoArthritis in Secondary care (HOSTAS) study. Radiographs of hands (22 joints) were scored 0–3 (scaphotrapeziotrapezoid and first interphalangeal joints 0–1) on osteophytes and joint space narrowing following the Osteoarthritis Research Society International atlas. The first carpometacarpal joint (CMC1) was scored 0–1 for subluxation. Pain was assessed with the Australian/Canadian Hand Osteoarthritis Index pain subscale, and health-related quality of life with the Short Form-36. Regression analysis served to investigate associations of hand strength with patient, disease, and radiographic features. Results Hand strength was negatively associated with female sex, age, and pain. Reduced hand strength was associated with reduced quality of life, although less after adjusting for pain. Radiographic features of hand OA were associated with reduced grip strength when solely adjusted for sex and body mass index, but only CMC1 subluxation in the dominant hand remained significantly associated with pinch grip adjusted additionally for age (−0.511 kg, 95% confidence interval −0.975; −0.046). Mediation analysis showed low and not significant percentages of mediation of hand OA in the association between age and grip strength. Conclusions Subluxation of CMC1 is associated with reduced grip strength, whereas associations with other radiographic features seem to be confounded by age. In the relationship between age and hand strength, radiographic hand OA severity is not an important mediator.

Meta-analysis of erosive hand osteoarthritis identifies four common variants that associate with relatively large effect

ObjectivesErosive hand osteoarthritis (EHOA) is a severe subset of hand osteoarthritis (OA). It is unclear if EHOA is genetically different from other forms of OA. Sequence variants at ten loci...

A Functional Polymorphism Downstream of Vitamin A Regulator Gene CYP26B1 Is Associated with Hand Osteoarthritis.

While genetic analyses have revealed ~100 risk loci associated with osteoarthritis (OA), only eight have been linked to hand OA. Besides, these studies were performed in predominantly European and Caucasian ancestries. Here, we conducted a genome-wide association study in the Han Chinese population to identify genetic variations associated with the disease. We recruited a total of 1136 individuals (n = 420 hand OA-affected; n = 716 unaffected control subjects) of Han Chinese ancestry. We carried out genotyping using Axiom Asia Precisi on Medicine Research Array, and we employed the RegulomeDB database and RoadMap DNase I Hypersensitivity Sites annotations to further narrow down our potential candidate variants. Genetic variants identified were tested in the Geisinger's hand OA cohort selected from the Geisinger MyCode community health initiative (MyCode®). We also performed a luciferase reporter assay to confirm the potential impact of top candidate single-nucleotide polymorphisms (SNPs) on hand OA. We identified six associated SNPs (p-value = 6.76 × 10-7-7.31 × 10-6) clustered at 2p13.2 downstream of the CYP26B1 gene. The strongest association signal identified was rs883313 (p-value = 6.76 × 10-7, odds ratio (OR) = 1.76), followed by rs12713768 (p-value = 1.36 × 10-6, OR = 1.74), near or within the enhancer region closest to the CYP26B1 gene. Our findings showed that the major risk-conferring CC haplotype of SNPs rs12713768 and rs10208040 [strong linkage disequilibrium (LD); D' = 1, r2 = 0.651] drives 18.9% of enhancer expression activity. Our findings highlight that the SNP rs12713768 is associated with susceptibility to and severity of hand OA in the Han Chinese population and that the suggested retinoic acid signaling pathway may play an important role in its pathogenesis.

Variants in ALDH1A2 reveal an anti-inflammatory role for retinoic acid and a new class of disease-modifying drugs in osteoarthritis.

More than 40% of individuals will develop osteoarthritis (OA) during their lifetime, yet there are currently no licensed disease-modifying treatments for this disabling condition. Common polymorphic variants in ALDH1A2, which encodes the key enzyme for synthesis of all-trans retinoic acid (atRA), are associated with severe hand OA. Here, we sought to elucidate the biological significance of this association. We first confirmed that ALDH1A2 risk variants were associated with hand OA in the U.K. Biobank. Articular cartilage was acquired from 33 individuals with hand OA at the time of routine hand OA surgery. After stratification by genotype, RNA sequencing was performed. A reciprocal relationship between ALDH1A2 mRNA and inflammatory genes was observed. Articular cartilage injury up-regulated similar inflammatory genes by a process that we have previously termed mechanoflammation, which we believe is a primary driver of OA. Cartilage injury was also associated with a concomitant drop in atRA-inducible genes, which were used as a surrogate measure of cellular atRA concentration. Both responses to injury were reversed using talarozole, a retinoic acid metabolism blocking agent (RAMBA). Suppression of mechanoflammation by talarozole was mediated by a peroxisome proliferator-activated receptor gamma (PPARγ)-dependent mechanism. Talarozole was able to suppress mechano-inflammatory genes in articular cartilage in vivo 6 hours after mouse knee joint destabilization and reduced cartilage degradation and osteophyte formation after 26 days. These data show that boosting atRA suppresses mechanoflammation in the articular cartilage in vitro and in vivo and identifies RAMBAs as potential disease-modifying drugs for OA.

The association of the lipid profile with knee and hand osteoarthritis severity: the IMI-APPROACH cohort

To investigate the association of the lipidomic profile with osteoarthritis (OA) severity, considering the outcomes radiographic knee and hand OA, pain and function. We used baseline data from the Applied Public-Private Research enabling OsteoArthritis Clinical Headway (APPROACH) cohort, comprising persons with knee OA fulfilling the clinical American College of Rheumatology classification criteria. Radiographic knee and hand OA severity was quantified with Kellgren-Lawrence sum scores. Knee and hand pain and function were assessed with validated questionnaires. We quantified fasted plasma higher order lipids and oxylipins with liquid chromatography with tandem mass spectrometry (LC-MS/MS)-based platforms. Using penalised linear regression, we assessed the variance in OA severity explained by lipidomics, with adjustment for clinical covariates (age, sex, body mass index (BMI) and lipid lowering medication), measurement batch and clinical centre. In 216 participants (mean age 66 years, mean BMI 27.3kg/m2, 75% women) we quantified 603 higher order lipids (triacylglycerols, diacylglycerols, cholesteryl esters, ceramides, free fatty acids, sphingomyelins, phospholipids) and 28 oxylipins. Lipidomics explained 3% and 2% of the variance in radiographic knee and hand OA severity, respectively. Lipids were not associated with knee pain or function. Lipidomics accounted for 12% and 6% of variance in hand pain and function, respectively. The investigated OA severity outcomes were associated with the lipidomic fraction of bound and free arachidonic acid, bound palmitoleic acid, oleic acid, linoleic acid and docosapentaenoic acid. Within the APPROACH cohort lipidomics explained a minor portion of the variation in OA severity, which was most evident for the outcome hand pain. Our results suggest that eicosanoids may be involved in OA severity.

MAINTAINING ALL-TRANS RETINOIC ACID LEVELS WITH TALAROZOLE SUPPRESSES MECHANFLAMMATION FOLLOWING CARTILAGE INJURY THROUGH A PERIXOSOME PROLIFERATOR ACTIVATED RECEPTOR GAMMA-DEPENDENT MECHANISM

Purpose: Severe hand osteoarthritis (OA) is associated with polymorphic variants in the ALDH1A2 gene. ALDH1A2 encodes the enzyme that catalyses the rate limiting step in the synthesis of all-trans retinoic acid (atRA). Injury of porcine articular cartilage, by explantation, causes upregulation of inflammatory genes by a process we have termed “mechanoflammation”. Injury also causes a rapid drop in atRA-responsive genes suggesting that atRA levels within the cell drop upon injury. If levels of atRA are maintained using talarozole, a retinoic acid metabolism blocking agent (RAMBA), this inhibits the mechano-inflammatory response.

IMPACT OF CARPAL TUNNEL SYNDROME ON SYMPTOMS < STRUCTURAL SEVERITY OF HAND OSTEOARTHRITIS: RESULTS FROM THE DIGICOD COHORT.

Purpose: Carpal tunnel syndrome (CTS) < hand osteoarthritis (HOA) are common diseases that can coexist in the same patient. Our work aimed to study the impact of CTS on the symptoms and structural severity of HOA in the DIGICOD (DIGItal Cohort Design) cohort.

Association Between Race and Radiographic, Symptomatic, and Clinical Hand Osteoarthritis: A Propensity Score-Matched Study Using Osteoarthritis Initiative Data.

To determine the associations between Black race and the presence of radiographic, symptomatic, and clinical hand osteoarthritis (OA). Using available hand radiographs from the Osteoarthritis Initiative cohort (total 4,699; n=849 Black subjects [18.1%], n=3,850 non-Black subjects [81.9%]), a propensity score-matching method was used to match Black subjects with non-Black subjects for known potential risk factors of hand OA (age, sex, body mass index, smoking status, cardiovascular disease, osteoporosis, excessive occupation- or recreation-related hand use, and knee OA). Posteroanterior radiographs of subjects' dominant hands were reviewed by a musculoskeletal radiologist in a blinded manner. To assess the severity of hand OA, the modified Kellgren/Lawrence (K/L) radiographic OA scoring scale (grades 0-4) was used, and the presence of erosive OA in the hand joints was recorded. Associations between race and the severity of hand OA (measured as the summed modified K/L grade), presence of radiographic hand OA (modified K/L grade ≥2), presence of erosive hand OA, presence of symptomatic hand OA (radiographic OA with hand pain), and presence of clinical hand OA (indicated by clinical findings of Heberden's nodes in the hands) were studied using regression models. In these models, beta coefficients or odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated for the associations between Black race and any of these radiographic and symptomatic hand OA phenotypes. Black subjects had less severe hand OA (β=-1.93 [95% CI -2.53, -1.34]), as well as a lower risk of developing radiographic hand OA (OR 0.79 [95% CI 0.66, 0.94]), erosive hand OA (OR 0.23 [95% CI 0.11, 0.47]), symptomatic hand OA (OR 0.63 [95% CI 0.49, 0.82]), and clinical hand OA (OR 0.49 [95% CI 0.41, 0.60]), as compared to non-Black subjects. In contrast to the well-established association between Black race and knee or hip OA, the findings of this study suggest that the risk of hand OA is lower in Black subjects compared to non-Black subjects, which is not mediated by known hand OA risk factors. Future studies are warranted to determine the mediating protective factors for hand OA among Black subjects.

PLasma proteomics identifies crtac1 as a biomarker for osteoarthritis severity and progression

Purpose: Accurate biomarkers for diagnosis and prediction of osteoarthritis (OA) are needed. In addition, biomarkers have the potential to serve as a measure of the different pathological processes underlying OA. Here, we report on a proteomics screen targeted at two important pathways thought to underlie the etiology of OA: the inflammation and metabolic pathways. The aim of this study was to identify a robust biomarker for OA severity and progression. Methods: We used data from the Rotterdam Study (RS), a population based prospective study with participants aged 45 and older. Participants of the RS underwent blood and radiographic measurements at baseline and after a mean follow-up time of 5 years. We measured 184 proteins (inflammation and cardiometabolic panel) in plasma from 3,517 participants in the RS using the Olink platform. We estimated the association for all available proteomic biomarkers with OA in knee, hip and hand. Specifically, phenotype-protein associations were estimated in three ways: 1) Cross-sectionally of overall OA burden, where we computed a weighted overall OA-score by adding up standardized score for knees, hands and hips for each individual; 2) Cross-sectionally in all joints separately, where we analyzed severity of OA by adding up bilateral KL-scores for knee or hip and all joints of the left and right hand (total amount of joints=30); 3) Longitudinally in knee and hip separately, where we defined cases of OA progression as individuals with at least 1 unit increase in KL-grade, excluding progressors from KL0 to KL1. For each of the three scenarios, we analyzed the relationships with multivariate regression models using linear models for continuous outcomes and generalized linear models with binomial link function for dichotomous outcomes. In model 1, we adjusted for age, sex and cell counts, whereas in model 2 we additionally adjusted for BMI. We report effect estimate (β) per standard deviation (SD) change in protein levels with 95% Confidence Interval (CI) and nominal p-value (significance level<0.05) for each protein. We used FDR-correction for multiple testing. All statistical analyses were performed in R version 3.5.2. Results: We found in total 56 proteins that were significantly associated with one or more OA-outcomes at nominal level. In total, we found 12 significant proteins to be associated with overall OA burden (Figure 1. illustrates these associations in decreasing order of the significance level), out of which 7 proteins stayed significant after BMI adjustment. The most robust association was found between the level of circulating Cartilage acidic protein 1 (CRTAC1) and overall OA burden (β=0.18, p=3.16 x10-6; FDR-corrected p=2.74 x10-4). When we examined the joints separately, we observed associations with severity of OA in the knee (β=0.16, p=1.0 x10-5) and hand (β=0.086, p=9.0 x10-4), while a similar trend was seen in hip (β=0.08, p=0.12), although power in hip was limited in our study. The association with baseline CRTAC1 was also found for progression in knee (β=0.21, p=0.016) and hip (β=0.18, p=0.062). These associations were independent of BMI. Among the findings were several other promising biomarkers, e.g. MMP-10, which we observed to be associated with overall OA burden (β=-0.104, p=0.01; FDR-corrected p=0.28), as well as for severity of hand OA (β=-0.09, p=6.7x10-4) and progression of knee OA (β=-0.24, p=7.3 x10-3). Additionally, COMP, a well-known biomarker for OA, was also found significant for overall OA burden (β=0.15, p=1.17 x10-4; FDR-corrected p=5 x10-3), OA severity in hand (β=0.10, p=5 x10-5) and knee (β=0.09, p=0.01). In a multivariable adjusted model with both COMP and CRTAC1 included, the estimate and significance of the latter remained while the estimate of COMP lowered and lost its significance. Conclusions: We identified a number of promising biomarkers reflecting overall OA burden and increased risk for OA progression. The CRTAC1 protein is a robust, promising biomarker for osteoarthritis severity and progression. Moreover, we showed that the association of CRTAC1 is independent from COMP. This protein is a glycosylated extracellular matrix protein that is found in the interterritorial matrix of articular deep zone cartilage. This protein can also be used to distinguish chondrocytes from osteoblasts and mesenchymal stem cells in culture. This suggests that CRTAC1-levels reflects a cartilage-specific process in the joint. Such a biomarker might be useful for targeting the right patients for clinical trials and designing novel therapies for OA.

Get a Grip on Factors Related to Grip Strength in Persons With Hand Osteoarthritis: Results From an Observational Cohort Study.

To compare levels of grip strength in individuals with hand osteoarthritis (OA) with normative values, and to examine how hand OA severity and other biopsychosocial factors are associated with grip strength. Levels of grip strength across age groups were compared with normative values from the general population in sex-stratified analyses using 2-sample t-tests. Associations between radiographic hand OA severity (Kellgren/Lawrence sum score) in different joint groups and grip strength of the same hand were examined in 300 individuals from the Nor-Hand study using linear regression. Analyses were repeated using markers of pain, demographic factors, comorbidities, and psychological and social factors as independent variables. We adjusted for age, sex, and body mass index. Individuals with hand OA had lower grip strength than the general population, especially in individuals age <60 years. In thumb base joints, increasing radiographic severity (range 0-8) and the presence of pain were associated with lower grip strength (β = -0.83 [95% confidence interval (95% CI) -1.12, -0.53] and β = -2.15 [95% CI -3.15, -1.16], respectively). Negative associations with grip strength were also found for women, low education, higher comorbidity index, and higher resting heart rate. Individuals with hand OA have lower grip strength than the general population. Our results support the idea that studies on thumb base OA should include grip strength as an outcome measure. However, other biopsychosocial factors should also be considered when the grip strength is being interpreted, because other factors such as sex, socioeconomic factors, physical fitness, and comorbidities are negatively associated with grip strength.

Role of Serum level of IL-1B and MMP-13 in detection of severity and functional impairment in hand Osteoarthritis patients

Hand Osteoarthritis (HOA) is one of the most common chronic degenerative joint diseases. Pain and decreased function are the leading symptom in HOA. Previously HOA was considered a pure degenerative disease, but this concept has changed and current research has demonstrated that inflammation is one of the key factors leading to the cartilage destruction. Cytokines as Interleukin-1β (IL1- β) induces expression and release of proteolytic enzymes such as matrix metalloproteinases (MMPs) and aggrecanases. Chondrocyte-derived MMPs are the main enzymes involved in the breakdown of cartilage collagens and proteoglycans. Research in the area of Hand OA is important to help early diagnosis, stop the progression of the disease, and preventing disability.The aim was to determine role of serum level of IL-1β and MMP-13 in detection of severity and functional impairment in patients with HOA.The study was carried out on 30 patients diagnosed with HOA, fulfilling the ACR 1990 criteria for diagnosis of HOA. Demographic data and anthropometric measurements were recorded for all participants. Clinical characteristics of the disease including duration of disease, pattern of joint involvement, pain and disease severity as well as functional assessment of HOA were assessed. Radiographic severity of HOA was assessed by Kellgren and Lawrence (K-L) score. Serum IL-1β and MMP-13 were assessed using double-antibody sandwich enzyme-linked immunosorbent assay method in both patients and control.The conclusion was that Interleukin-1B and MMP-13 seem to have an insignificant role in detection of severity and functional impairment in mild to moderate HOA.

P131 Patients with hand osteoarthritis have a long duration of symptoms and significant pain scores at the time of referral to rheumatology services

Abstract Background Osteoarthritis is the most common arthritic condition worldwide affecting 9.6% of men and 18% of women aged &amp;gt;60 years with an Irish prevalence &amp;gt;50 years of age is 17.3% for women and 9.4% for men. It can occur in any joint but is most common in the hip, knee and spine. It is also prevalent in the hand and can lead to significant pain and disability. The aim of this study was to examine the pattern and severity of hand osteoarthritis in patients referred to a regional rheumatology service. Methods Consecutive patients seen in general rheumatology clinics of all ages and gender who had confirmed diagnosis of hand osteoarthritis based on the ACR criteria were recruited (patients with RA, psoriatic arthritis, gout and haemochromatosis were excluded). All gave written informed consent to participate and had a single assessment performed including demographic details, symptom assessment using the AUSCAN Osteoarthritis Hand Index. In addition, measures of functional ability, grip strength and pincer strength were performed in the OT department. All patients also had an up to date hand X-ray performed. For the purposes of this paper we will report the initial assessments including the demographic details and pain scores. Results 103 consecutive patients were included in this analysis. M:F ratio 1:5.25. Mean age was 66.13 years. Mean duration of symptoms 74.63 months (8-422). At assessment the mean pain scores (0-10 VAS) were 4.53 (at rest), 6.09 (when gripping), 6.06 (when lifting) and 6.42 (when turning objects). The mean tender joint count was 7.14 and the mean score for objective soft tissue swelling in the joints was 1.36. Subject Average VAS (0-10) Pain Score at presentation by Gender Conclusion From these analyses, we can see that patients are referred very late with no one being seen within 6 months of symptoms onset. This is despite patients having pain scores which are comparable to those with inflammatory arthritis and in a small minority evidence of soft tissue swelling in joints at the time of presentation. In addition, it is noticeable that men are under-represented in the cohort of referred patients based on estimates of prevalence. Disclosures M. Ghaffar None. M. O'Sullivan None. C. Silke None. B. Whelan None.

Hyperuricemia is associated with intermittent hand joint pain in a cross sectional study of elderly females: The AGES-Reykjavik Study.

BackgroundThe debate whether "asymptomatic hyperuricemia" should be treated is still ongoing. The objective of this cross-sectional study was to analyze whether hyperuricema in the elderly is associated with joint pain.Methods and findingsParticipants in the population-based AGES-Reykjavik Study (males 2195, females 2975, mean age 76(6)) answered standardized questions about joint pain. In addition they recorded intermittent hand joint pain by marking a diagram of the hand. In males, no association was found between hyperuricemia and pain. Females however, showed a positive association between hyperuricemia and joint pain at many sites. After adjustment for age, BMI and hand osteoarthritis however, only intermittent hand joint pain (OR 1.30(1.07–1.58), p = 0.008) and intermittent pain in ≥10 hand joints (OR 1.75(1.32–2.31), p<0.001) remained significant. The best model for describing the relationship between serum uric acid levels (SUA) and intermittent hand joint pain in ≥10 joints was non-linear with a cut-off at 372 μmol/L. The attributable surplus number of symptomatic females with SUA ≥372 μmol/L was approximately 2.0% of the study population for those reporting pain in ≥10 hand joints. Next after having severe hand osteoarthritis, SUA ≥372 was an independent predictive factor of intermittent pain in ≥10 hand joints. Intermittent hand joint pain was also an independent risk factor for worse general health description.ConclusionResults from this population based study indicate that hyperuricemia in elderly females may be a rather frequent cause of intermittent hand joint pain, often in many joints. The most likely explanation relates to low-grade urate crystal induced inflammation. Our data do not allow for assessment of the severity of symptoms or whether they merit specific treatment, but intermittent hand joint pain was an independent predictor of worse general health. These findings may be an important contribution to the debate on whether hyperuricemia should be treated.

Age related prevalence of hand osteoarthritis diagnosed by photography (HOASCORE)

BackgroundHand photography has been used in a number of studies to determine the presence and severity of hand osteoarthritis (HOA). The aim of this study was to present age and gender specific prevalences of HOA diagnosed by this method.MethodsSix thousand three hundred forty three photographs (from 3676 females and 2667 males aged 40–96) were scored for hand osteoarthritis by a 0–3 grade (0 = no evidence of OA, 1 = possible OA, 2 = definite OA and 3 = severe OA) for each of the three main sites, distal interphalangeal joints (DIP), proximal interphalangeal joints (PIP) and thumb base (CMC1). An aggregate score of 0–9 was thus obtained (HOASCORE) to reflect the severity of HOA in each case.ResultsDIP joints were most commonly affected, followed by the thumb base and the PIP joints. Having definite DIP joint OA starts at a younger age compared with the other two sites, and there is a marked female preponderance in the age groups from 55 to 69, but after 70 the gender differences are less marked and the prevalence is fairly stable. PIP joint prevalence also indicates a female preponderance from 60 to 79. Thumb base OA has a more marked female preponderance and a rising prevalence thoughout life. The prevalence of individuals with no evidence of photographic OA (HOASCORE = 0) drops from 88% to 57% between the age categories 40–49 and 50–54 and decreased to 33% in the 70–74 age group with a slower decline after that age.DIP and PIP prevalence were strongly associated with each other with an OR of 16.6(12.8–21.5),p < 0.001 of having definite OA at the other site. This was less marked for the thumb base with an OR of 2.2(1.8–2.7, p < 0.001), and 2.7(2.0–3.5, p < 0.001) of having definite DIP or PIP HOA respectively.ConclusionsThe prevalence of hand OA in DIP, PIP and thumb base joints obtained by the photographic HOASCORE method is higher in women and increases after the age of fifty. These results are in line with those obtained by clinical examination and radiography. The advantage of the method lies in easy applicability and low cost.

The Prevalence, Incidence, and Progression of Hand Osteoarthritis in Relation to Body Mass Index, Smoking, and Alcohol Consumption.

To estimate the extent that overweight/obesity, smoking, and alcohol are associated with prevalence and longitudinal changes of radiographic hand osteoarthritis (OA). Participants from the Osteoarthritis Initiative (n = 1232) were included, of whom 994 had 4-year followup data. In analyses on incident hand OA, only persons without hand OA at baseline were included (n = 406). Our exposure variables were overweight/obesity [body mass index (BMI), waist circumference], smoking (current/former, smoking pack-yrs), and alcohol consumption (drinks/week). Using linear and logistic regression analyses, we analyzed possible associations between baseline exposure variables and radiographic hand OA severity, erosive hand OA, incidence of hand OA, and radiographic changes. Analyses were adjusted for age, sex, and education. Neither overweight nor obesity were associated with hand OA. Current smoking was associated with less hand OA in cross-sectional analyses, whereas longitudinal analyses suggested higher odds of incident hand OA in current smokers (OR 2.20, 95% CI 1.02-4.77). Moderate alcohol consumption was associated with higher Kellgren-Lawrence sum score at baseline (1-3 drinks: 1.55, 95% CI 0.43-2.67) and increasing sum score during 4-year followup (4-7 drinks: 0.33, 95% CI 0.01-0.64). Moderate alcohol consumption (1-7 drinks/week) was associated with 2-fold higher odds of erosive hand OA, which was statistically significant. Additional adjustment for BMI gave similar strengths of associations. Overweight/obesity were not associated with hand OA. Contrasting results were observed for smoking and hand OA, suggesting lack of association. Moderate alcohol consumption was associated with hand OA severity, radiographic changes, and erosive hand OA, warranting further investigation.

Serum levels of matrix metalloproteinase-3 and autoantibodies related to rheumatoid arthritis in the general Japanese population and their association with osteoporosis and osteoarthritis: the ROAD study.

To purpose of this study was to reveal the mean levels and positive proportion of serological markers related to rheumatoid arthritis, and clarify their relationship with osteoporosis and hand osteoarthritis (OA). A total of 1546 participants from the third survey of the research on osteoarthritis/osteoporosis against disability study were enrolled in the current study. Using participant blood samples, the levels of anti-cyclic citrullinated protein (CCP) antibody, rheumatoid factor (RF), matrix metalloproteinase-3 (MMP-3), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP) were measured. Subjects with higher than normal levels were defined as being positive. Osteoporosis was defined according to the recommendations set by World Health Organization criteria in 1994. Radiographic hand OA was evaluated using the modified Kellgren-Lawrence (KL) scale. The positive proportion of anti-CCP antibody, RF, MMP-3, CRP, and hsCRP was 1.8, 7.1, 15.0, 6.7, and 6.4%, respectively. MMP-3 was associated with age, and was significantly higher in men than in women. Positive MMP-3 was not significantly related to osteoporosis or severe hand OA (KL grade ≥3) after adjustment for other factors including age, sex, and body mass index. The results from this study clarified the values and positive proportion of RA-related markers and revealed their relationship with osteoporosis and hand OA.

Association of leptin levels with radiographic hand osteoarthritis and severity among a cohort of midlife women

Purpose: Associations of leptin levels with knee osteoarthritis (OA) risk have suggested a metabolic role of obesity in addition to the impact of mechanical loading in the etiology of OA. The few studies examining an association of leptin and OA of the hand, a non-weight bearing joint, have been null but were limited by small sample sizes or the use of photography for hand OA assessment. The purpose of this study was to relate serum leptin levels to radiographically-defined hand OA and severity in a large, well-characterized population of midlife women. Methods: Participants at the Michigan site of the Study of Women’s Health Across the Nation (SWAN) underwent hand radiographs and each joint within the hand was scored for OA using the Kellgren/Lawrence (KL) classification. Leptin was assayed in serum collected at the same time the radiographs were acquired. Results: Among the 543 Michigan SWAN women with a hand x-ray, the average age of participants was 46.1 years of age, the average body mass index (BMI) was 32.1 kg/m2 and 60% of participants were African-American and 40% were white. One-quarter (n=139) of participants had radiographic hand OA, defined as at least one hand joint with a KL score≥2. In multivariable models adjusting for age, race/ethnicity and BMI, there was no statistically significant association between serum leptin and this global definition of hand OA. However, when considering the OA status of each joint individually and adjusting for the inter-individual clustering of joints, there was a statistically significant association of serum leptin and hand joint OA. A 5 ng/mL higher serum leptin level was associated with 6% higher odds of a joint having radiographic OA (odds ratio=1.06, 95% confidence interval 1.01, 1.12) after adjusting for age, race/ethnicity and BMI. Similarly, the total hand OA burden, defined as the summed value of the KL scores for all joints on a given hand was positively associated with serum leptin levels. A 5 ng/mL higher serum leptin level was associated with a 1.04 higher total OA burden score. Conclusions: Our findings support a metabolic role of obesity in hand OA given observed associations of serum leptin with hand joint OA and hand OA severity. Consideration of the multiple mechanisms by which excess adipose tissue may be detrimental for joint damage is needed to effectively understand the disease and work towards prevention and treatment.

Increased prevalence and severity of radiographic hand osteoarthritis in patients with HIV-1 infection associated with metabolic syndrome: data from the cross-sectional METAFIB-OA study

ObjectiveTo determine radiographic hand osteoarthritis (HOA) prevalence in patients with HIV-1 infection in comparison with the general population and to address whether metabolic syndrome (MetS) may increase the risk of...