Evaluation of bone marrow lesion volume as a knee osteoarthritis biomarker--longitudinal relationships with pain and structural changes: data from the Osteoarthritis Initiative.
Evaluation of bone marrow lesion volume as a knee osteoarthritis biomarker--longitudinal relationships with pain and structural changes: data from the Osteoarthritis Initiative.
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DOI：
10.1186/ar4292
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发表时间：
2013
影响因子：
4.9
通讯作者：
McAlindon TE
中科院分区：
文献类型：
--
作者：
Driban JB;Price L;Lo GH;Pang J;Hunter DJ;Miller E;Ward RJ;Eaton CB;Lynch JA;McAlindon TE
骨髓病变（BML）大小可能是骨关节炎相关临床试验的重要成像生物标志物，减小BML大小可能是一个重要的治疗目标。然而，关于BML大小、疼痛和结构进展之间相互关系的数据是不一致的，很少在同一队列中进行检查。因此，我们评估了BML体积与膝关节疼痛和关节间隙狭窄（JSN）的横断面和纵向关联。对进展队列中404名参与者在24个月和48个月骨关节炎倡议访问时收集的膝关节磁共振图像进行BML体积评估。在同一次访问中，用WOMAC疼痛评分评估膝关节疼痛，并获得膝关节x线片并对JSN进行评分。对BML体积进行求和，得到膝关节总体积和胫股间室指数体积（JSN基线较大的间室）。主要分析包括多元线性回归（结果=疼痛，预测因子=膝关节总BML体积）和逻辑回归（结果= JSN，预测因子=胫股室BML体积指数）。该样本中49%为女性，平均年龄为63岁（9.2标准差（SD））岁，71%的研究膝关节患有影像学骨关节炎。较大的基线bml与较大的基线膝关节疼痛（P = 0.01）、基线时JSN的存在(优势比（OR) = 1.50, 95%可信区间(CI) = 1.23至1.83）和JSN进展（OR = 1.27, 95%CI = 1.11至1.46）相关。膝关节总BML体积的变化与膝关节疼痛严重程度的变化呈正相关（P = 0.004），这种关联可能是由于膝关节从无基线BML或小基线BML发展到较大基线BML所致。相反，我们发现BML体积变化与JSN进展之间没有线性正相关。相反，与膝关节相比，内侧胫股BML体积的消退与JSN进展相关，BML体积没有或只有很小的变化（or = 3.36, 95%CI = 1.55至7.28）。然而，随访分析表明，JSN进展与BML体积变化之间的关联可能主要受基线BML体积的影响。大的基线bml与更大的基线膝关节疼痛、基线时JSN的存在和疾病进展相关。此外，BML消退与膝关节疼痛减轻有关，但与并发JSN进展的风险降低无关。
Bone marrow lesion (BML) size may be an important imaging biomarker for osteoarthritis-related clinical trials and reducing BML size may be an important therapeutic goal. However, data on the interrelationships between BML size, pain, and structural progression are inconsistent and rarely examined in the same cohort. Therefore, we evaluated the cross-sectional and longitudinal associations of BML volume with knee pain and joint space narrowing (JSN). A BML volume assessment was performed on magnetic resonance images of the knee collected at the 24- and 48-month Osteoarthritis Initiative visits from a convenience sample of 404 participants in the progression cohort. During the same visits, knee pain was assessed with WOMAC pain scores and knee radiographs were acquired and scored for JSN. BML volume was summed to generate a total knee volume and an index tibiofemoral compartment volume (compartment with greater baseline JSN). Primary analyses included multiple linear regressions (outcome = pain, predictor = total knee BML volume) and logistic regressions (outcome = JSN, predictor = index tibiofemoral compartment BML volume). This sample was 49% female with a mean age of 63 (9.2 standard deviation (SD)) years, and 71% had radiographic osteoarthritis in the study knee. Larger baseline BMLs were associated with greater baseline knee pain (P = 0.01), the presence of JSN at baseline (odds ratio (OR) = 1.50, 95% confidence interval (CI) = 1.23 to 1.83), and JSN progression (OR = 1.27, 95%CI = 1.11 to 1.46). Changes in total knee BML volume had a positive association with changes in knee pain severity (P = 0.004) and this association may be driven by knees that were progressing from no or small baseline BMLs to larger BMLs. In contrast, we found no linear positive relationship between BML volume change and JSN progression. Instead, regression of medial tibiofemoral BML volume was associated with JSN progression compared to knees with no or minimal changes in BML volume (OR = 3.36, 95%CI = 1.55 to 7.28). However, follow-up analyses indicated that the association between JSN progression and BML volume change may primarily be influenced by baseline BML volume. Large baseline BMLs are associated with greater baseline knee pain, the presence of JSN at baseline, and disease progression. Additionally, BML regression is associated with decreased knee pain but not a reduced risk of concurrent JSN progression.
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影响因子：
7
作者：
Felson, D. T.;Parkes, M. J.;Hutchinson, C. E.
通讯作者：
Hutchinson, C. E.
影响因子：
--
作者：
Hunter, David J.;Zhang, Yuqing;Felson, David T.
通讯作者：
Felson, David T.
影响因子：
4.9
作者：
Dore, Dawn;Quinn, Stephen;Jones, Graeme
通讯作者：
Jones, Graeme
影响因子：
7
作者：
Peterfy CG;Schneider E;Nevitt M
通讯作者：
Nevitt M
影响因子：
39.2
作者：
Felson, DT;Chaisson, CE;Gale, DR
通讯作者：
Gale, DR