Diabetes-associated thigh muscle degeneration mediates knee osteoarthritis-related outcomes: results from a longitudinal cohort study.
Diabetes-associated thigh muscle degeneration mediates knee osteoarthritis-related outcomes: results from a longitudinal cohort study.
复制标题
DOI：
10.1007/s00330-022-09035-4
复制
发表时间：
2023-01
影响因子：
5.9
通讯作者：
Demehri, Shadpour
中科院分区：
文献类型：
--
作者：
Mohajer, Bahram;Moradi, Kamyar;Guermazi, Ali;Dolatshahi, Mahsa;Zikria, Bashir;Najafzadeh, Nima;Kalyani, Rita R.;Roemer, Frank W.;Berenbaum, Francis;Demehri, Shadpour
关键词：
我们研究了糖尿病（DM）与膝骨关节炎（KOA）患者大腿肌肉退行性变的纵向MRI生物标志物之间的关系，以及它们在恶化KOA相关症状中的介导作用。骨性关节炎倡议（OAI）的影像学KOA （Kellgren-Lawrence分级≥2）患者纳入研究。使用倾向评分（PS）匹配，对有和没有自我报告糖尿病的KOA患者的大腿和相应的膝盖进行潜在混杂因素的匹配。我们开发并使用了一种经过验证的深度学习方法进行纵向大腿分割。我们通过肌肉横截面积（CSA）和收缩百分比（非脂肪CSA/总CSA）的生物标志物评估了DM与4年纵向肌肉变性的关系。我们进一步调查了糖尿病是否与9年KOA影像学进展、膝关节置换术（KR）和症状恶化的风险相关。最后，我们评估了DM-KOA恶化的关联是否通过先前的肌肉变性介导。经PS匹配后，纳入698个大腿/膝盖（185:513，无糖尿病；平均±SD年龄：64±8岁；女/男：1.4）。基线DM与总大腿肌肉和股四头肌收缩率下降相关（95%CI为- 0.16%/年，- 0.25至- 0.07,- 0.21%/年，- 0.33至- 0.08）。DM还与koa相关症状恶化的风险增加相关（95%CI 1.70, 1.18-2.46），但与影像学进展或KR无关。股四头肌收缩率的降低部分调节了DM患者症状恶化的风险增加。基线DM与大腿肌肉变性和koa相关症状恶化相关。作为一个潜在的可改变的危险因素，DM相关的大腿纵肌变性可能部分介导DM和KOA共存患者的症状恶化。
We examined the association between diabetes mellitus (DM) and longitudinal MRI biomarkers for thigh muscle degeneration in patients with knee osteoarthritis (KOA) and their mediatory role in worsening KOA-related symptoms. The Osteoarthritis Initiative (OAI) participants with radiographic KOA (Kellgren-Lawrence grade ≥ 2) were included. Thighs and corresponding knees of KOA patients with versus without self-reported DM were matched for potential confounders using propensity score (PS) matching. We developed and used a validated deep learning method for longitudinal thigh segmentation. We assessed the association of DM with 4-year longitudinal muscle degeneration in biomarkers of muscle cross-sectional area (CSA) and contractile percentage (non-fat CSA/total CSA). We further investigated whether DM is associated with 9-year risk of KOA radiographic progression, knee replacement (KR), and symptoms worsening. Finally, we evaluated whether the DM–KOA worsening association is mediated through preceding muscle degeneration. After PS matching, 698 thighs/knees were included (185:513 with:without DM; average ± SD age:64 ± 8-years; female/male:1.4). Baseline DM was associated with a decreased contractile percent of total thigh muscles and quadriceps (mean difference, 95%CI −0.16%/year, −0.25 to −0.07, and −0.21%/year, −0.33 to −0.08). DM was also associated with an increased risk of worsening KOA-related symptoms (hazard ratio, 95%CI 1.70, 1.18–2.46) but not radiographic progression or KR. The decrease in quadriceps contractile percent partially mediated the increased risk of symptoms worsening in patients with DM. Baseline DM is associated with thigh muscle degeneration and KOA-related symptoms worsening. As a potentially modifiable risk factor, DM-associated longitudinal thigh muscle degeneration may partially mediate the symptoms worsening in patients with DM and coexisting KOA.
登录
查看更多内容
DOI：
10.3390/diseases8030025
发表时间：
2020-07-01
期刊：
Diseases (Basel, Switzerland)
影响因子：
--
作者：
Modesto AE;Ko J;Stuart CE;Bharmal SH;Cho J;Petrov MS
通讯作者：
Petrov MS
影响因子：
5.8
作者：
Granados, Andrea;Gebremariam, Achamyeleh;Lee, Joyce M.
通讯作者：
Lee, Joyce M.
影响因子：
27.4
作者：
Berenbaum, Francis
通讯作者：
Berenbaum, Francis
影响因子：
5.8
作者：
Kiefer, Lena S.;Fabian, Jana;Bamberg, Fabian
通讯作者：
Bamberg, Fabian
影响因子：
19.7
作者：
Haj-Mirzaian, Arya;Mohajer, Bahram;Demehri, Shadpour
通讯作者：
Demehri, Shadpour