Bone marrow lesions predict site-specific cartilage defect development and volume loss: a prospective study in older adults.
Bone marrow lesions predict site-specific cartilage defect development and volume loss: a prospective study in older adults.
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DOI：
10.1186/ar3209
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发表时间：
2010
影响因子：
4.9
通讯作者：
Jones G
中科院分区：
文献类型：
--
作者：
Dore D;Martens A;Quinn S;Ding C;Winzenberg T;Zhai G;Pelletier JP;Martel-Pelletier J;Abram F;Cicuttini F;Jones G
最近的证据表明，骨髓病变在膝关节骨关节炎(OA)中起着关键作用。这项研究的目的是确定：1)基线BML的存在和/或严重程度是否预测特定部位的软骨缺损进展和软骨体积损失；以及2)基线软骨缺陷是否预测特定部位的BML进展。共有405名受试者(平均年龄63岁，范围从52到79岁)在基线和大约2.7年后进行了测量。测量右膝关节的软骨体积、软骨缺损量(0~4)和胫骨内侧(MT)、股骨内侧(MF)、胫骨外侧(LT)和股骨外侧(LF)部位的BMLS(0~3)。用Logistic回归和广义估计方程检验BMLS与软骨缺损和软骨体积丢失的关系。在所有四个部位，基线BML的存在预测了同一部位的缺陷进展(优势比(OR)2.4至6.4，均P<；0.05)和软骨体积丢失(每年相差-0.9至-2.9%，均P<；0.05)。在多变量分析中，在所有四个部位(OR1.8~3.2，均P<0.05)和MF、LT和LF部位(β-22.1~-42.0，均P<0.05)的骨髓瘤严重程度和软骨体积丢失之间存在显著的相关性。此外，基线缺陷严重程度预测了MT和LF部位的BML进展(OR3.3至3.7，均为P<；0.01)。最后，当基线上同时存在较大的缺损区和BMLS时，MT和LT部位的软骨体积丢失增加得更多(均P<；0.05)。基线BMLS以剂量-反应的方式预测特定部位的缺损进展和软骨体积丢失，提示BMLS可能对软骨内稳态有局部影响。基线缺陷可以预测特定部位的BML进展，这可能代表着邻近缺损区的骨负荷增加。这些结果表明，BMLS和缺陷是相互关联的，并在膝关节软骨体积丢失中发挥关键作用；因此，两者都应该被认为是干预的目标。
Recent evidence suggests that bone marrow lesions (BMLs) play a pivotal role in knee osteoarthritis (OA). The aims of this study were to determine: 1) whether baseline BML presence and/or severity predict site-specific cartilage defect progression and cartilage volume loss; and 2) whether baseline cartilage defects predict site-specific BML progression. A total of 405 subjects (mean age 63 years, range 52 to 79) were measured at baseline and approximately 2.7 years later. Magnetic resonance imaging (MRI) of the right knee was performed to measure knee cartilage volume, cartilage defects (0 to 4), and BMLs (0 to 3) at the medial tibial (MT), medial femoral (MF), lateral tibial (LT), and lateral femoral (LF) sites. Logistic regression and generalized estimating equations were used to examine the relationship between BMLs and cartilage defects and cartilage volume loss. At all four sites, baseline BML presence predicted defect progression (odds ratio (OR) 2.4 to 6.4, all P < 0.05), and cartilage volume loss (-0.9 to -2.9% difference per annum, all P < 0.05) at the same site. In multivariable analysis, there was a significant relationship between BML severity and defect progression at all four sites (OR 1.8 to 3.2, all P < 0.05) and BML severity and cartilage volume loss at the MF, LT, and LF sites (β -22.1 to -42.0, all P < 0.05). Additionally, baseline defect severity predicted BML progression at the MT and LF sites (OR 3.3 to 3.7, all P < 0.01). Lastly, there was a greater increase in cartilage volume loss at the MT and LT sites when both larger defects and BMLs were present at baseline (all P < 0.05). Baseline BMLs predicted site-specific defect progression and cartilage volume loss in a dose-response manner suggesting BMLs may have a local effect on cartilage homeostasis. Baseline defects predicted site-specific BML progression, which may represent increased bone loading adjacent to defects. These results suggest BMLs and defects are interconnected and play key roles in knee cartilage volume loss; thus, both should be considered targets for intervention.
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影响因子：
4.7
作者：
Kothari, Ami;Guermazi, Ali;Chmiel, Joan S.;Dunlop, Dorothy;Song, Jing;Almagor, Orit;Marshall, Meredith;Cahue, September;Prasad, Pottumarthi;Sharma, Leena
通讯作者：
Sharma, Leena
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：
7
作者：
Pessis, E;Drapé, JL;Ayral, X
通讯作者：
Ayral, X
影响因子：
5
作者：
DISLER, DG;MCCAULEY, TR;FUCHS, MD
通讯作者：
FUCHS, MD
影响因子：
--
作者：
Garnero, P;Peterfy, C;Schoenharting, M
通讯作者：
Schoenharting, M