Low-level increases in serum C-reactive protein are present in early osteoarthritis of the knee and predict progressive disease
Low-level increases in serum C-reactive protein are present in early osteoarthritis of the knee and predict progressive disease
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DOI：
10.1002/art.1780400419
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发表时间：
1997-04-01
影响因子：
--
通讯作者：
Pepys, MB
中科院分区：
文献类型：
--
作者：
Spector, TD;Hart, DJ;Pepys, MB
Objective.研究低度炎症在早期膝关节骨关节炎（OA）病因和进展中的作用。我们使用一种新的、高灵敏度的、自动化的单克隆抗体免疫测定法检测血清中经典的急性时相蛋白C反应蛋白（CRP），对845名妇女进行了膝关节负重前后位X线片检查（年龄44-67岁）在进入北伦敦Chingford的基于人群的OA研究时，在那些放射学定义为“病例”的患者中，4年后复查膝关节X线片。在105名膝关节OA患者中，CRP水平较高，放射学定义为Kelling-Lawrence分级2+（中位数2.4 mg/L，四分位距[IQR] 1.0-5.1），与740名无OA的女性相比（中位数0.7毫克/升，IQR 0.3-1.8）31例Kelling-Lawrence分级≥ 1级的患者中CRP水平明显高于对照组（P < 0.001）（中位数2.6毫克/升，IQR 1.9-4.6），而39名疾病没有（中位数1.3毫克/升，IQR 0.6-2.4）（P = 0.006），在调整年龄、体重、身高、吸烟、膝关节疼痛或损伤后，这些差异的显著性仍然存在，根据关节间隙狭窄或单独骨赘的存在对疾病进行分类也产生了类似的结果。CRP水平在早期膝关节OA女性中适度但显著增加，并且较高水平预测疾病将在4年内进展的患者，这表明低度炎症可能是早期OA的重要方面，并且可能适合治疗干预和二级预防。
Objective. To examine the role of low-grade inflammation in the etiology and progression of early osteoarthritis (OA) of the knee.Methods. We used a new, high-sensitivity, automated monoclonal antibody immunoassay for the classic acute-phase protein, C-reactive protein (CRP), in serum, Anteroposterior radiographs of the knee with weight bearing were obtained on 845 women (ages 44-67) on entry into a population-based study of OA in Chingford, North London, In those defined radiologically as ''cases,'' the knee radiographs were repeated after 4 years.Results. Levels of CRP were higher in 105 women with knee OA defined radiologically as Kellgren-Lawrence grade 2+ (median 2.4 mg/liter, interquartile range [IQR] 1.0-5.1), compared with 740 women without OA (median 0.7 mg/liter, IQR 0.3-1.8) (P < 0.001), Median levels of CRP were higher in the 31 women whose disease progressed at least 1 Kellgren-Lawrence grade (median 2.6 mg/liter, IQR 1.9-4.6), compared with the 39 whose disease did not (median 1.3 mg/liter, IQR 0.6-2.4) (P = 0.006), The significance of these differences persisted after adjustment for age, weight, height, smoking, knee pain, or injury, Classifying disease by the presence of joint space narrowing or osteophytes alone produced similar results.Conclusion. CRP levels are modestly but significantly increased in women with early knee OA, and higher levels predict those whose disease will progress over 4 years, suggesting that low-grade inflammation may be a significant aspect of early OA and may be amenable to therapeutic intervention and secondary prevention.