Bone loss at subchondral plate in knee osteoarthritis patients with hypertension and type 2 diabetes mellitus
Bone loss at subchondral plate in knee osteoarthritis patients with hypertension and type 2 diabetes mellitus
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DOI：
10.1016/j.joca.2013.06.027
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发表时间：
2013-11-01
影响因子：
7
通讯作者：
Chiu, K. Y.
中科院分区：
文献类型：
--
作者：
Wen, C. Y.;Chen, Y.;Chiu, K. Y.
目的：本研究的目的是描述膝关节骨关节炎（OA）患者在存在合并症（即，方法：43例晚期原发性膝关节骨性关节炎患者，在知情同意的情况下，术中采集胫骨平台标本。对标本进行显微CT和组织学检查，以评估软骨下骨损伤的严重程度。合并症的存在，例如，在多变量线性回归模型中考虑了高血压和2型糖尿病以及协变量如年龄、性别和体重指数（BMI）的数据，以探讨在调整协变量后，合并症对膝关节OA软骨下骨损伤的潜在影响。与15例无合并症的受试者相比，在28例高血压和T2DM膝关节OA患者中观察到软骨下板显著的骨丢失，胫骨平台内侧骨密度（BMD）较低（P = 0.034），孔隙率较高（P = 0.032）。在调整年龄、性别和BMI后，高血压或T2DM的存在被纳入回归模型，以部分解释膝关节OA软骨下板BMD降低（r（2）= 0.551，P = 0.004）和孔隙度增加（r（2）= 0.545，P = 0.003）。我们的研究结果表明，膝关节OA中软骨下骨板的骨丢失与共病疾病之间存在生物学联系，高血压和T2DM，这提示需要进行大规模队列研究以确认因果关系。(C)2013年国际骨关节炎研究学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: This study aimed to characterize subchondral bone damages of knee osteoarthritis (OA) patients in presence of the comorbidities, i.e., hypertension and type 2 diabetes mellitus (T2DM).Methods: A total of 43 patients with advanced stage of primary knee OA were recruited, and tibial plateau specimens were collected during surgery with informed consent. The specimens were processed for microCT and histological examination to assess the severity of subchondral bone damages. The presence of the comorbid disease, e.g., hypertension and T2DM, and the data on covariates, such as the age, gender and body mass index (BMI), were taken into account in a multi-variable linear regression model to explore the potential effect of the comorbidities on subchondral bone damages in knee OA after adjusting the covariates.Results: As compared to 15 subjects without the comorbidities, significant bone loss was observed at subchondral plate in 28 knee OA patients with hypertension and T2DM, in terms of the lower bone mineral density (BMD) (P = 0.034) and higher porosity (P = 0.032) on the medial portion of tibial plateau. After adjusting the age, gender and BMI, the presence of hypertension or T2DM was included in a regression model to explain in part the decreased BMD (r(2) = 0.551, P = 0.004) and increased porosity (r(2) = 0.545, P = 0.003) at subchondral plate in knee OA.Conclusion: Our findings suggest the biological link between bone loss at subchondral bone plate in knee OA and the comorbid diseases, i.e., hypertension and T2DM, which prompt the needs for a large-scale cohort study to confirm the causality. (C) 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.