Clinical, radiographic, molecular and MRI-based predictors of cartilage loss in knee osteoarthritis
Clinical, radiographic, molecular and MRI-based predictors of cartilage loss in knee osteoarthritis
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DOI：
10.1136/ard.2010.141382
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发表时间：
2011-07-01
影响因子：
27.4
通讯作者：
Buck, R.
中科院分区：
文献类型：
--
作者：
Eckstein, F.;Le Graverand, M. P. Hellio;Buck, R.
目的探讨膝骨关节炎（OA）患者的临床、影像学、分子生物学和MRI指标与OA结构进展（次区域MRI为基础的股胫软骨丢失）的关系。在基线和随访时测定次区域股胫软骨厚度。获得半月板和软骨的基线临床、放射学、分子（n = 16）和定量MRI测量结果，包括延迟钆增强MRI（dGEMRIC）和T2。放射学骨关节炎膝关节纵向软骨变薄之间这些基线测量的差异结果纵向软骨变薄的相对最强的预测因子是股骨内侧软骨厚度的降低（曲线下面积（AUC）= 0.81）、内翻对线不良（AUC = 0.77）、最小关节间隙宽度减小和放射学关节间隙狭窄（JSN）评分更大（均AUC = 0.74）。在使用错误发现率进行多重比较调整后，这些仍然很重要。减少骨吸收（I型胶原的C末端肽; AUC = 0.65）和低dGEMRIC指数（反映蛋白多糖含量低）（AUC = 0.68）与纵向软骨变薄有关，但在此（小）中多次检验校正后未达到统计学显著性结论：这项探索性研究表明，基线分子或MRI软骨成分标记物可能不能比简单的放射学检查更好地区分软骨变薄的膝关节和没有纵向变化的膝关节例如，更高的JSN分数。
Objective To examine the relationship of baseline clinical, radiographic, molecular and MRI measures with structural progression (subregional MRI-based femorotibial cartilage loss) in knee osteoarthritis (OA).Methods Single knees of 75 female participants with radiographic knee OA (and 77 healthy control participants) were examined over 24 months using MRI. Subregional femorotibial cartilage thickness was determined at baseline and follow-up. Baseline clinical, radiographic, molecular (n = 16) and quantitative MRI-based measures of the meniscus and cartilage, including delayed gadolinium-enhanced MRI (dGEMRIC) and T2, were obtained. Differences in these baseline measures between radiographic osteoarthritic knees with longitudinal cartilage thinning (or thickening) and those with no significant change were evaluated by receiver operator characteristic analyses and Wilcoxon rank sum tests.Results The relatively strongest predictors of longitudinal cartilage thinning were reduced baseline cartilage thickness in the medial femur (area under the curve (AUC) = 0.81), varus malalignment (AUC = 0.77), reduced minimum joint space width and a greater radiographic joint space narrowing (JSN) score (both AUC = 0.74). These remained significant after adjusting for multiple comparisons using false discovery rates. Reduced bone resorption (C-terminal telopeptide of type I collagen; AUC = 0.65) and a low dGEMRIC index (reflecting low proteoglycan content) in the medial tibia (AUC = 0.68) were associated with longitudinal cartilage thinning, but failed to reach statistical significance after correction for multiple testing in this (small) sample.Conclusions This exploratory study indicates that baseline molecular or MRI cartilage compositional markers may not provide better discrimination between knees with cartilage thinning and those without longitudinal change than simple radiographic measures, such as greater JSN score.