Increased fasting serum glucose concentration is associated with adverse knee structural changes in adults with no knee symptoms and diabetes
Increased fasting serum glucose concentration is associated with adverse knee structural changes in adults with no knee symptoms and diabetes
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DOI：
10.1016/j.maturitas.2012.05.013
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发表时间：
2012-08-01
期刊：
影响因子：
4.9
通讯作者：
Cicuttini, Flavia M.
中科院分区：
文献类型：
--
作者：
Davies-Tuck, Miranda L.;Wang, Yuanyuan;Cicuttini, Flavia M.
目的：有证据表明，高血糖和临床糖尿病与骨关节炎（OA）有关。然而，膝关节症状、伴随治疗OA或糖尿病可能混淆这种关联。我们进行了一项纵向队列研究，以检查血清葡萄糖浓度和膝关节结构之间的关系，在成年人没有膝关节症状或糖尿病.Methods：179名参与者在1990年至1994年的空腹血清葡萄糖测量，没有膝关节症状或糖尿病（医生诊断或空腹血清葡萄糖>= 7 mmol/L），在2003年至2004年和2年后进行了膝关节MRI。1990-4年和2003-4年测量了体重指数。在2003-4和2006- 7通过MRI确定软骨体积和骨髓病变。空腹血清葡萄糖浓度与女性胫骨软骨体积损失率在2年以上呈正相关（B = 44.2 mm（3），95% CI 4.6，83.8），但在男性中没有（B = 6.0 mm（3），95% CI 68.5，80.6）。空腹血糖浓度与女性骨髓病变的发生呈正相关（OR = 5.76，95%CI 1.06，31.21），但男性未发生（OR = 0.11，95% CI 0.01，1.79），性别差异显著（相互作用p = 0.001）。在非糖尿病人群中，空腹血糖浓度升高与女性膝关节的不良结构变化相关，但与男性无关，这表明即使在血清葡萄糖水平的任意“糖尿病范围”以下，也可能存在对膝结构变化的敏感性。性别差异值得进一步研究，因为这可能是膝关节OA性别差异的一种机制。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Objective: There is evidence to suggest that elevated glucose concentration and clinical diabetes are associated with osteoarthritis (OA). However, the association may be confounded by knee symptoms, concomitant treatment for OA or diabetes. We performed a longitudinal cohort study to examine the relationship between serum glucose concentration and knee structure in adults with no knee symptoms or diabetes.Methods: 179 participants who had fasting serum glucose measurements at 1990-4, with no knee symptoms or diabetes (physician-diagnosed or fasting serum glucose >= 7 mmol/L), underwent knee MRI in 2003-4 and 2 years later. Body mass index was measured at 1990-4 and 2003-4. Cartilage volume and bone marrow lesions were determined from MRI at 2003-4 and 2006-7.Results: Fasting serum glucose concentration was positively associated with the rate of tibial cartilage volume loss over 2 years in women (B = 44.2 mm(3), 95% Cl 4.6, 83.8) but not in men (B = 6.0 mm(3), 95% Cl 68.5, 80.6). Fasting serum glucose concentration was positively associated with incident bone marrow lesions in women (OR = 5.76, 95% Cl 1.06, 31.21) but not in men (OR = 0.11, 95% CI 0.01, 1.79) with significant gender difference (p = 0.001 for interaction).Conclusion: Increased fasting serum glucose concentration in a non-diabetic population was associated with adverse structural changes at the knee in women but not in men, suggesting that there may be susceptibility to knee structural change even below the arbitrary "diabetic range" of serum glucose levels. The sex differences warrant further investigation as this may be one mechanism underlying the sex difference in knee OA. (C) 2012 Elsevier Ireland Ltd. All rights reserved.