Abstract
Osteoarthritis (OA) is a slow, chronic disease characterized by the focal deterioration and abrasion of articular cartilage. Leptin may play an important role in the pathophysiology of OA. Exercise and glucosamine sulfate therapy is one of the most commonly used in patients with knee OA. The goals of the present study are performed to investigate whether 12-week strength training program and glucosamine sulfate have an effect on serum leptin levels in knee OA and the relationship between leptin, clinical parameters, and radiographic severity of knee OA. Thirty-seven women with the diagnosis of knee OA were enrolled in the study. Patients were randomized into two groups. Group I (n = 19) received an exercise program, while group II (n = 18) received glucosamine sulfate (1,500 mg/day) in addition to the exercise therapy. Both groups were treated for 12 weeks. Leptin level was assessed at baseline and after 12 weeks. The concentration of leptin was measured by ELISA. The patients were evaluated regarding pain, disability, functional performance, and muscle strength. Both groups showed significant improvements in leptin levels, pain, disability, muscle strength, and functional performance with no statistically significant difference between the groups after the therapy. At basal time, plasma leptin levels were significantly correlated with body mass index and duration of disease, but no significant correlation was found with patient age, pain, disability, functional performance, muscle strength, and radiographic severity of knee OA. The results of this preliminary study revealed that exercise alone was adequate to prevent structural changes relieving the symptoms of OA. We also found that exercise alone could affect serum plasma levels of the leptin, important mediators of cartilage metabolism. Decreases in serum leptin may be one mechanism by which cartilage metabolism affects physical function and symptoms in OA patients.
Similar content being viewed by others
References
Pelletier JP, Martel-Pelletier J, Abramson SB (2001) Osteoarthritis, an inflammatory disease: potential implication for the selection of new therapeutic targets. Arthritis Rheum 44:1237–1247
Pallu S, Francin PJ, Guillaume C, Gegout-Pottie P, Netter P, Mainard D, Terlain B, Presle N (2010) Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis. Arthritis Res Ther 12:112 (Epub 2010 June 9)
Fioravanti A, Cantarini L, Bacarelli MR, de Lalla A, Ceccatelli L, Blardi P (2011) Effects of Spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis. Rheumatol Int 31:879–882 (Epub 2010 Mar 18)
Wen ZH, Tang CC, Chang YC, Huang SY, Hsieh SP, Lee CH, Huang GS, Ng HF, Neoh CA, Hsieh CS, Chen WF, Jean YH (2010) Glucosamine sulfate reduces experimental osteoarthritis and nociception in rats: association with changes of mitogen-activated protein kinase in chondrocytes. Osteoarthritis Cartilage 18:1192–1202
Towheed TE, Maxwell L, Anastassiades TP, Shea B, Houpt J, Robinson V, Hochberg MC, Wells G (2005) Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 18:CD002946
Laferrère B, García-Lorda P, Russell CD, Pi-Sunyer FX (2004) Effect of oral glucosamine sulfate on serum leptin levels in human subjects. Nutrition Mar 20:321–322
Petrella RJ, Bartha C (2000) Home based exercise therapy for older patients with knee osteoarthritis: a randomized clinical trial. J Rheumatol 27:2215–2221
Mikesky AE, Mazzuca SA, Brandt KD, Perkins SM, Damush T, Lane KA (2006) Effects of strength training on the incidence and progression of knee osteoarthritis. Arthritis Rheum 55:690–699
Penninx BW, Messier SP, Rejeski WJ, Williamson JD, DiBari M, Cavazzini C, Applegate WB, Pahor M (2001) Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med 161:2309–2316
Ara I, Perez-Gomez J, Vicente-Rodriguez G, Chavarren J, Dorado C, Calbet JAL (2006) Serum free testosterone, leptin and soluble leptin receptor changes in a 6-week strength-training programme. Br J Nutr 96:1053–1059
Altman R, Alarcon G, Appelrouth D, Altman R, Alarcon G, Appelrouth D et al (1991) The American College of rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 34:505–514
Fitzgerald G, Oatis C (2004) Role of physical therapy in management of knee osteoarthritis. Curr Opin Rheumatol 16:143–147
Van Baar M, Assendelft W, Dekker J, Oostendorp RA, Bijlsma JW (1999) Effectiveness of exercise therapy in patients with osteoarthritis of the hip and knee: a systematic review of randomized clinical trials. Arthritis Rheum 42:1361–1369
Durmus D, Alayli G, Canturk F (2007) Effects of quadriceps electrical stimulation program on clinical parameters in the patients with knee osteoarthritis. Clin Rheumatol 26:674–678
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a heath status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip and knee. J Rheumatol 15:1833–1840
Bohannon RW (2001) Measuring knee extensor muscle strength. Am J Phys Med Rehabil 80:13–18
Pallu S, Francin PJ, Guillaume C, Gegout-Pottie P, Netter P, Mainard D, Terlain B, Presle N (2010) Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis. Arthritis Res Ther 12:R112
Reginster JY, Bruyere O, Neuprez A (2007) Current role of glucosamine in the treatment of osteoarthritis. Rheumatology 46:731–735 (review)
Dahmer S, Schiller RM (2008) Glucosamine. Am Fam Phys 15:471–476
Pavelká K, Gatterová J, Olejarová M, Machacek S, Giacovelli G, Rovati LC (2002) Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 162:2113–2123
Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martín-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araújo D, Figueroa M, Branco J (2007) Glucosamine sulfate in the treatment of knee osteoarthritis symptoms. Arthritis Rheum 56:555–567
Cibere J, Kopec JA, Thorne A, Singer J, Canvin J, Robinson DB, Pope J, Hong P, Grant E, Esdaile JM (2004) Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum 51:738–745
Hughes R, Carr A (2002) A randomized, double-blind, placebo controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee. Rheumatology 41:279–284
Rozendaal RM, Koes BW, van Osch GJ, Uitterlinden EJ, Garling EH, Willemsen SP, Ginai AZ, Verhaar JA, Weinans H, Bierma-Zeinstra SM (2008) Effect of glucosamine sulfate on hip osteoarthritis. Ann Intern Med 148:268–277
McAlindon T, Formica M, LaValley M, Lehmer M, Kabbara K (2004) Effectiveness of Glucosamine for symptoms of knee osteoarthritis: Results from an Internet-based randomized double-blind controlled trial. Am J Med 117:643–649
McClain DA, Alexander T, Cooksey RC, Considine RV (2000) Hexosamines stimulate leptin production in transgenic mice. Endocrinology 141:1999
Pisters MF, Veenhof C, Schellevis FG, De Bakker DH, Dekker J (2010) Long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized controlled trial comparing two different physical therapy interventions. Osteoarthritis Cartilage 19:1–8
Pedersen BK, Bruunsgaard H (2003) Possible beneficial role of exercise in modulating low-grade inflammation in elderly. Scand J Med Sci Sports 13:56–62
Helmark IC, Mikkelsen UR, Borglum J, Rothe A, Petersen MC, Andersen O, Langberg H, Kjaer M (2010) Exercise increases interleukin- 10 levels both intraarticularly and peri-synovially in patients with knee osteoarthritis: a randomized controlled trial. Arthritis Res Ther 12:R126
Galois L, Etienne S, Grossin L, Watrin-Pinzano A, Cournil-Henrionnet C, Loeuille D, Netter P, Mainard D, Gillet P (2004) Dose-response relationship for exercise on severity of experimental osteoarthritis in rats: a pilot study. Osteoarthritis Cartilage 12:779–786
Weaver BT, Haut RC (2005) Enforced exercise after blunt trauma significantly affects biomechanical and histological changes in rabbit retro-patellar cartilage. J Biomech 38:1177–1183
Roos EM, Dahlberg L (2005) Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis Rheum 52:3507–3514
Fatouros IG, Chatzinikolaou A, Tournis S, Nikolaidis MG, Jamurtas AZ, Douroudos II, Papassotiriou I, Thomakos PM, Taxildaris K, Mastorakos G, Mitrakou A (2009) Intensity of resistance exercise determines adipokine and resting energy expenditure responses in overweight elderly individuals. Diabetes Care 32:2161–2167 (Epub 2009 Sep 3)
Zafeiridis A, Smilios I, Considine RV, Tokmakidis SP (2003) Serum leptin responses after acute resistance exercise protocols. J Appl Physiol 94:591–597 (Epub 2002 Oct 4)
Pallu S, Francin PJ, Guillaume C, Gegout-Pottie P, Netter P, Mainard D, Terlain B, Presle N (2010) Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis. Arthritis Res Ther 12:R112 (Epub 2010 June 9)
Miyatake N, Takahashi K, Wada J, Nishikawa H, Morishita A, Suzuki H, Kunitomi M, Makino H, Kira S, Fujii M (2004) Changes in serum leptin concentrations in overweight Japanese men after exercise. Diabetes Obes Metab 6:332–337
White DW, Tartaglia LA (1996) Leptin and OB-R: body weight regulation by a cytokine receptor. Cytokine Growth Factor Rev 7:303–309
Guerra B, Santana A, Fuentes T, Delgado-Guerra S, Gabrera-Socorro A, Dorado C, Galbet JAL (2007) Leptin receptors in human skeletal muscle. J Appl Physiol 102:1786–1792
Acknowledgments
This study was supported by the Ondokuz Mayıs University Research Fund (T-529).
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Durmus, D., Alayli, G., Aliyazicioglu, Y. et al. Effects of glucosamine sulfate and exercise therapy on serum leptin levels in patients with knee osteoarthritis: preliminary results of randomized controlled clinical trial. Rheumatol Int 33, 593–599 (2013). https://doi.org/10.1007/s00296-012-2401-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-012-2401-9