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The association of the progression of knee osteoarthritis with high-sensitivity CRP in community-dwelling people—the Yakumo study

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Abstract

Objective

We aimed to investigate the relationship between high-sensitivity CRP (hs-CRP) levels and the knee osteoarthritis (KOA) status and whether high hs-CRP levels predict the progression of clinical KOA in community-dwelling people.

Methods

We enrolled 247 subjects (male, n = 99; female, n = 148) who participated in the “Yakumo study” at least twice from 2003 to 2008. The KOA was evaluated by knee X-ray using the knee osteoarthritis computer-aided diagnosis (KOACAD) measurement system to obtain the mJSW, the size of the osteophyte area (OPA), and femorotibial angle (FTA). The pain intensity of the knee joint was measured using a visual analog scale (VAS, 0–100). First, we performed a multiple regression analysis to assess the relationship between the initial hs-CRP and mJSW, OPA, FTA, and VAS. Second, we examined the correlated coefficients between the amount of change hs-CRP and radiographic progressions and VAS changes. Third, we divided into two groups. Group H elevated hs-CRP levels (> 0.1 mg/dl). We picked up the subject matched to Group H according to BMI, age, sex, and medial mJSW at baseline in a 1:1 ratio; these participants were classified as the control group (Group L). The Mann-Whitney U test was used to compare the demographic data between the two groups. P values of < 0.05 were considered to indicate statistical significance.

Results

The initial hs-CRP was a significant explanatory factor for mJSW and VAS change in multiple regression analysis. The change of VAS value negatively correlated with the change of hs-CRP. Besides, the change of hs-CRP did not correlate with the radiographical change. Among these subjects, 55 had elevated hs-CRP levels (> 0.1 mg/dl) (Group H). Among the 192 subjects whose hs-CRP levels were ≤ 0.1 mg/dl, 55 subjects were matched to patients in Group H according to the age, sex, BMI, and average minimum joint space width (mJSW) at baseline and were used as a control group (Group L). The narrowing of the medial mJSW and the amount of change in OPA in group H were significantly greater than group L. The amount of change in FTA and VAS scores did not differ between the two groups.

Conclusion

Hs-CRP levels would be significantly associated with the progression of knee osteoarthritis.

Key Points

• We investigated the relationship between hs-CRP levels and the progression and the pain of osteoarthritis knee.

• We used a KOACAD system, which can measure the medial and lateral joint space narrowing, osteophyte, and femoral-tibia angle from plain radiographs automatically.

• Hs-CRP levels were significantly associated with the progression of knee osteoarthritis.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

We are grateful to the staff of the Comprehensive Health Care Program held in Yakumo, Hokkaido.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan

    Fumiki Kondo, Yasuhiko Takegami, Shinya Ishizuka & Shiro Imagama

  2. Department of Rehabilitation, Kansai University of Welfare Sciences, Osaka, Japan

    Yukiharu Hasegawa

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  1. Fumiki Kondo
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Correspondence to Yasuhiko Takegami.

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Supplementary Information

Supplemental Fig. 1

Schema of image processing by KOACAD. (A) A digitized AP radiograph of knee, as a DICOM file. (B) An outline of femoral condyle and tibial plateau (gray line) as the upper and lower rims of the joint space. (C) FTA (black line) as the lateral angle between the straight lines of the middle lines above in the femur and tibia. (D) Medial mJSWs (white line) as the minimum vertical distances. These processes are performed automatically (JPG 5279 kb)

Supplemental Fig. 2

Measurement of osteophyte area by KOACAD. (A) A digitized AP radiograph of knee, as a DICOM file. (B) Osteophyte area (white area) that is medially prominent over the smoothly extended outline of the tibia and femur. The size of osteophyte area was calculated automatically (JPG 2668 kb)

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Kondo, F., Takegami, Y., Ishizuka, S. et al. The association of the progression of knee osteoarthritis with high-sensitivity CRP in community-dwelling people—the Yakumo study. Clin Rheumatol 40, 2643–2649 (2021). https://doi.org/10.1007/s10067-020-05541-2

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