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Polycystic ovary syndrome and (pre)osteoarthritis: assessing the link between hyperandrogenism in young women and cartilage oligomeric matrix protein as a marker of cartilage breakdown

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Abstract

Introduction

Objectives

Our aim was to analyze the link between hyperandrogenism and early clinical manifestations of osteoarthritis (OA), knee cartilage thickness, and serum cartilage oligomeric matrix protein (sCOMP) levels in patients with polycystic ovary syndrome (PCOS) and to compare them with healthy volunteers.

Methods

Fifty-four PCOS patients who met the Rotterdam criteria with phenotypes A, B, and C were included. They were compared with 26 age- and body mass index (BMI)-matched controls. Detailed anthropometric measurements and clinical evaluation for hyperandrogenism were performed for all participants who also filled in the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Furthermore, laboratory tests including sCOMP and hormone quantification were performed in a fasting stage. Finally, an ultrasound assessment was carried out in randomly selected 56 study participants.

Results

PCOS women reported more prominent knee-related symptoms (p = 0.035) and more impaired activities of daily living (ADL) (p = 0.001) than controls. Cartilage thickness of the left and right medial condyle and left lateral condyle was significantly greater in PCOS group (n = 41) than in control group (n = 15) (p = 0.05, p = 0.006, and p = 0.036, respectively). COMP correlated significantly and negatively with testosterone levels (p = 0.029, r =  − 0.297) in women with PCOS and the correlation remained significant after controlling for BMI.

Conclusions

Women with PCOS may experience knee-related symptoms and impaired ADL. They had greater knee femoral cartilage thickness. Although sCOMP levels did not significantly differ between the groups, lower levels of sCOMP may be inherent to PCOS patients with higher testosterone levels.

Key Points

• Although PCOS patients may experience more prominent knee related symptoms, their femoral cartilage of the knee joint is found thicker than controls.

• PCOS patients did not have significantly elevated levels of sCOMP.

• Lower sCOMP levels were related to higher testosterone levels.

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Data or materials are available upon reasonable request.

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Funding

The study was performed with the financial support of Medical University-Sofia, Bulgaria, grant “Young Investigator” Project No 8378/20.11.2019, Contract D-85/24.06.2020.

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Authors and Affiliations

  1. Clinic of Endocrinology, University Hospital “Alexandrovska”, Department of Internal Medicine, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria

    Plamena Kabakchieva, Antoaneta Gateva & Zdravko Kamenov

  2. Clinic of Internal Diseases, Naval Hospital - Varna, Military Medical Academy, Sofia, Bulgaria

    Plamena Kabakchieva

  3. Clinic of Rheumatology, University Hospital “St. Marina”, First Department of Internal Medicine, Medical Faculty, Medical University – Varna, Varna, Bulgaria

    Tsvetoslav Georgiev

  4. Clinical Laboratory and Clinical Pharmacology, University Hospital “Alexandrovska”, Department of Clinical Laboratory, Medical University-Sofia, Sofia, Bulgaria

    Julieta Hristova

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  1. Plamena Kabakchieva
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  2. Tsvetoslav Georgiev
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Contributions

PK: Study design, data acquisition, data analysis, and data interpretation, critical revision, and final approval of the manuscript. TG: Study design, data interpretation, ultrasound assessment, critical revision, and final approval of the manuscript. JH: Data interpretation, immunological assay evaluation, critical revision, and final approval of the manuscript. AG: Data interpretation, critical revision, and final approval of the manuscript. ZK: Data interpretation, critical revision, and final approval of the manuscript.

Corresponding author

Correspondence to Tsvetoslav Georgiev.

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Ethics approval

The study protocol was approved by the Research Ethics Committee of the Medical University of Sofia, Bulgaria with approval protocol number 05/28.02.2020.

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Written informed consent was obtained from all participants included in the study.

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Kabakchieva, P., Georgiev, T., Gateva, A. et al. Polycystic ovary syndrome and (pre)osteoarthritis: assessing the link between hyperandrogenism in young women and cartilage oligomeric matrix protein as a marker of cartilage breakdown. Clin Rheumatol 40, 4217–4223 (2021). https://doi.org/10.1007/s10067-021-05753-0

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  • DOI: https://doi.org/10.1007/s10067-021-05753-0

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