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Biomarkers of joint metabolism and bone mineral density are associated with early knee osteoarthritis in premenopausal females

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Abstract

Introduction

Biomarkers of bone and cartilage metabolism were proposed as early diagnosis indicators for knee osteoarthritis (OA), however, which were influenced by disease stage, age, and menopause state. Accurate diagnosis indicators are eagerly awaited. The current study aims to investigate associations of joint metabolism biomarkers and bone mineral density (BMD) with early knee OA in males and premenopausal females before age 50 years.

Method

A total of 189 patients aged before 50 years with early knee OA and 152 healthy participants were enrolled. Levels of bone biomarkers (PINP, OC, and CTX-I) and cartilage biomarkers (PIIANP, COMP, CTX-II, and MMP-3) were assessed. BMD was measured at the lumbar, femoral neck, and hip. Multivariate regression analyses were performed to evaluate the relationship between biomarkers, BMD, and early knee OA.

Results

Serum COMP, urine CTX-II and BMD at femoral neck and hip were increased in premenopausal patients as compared to control; with serum PINP and OC reduced. Meanwhile, serum COMP, urine CTX-II, and BMD at femoral neck and hip showed positive associations with premenopausal early knee OA, while serum PINP had negative association. However, in male patients, only serum COMP was higher than control, and no association of biomarkers or BMD was found with early knee OA.

Conclusions

The joint metabolism biomarkers and BMD showed multiple associations with early knee OA in premenopausal females, but not in males aged before 50 years. It was suggested that sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA.

Key Points

• The joint metabolism biomarkers and BMD are associated with early knee OA in premenopausal females, but not in males aged before 50 years.

• Sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA.

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Data availability

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

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Acknowledgements

The authors thank numerous individuals participated in this study.

Funding

This study was supported by the China National Natural Science Foundation (No. 81601877 and No. 81702119), the Shaanxi Province National Natural Science Foundation (No. 2018JQ8031), and grants from the institutional science foundation of the first Affiliated Hospital of Xi'an Jiaotong University (No.2018MS-05). The funders had no role in study design, data collection/analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Rheumatology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yan Ta Road, Xi’an, 710061, Shaanxi, China

    Nan Hu, Jing Zhang, Jing Wang, Pei Wang, Xiuyuan Feng, Bomiao Ju, Zhiming Hao, Dan Pu, Xiaohong Lu & Lan He

  2. Department of Radiography, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Jing Wang & Yongqian Qiang

  3. Department of Radiography, Shenmu Hospital, Shenmu, China

    Zicheng Li, Jiao Li & Jirong Zhang

  4. Clinical Laboratory, Shenmu Hospital, Shenmu, China

    Tianming Wu

  5. Physical Examination Center, Shenmu Hospital, Shenmu, China

    Xing Wang & Yahong Wang

  6. Department of Orthopaedics, Shenmu Hospital, Middle Section of Guangming Road, Shenmu, 719300, Shaanxi, China

    Xiaoping Liu & Qiang Wang

Authors
  1. Nan Hu
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  2. Jing Zhang
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  3. Jing Wang
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  20. Lan He
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Contributions

1. Conception and design: LH, QW, NH, JZ, XYF, JBM

2. Provision of study materials or patients: ZCL, TMW, XW, YHW, XPL, QW

3. Administrative, technical, or logistic support: JW, YQQ, JL, JRZ, XYF, BMJ

4. Acquisition of data: NH, JZ, PW, JL, JRZ

5. Analysis and interpretation of the data: NH, JZ, PW, XYF

6. Drafting of the article: NH, JZ, PW, LH

7. Critical revision of the article for important intellectual content: All authors

8. Final approval of the article: All authors

All authors take responsibility for the integrity of the work as a whole from inception to finished article.

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Correspondence to Qiang Wang or Lan He.

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Hu, N., Zhang, J., Wang, J. et al. Biomarkers of joint metabolism and bone mineral density are associated with early knee osteoarthritis in premenopausal females. Clin Rheumatol 41, 819–829 (2022). https://doi.org/10.1007/s10067-021-05885-3

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