Sharif M, Granell R, Johansen J, Clarke S, Elson C, Kirwan J R
Department of Anatomy, University of Bristol, Southwell Street, Bristol BS2 8EJ, UK.
Rheumatology (Oxford). 2006 May;45(5):522-6. doi: 10.1093/rheumatology/kei216. Epub 2005 Nov 30.
There is some evidence that tibiofemoral osteoarthritis (TFJ OA) and patellofemoral osteoarthritis (PFJ OA) may have different risk factors. To investigate the possibility that these conditions are separate disease entities, we compared biomarker profiles of patients with each disease.
Serum samples were taken from 222 patients who had knee pain and X-ray signs of knee OA. Eighty-two had only medial TFJ OA and 38 only PFJ OA in one or both knees. The remaining patients had either mixed disease or equivocal radiographic evidence of OA. The following biomarkers were measured in serum samples from baseline and follow-up visits: cartilage oligomeric matrix protein (COMP), glycosaminoglycan, keratan sulphate epitope 5D4, YKL-40, osteocalcin, C-telopeptide of type I collagen, hyaluronan and C-reactive protein.
The two subsets of OA (TFJ and PFJ) had similar radiographic disease severity and there were no significant differences in the presence and patterns of pain scores (visual analogue scale and Western Ontario and McMaster Universities Osteoarthritis Index). No difference was found for the biomarkers between the two groups, with one exception. Both baseline and area under the curve per month COMP concentrations were significantly higher in the TFJ than the PFJ group (P<0.01).
The reduced serum COMP in PFJ disease compared with TFJ OA could be due to small articular cartilage volume in the latter or to a qualitative difference in cartilage metabolism.
有证据表明,胫股关节骨关节炎(TFJ OA)和髌股关节骨关节炎(PFJ OA)可能具有不同的危险因素。为了研究这两种疾病是否为独立的疾病实体,我们比较了每种疾病患者的生物标志物谱。
采集了222例有膝关节疼痛且有膝关节骨关节炎X线征象患者的血清样本。其中82例仅一侧或双侧膝关节存在内侧TFJ OA,38例仅一侧或双侧膝关节存在PFJ OA。其余患者患有混合性疾病或骨关节炎的X线表现不明确。在基线和随访时采集的血清样本中检测以下生物标志物:软骨寡聚基质蛋白(COMP)、糖胺聚糖、硫酸角质素表位5D4、YKL-40、骨钙素、I型胶原C末端肽、透明质酸和C反应蛋白。
OA的两个亚组(TFJ和PFJ)具有相似的X线疾病严重程度,疼痛评分(视觉模拟量表和西安大略和麦克马斯特大学骨关节炎指数)的存在和模式没有显著差异。两组之间的生物标志物除一项外没有差异。TFJ组的基线和每月曲线下面积COMP浓度均显著高于PFJ组(P<0.01)。
与TFJ OA相比,PFJ疾病中血清COMP降低可能是由于后者关节软骨体积较小或软骨代谢存在质的差异。