Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, Victoria 3004, Australia.
J Rheumatol. 2010 Jun;37(6):1252-9. doi: 10.3899/jrheum.091055. Epub 2010 Apr 15.
To determine whether serum markers of bone formation and resorption, used individually or in combination, can be used to identify subgroups who lose cartilage volume at different rates over 2 years within a knee osteoarthritis (OA) population.
Changes in cartilage volume over 2 years were measured in 117 subjects with knee OA using magnetic resonance imaging. We examined relationships between change in cartilage volume and baseline serum markers of bone formation [intact N-terminal propeptide of type I procollagen (PINP) and osteocalcin] and resorption [N-telopeptide of type I collagen (NTX-I), C-telopeptide of type I collagen (CTX-I), and C-telopeptide of type I collagen (ICTP).
The baseline markers of bone formation, PINP and osteocalcin (p = 0.02, p = 0.01, respectively), and the baseline markers of bone resorption, CTX-I and NTX-I (p = 0.02 for both), were significantly associated with reduced cartilage loss. There were no significant associations between baseline ratios of bone formation to resorption markers and cartilage loss. However, when subjects were divided into subgroups with high or low bone formation markers (based on levels of marker >or= mean or < mean for the population, respectively), in the subgroup with high PINP there was a significant association between increasing bone resorption markers CTX-I and NTX-I and reduced cartilage loss (p = 0.02, p = 0.001, respectively). Similarly, in the subgroup with high osteocalcin, there was a significant association between increasing CTX-I and NTX-I and reduced cartilage loss (p = 0.02, p = 0.003, respectively). In contrast, in subgroups with low bone formation markers, no significant associations were obtained between markers of bone resorption and cartilage loss.
Overall, the results suggest that higher bone remodeling (i.e., higher serum levels of bone formation and resorption) is associated with reduced cartilage loss. Considering markers of bone formation and resorption together, it is possible to identify subgroups within the OA population who have reduced rates of cartilage loss.
确定骨形成和吸收的血清标志物，单独或联合使用，是否可用于识别膝关节骨关节炎（OA）人群中在 2 年内以不同速度丧失软骨体积的亚组。
使用磁共振成像测量 117 例膝关节 OA 患者 2 年内的软骨体积变化。我们研究了软骨体积变化与基线骨形成标志物[I 型前胶原 N 端肽（PINP）和骨钙素]和骨吸收标志物[N 端肽 I 型胶原（NTX-I）、I 型胶原 C 端肽（CTX-I）和 I 型胶原 C 端肽（ICTP）]之间的关系。
基线骨形成标志物 PINP 和骨钙素（p = 0.02，p = 0.01）以及基线骨吸收标志物 CTX-I 和 NTX-I（均为 p = 0.02）与软骨丢失减少显著相关。基线骨形成标志物与骨吸收标志物的比值与软骨丢失无显著相关性。然而，当根据标志物水平将受试者分为高或低骨形成标志物亚组（基于标志物水平大于或小于人群的平均值）时，在高 PINP 亚组中，骨吸收标志物 CTX-I 和 NTX-I 的增加与软骨丢失减少之间存在显著相关性（p = 0.02，p = 0.001）。同样，在高骨钙素亚组中，CTX-I 和 NTX-I 的增加与软骨丢失减少之间存在显著相关性（p = 0.02，p = 0.003）。相比之下，在低骨形成标志物亚组中，骨吸收标志物与软骨丢失之间无显著相关性。
总体而言，结果表明较高的骨重塑（即骨形成和吸收的血清水平较高）与软骨丢失减少相关。考虑到骨形成和吸收标志物，有可能在 OA 人群中识别出软骨丢失率较低的亚组。
