Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia Research Institute of Orthopaedics, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia.
Ann Rheum Dis. 2014 Nov;73(11):2003-9. doi: 10.1136/annrheumdis-2013-203691. Epub 2013 Jul 31.
To investigate cross-sectional and longitudinal associations between systemic bone mineral density (BMD), subchondral BMD (sBMD) and knee cartilage thickness in older adults with or without radiographic osteoarthritis (ROA).
A prospective cohort of 158 randomly selected subjects (mean 63 years, 48% women) including 69 non-ROA and 89 ROA subjects were studied at baseline and 2.7 years later. Knee cartilage thickness was semi-automatically determined from T1-weighted fat-suppressed MRI. Knee cartilage volume was measured from MRI. Systemic BMD and sBMD were measured by dual-energy X-ray absorptiometry (DXA).
Cross-sectionally, total body, total hip, spine BMD and/or lateral tibial sBMD were significantly and positively associated with femoral, lateral tibial and/or patellar cartilage thickness in subjects with ROA after adjustment for potential confounders. Longitudinally, a high total body BMD was associated with an increase in femoral cartilage thickness (β: 0.33 mm/g/cm(2), 95% CI 0.13 to 0.53); a high spine BMD was associated with increases in femoral and lateral tibial cartilage thickness (β: 0.25 mm/g/cm(2), 95% CI 0.10 to 0.41; and β: 0.18 mm/g/cm(2), 95% CI: 0.01 to 0.34, respectively) and a high medial tibial sBMD was associated with an increase in medial tibial cartilage thickness (β: 0.45 mm/g/cm(2), 95% CI 0.02 to 0.89) in subjects with ROA. In contrast, there were no significant associations between baseline systemic BMD, sBMD and cartilage volume loss, nor were there associations between BMD and cartilage thickness in subjects without ROA.
Both systemic and subchondral BMD are positively associated with increased cartilage thickness in subjects with ROA, suggesting BMD may play a protective role against cartilage loss in knee OA.
研究伴有或不伴有放射学骨关节炎（ROA）的老年人系统骨密度（BMD）、软骨下骨密度（sBMD）与膝关节软骨厚度之间的横断面和纵向关联。
一项前瞻性队列研究纳入了 158 名随机选择的受试者（平均年龄 63 岁，48%为女性），包括 69 名非 ROA 受试者和 89 名 ROA 受试者，他们在基线和 2.7 年后接受了研究。使用 T1 加权脂肪抑制 MRI 半自动确定膝关节软骨厚度。使用 MRI 测量膝关节软骨容积。使用双能 X 射线吸收法（DXA）测量系统 BMD 和 sBMD。
横断面研究显示，在调整了潜在混杂因素后，ROA 受试者的全身、全髋、脊柱 BMD 和/或胫骨外侧 sBMD 与股骨、胫骨外侧和/或髌骨软骨厚度呈显著正相关。纵向研究显示，全身高 BMD 与股骨软骨厚度增加相关（β：0.33mm/g/cm²，95%CI 0.13 至 0.53）；脊柱高 BMD 与股骨和胫骨外侧软骨厚度增加相关（β：0.25mm/g/cm²，95%CI 0.10 至 0.41；β：0.18mm/g/cm²，95%CI：0.01 至 0.34）；内侧胫骨 sBMD 高与 ROA 受试者的内侧胫骨软骨厚度增加相关（β：0.45mm/g/cm²，95%CI 0.02 至 0.89）。相反，在 ROA 受试者中，基线系统 BMD 和 sBMD 与软骨容积丢失之间没有显著关联，在无 ROA 受试者中也没有 BMD 与软骨厚度之间的关联。
系统 BMD 和软骨下 BMD 均与 ROA 患者的软骨厚度增加呈正相关，提示 BMD 可能对膝骨关节炎的软骨丢失具有保护作用。
