University of Pittsburgh and VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; University of Arizona, Tucson.
Arthritis Rheumatol. 2014 Apr;66(4):930-9. doi: 10.1002/art.38314.
To determine the short-term efficacy of oral glucosamine supplementation by evaluating structural lesions in the knee joints, as assessed using 3T magnetic resonance imaging (MRI).
This study was designed as a randomized, double-blind, placebo-controlled trial. Recruitment was performed via mass mailings and an arthritis registry in southwestern Pennsylvania. In total, 201 participants with mild-to-moderate pain in one or both knees, as defined by a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score ≥25 and ≤100, were enrolled. Of these subjects, 69.2% had a Kellgren/Lawrence grade ≥2 in at least 1 knee. Participants received 24 weeks of treatment with 1,500 mg glucosamine hydrochloride in beverage form or a placebo beverage. The primary outcome was decreased worsening of cartilage damage on 3T MRI of both knees, assessed according to a validated scoring system, the Whole-Organ MRI Score (WORMS). Secondary outcomes included change in bone marrow lesion (BML) scores in all knees and change in excretion of urinary C-terminal crosslinking telopeptide of type II collagen (CTX-II).
The adjusted odds ratio (OR) for the likelihood of decreased cartilage damage over 24 weeks in any WORMS-scored subregion of the knee in the glucosamine treatment group compared to the control group was 0.938 (95% confidence interval [95% CI] 0.528, 1.666). Compared to subjects treated with glucosamine, control subjects showed more improvement in BMLs (adjusted OR 0.537, 95% CI 0.291, 0.990) but no difference in worsening BMLs (adjusted OR 0.691, 95% CI 0.410, 1.166) over 24 weeks. There was no indication that treatment with glucosamine decreased the excretion of urinary CTX-II (β = -0.10, 95% CI -0.21, 0.002).
The results of this short-term study provide no evidence of structural benefits (i.e., improvements in MRI morphologic features or urinary CTX-II excretion) from glucosamine supplementation in individuals with chronic knee pain.
通过评估使用 3T 磁共振成像（MRI）评估膝关节的结构病变，确定口服葡萄糖胺补充剂的短期疗效。
本研究设计为随机、双盲、安慰剂对照试验。通过在宾夕法尼亚州西南部的大规模邮寄和关节炎登记处进行招募。共有 201 名患有单侧或双侧膝关节轻度至中度疼痛的参与者入选，其定义为 Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）疼痛评分≥25 且≤100。其中 69.2%的患者至少有 1 个膝关节的 Kellgren/Lawrence 分级≥2。参与者接受了 24 周的治疗，分别服用 1500 毫克盐酸氨基葡萄糖饮料或安慰剂饮料。主要结局是根据经过验证的评分系统（全器官 MRI 评分[WORMS]）评估双侧膝关节软骨损伤恶化程度降低。次要结局包括所有膝关节骨髓病变（BML）评分的变化和尿液 II 型胶原 C 端交联肽（CTX-II）排泄的变化。
与对照组相比，在任何 WORMS 评分的膝关节亚区中，24 周内葡萄糖胺治疗组膝关节软骨损伤减少的可能性的调整后比值比（OR）为 0.938（95%置信区间[95%CI]0.528，1.666）。与接受葡萄糖胺治疗的受试者相比，对照组在 24 周内 BML 的改善更为明显（调整后 OR 0.537，95%CI 0.291，0.990），但在 BML 恶化方面无差异（调整后 OR 0.691，95%CI 0.410，1.166）。没有迹象表明葡萄糖胺治疗可减少尿液 CTX-II 的排泄（β=-0.10，95%CI-0.21，0.002）。
这项短期研究的结果并未提供任何证据表明慢性膝关节疼痛患者补充葡萄糖胺可带来结构上的益处（即 MRI 形态特征或尿液 CTX-II 排泄的改善）。
