Wang B, Pramono H K, Cicuttini F M, Hanna F, Davis S R, Bell R J, Wang Y
Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia; School of Rural Health, Monash University, Melbourne, VIC 3800, Australia.
Osteoarthritis Cartilage. 2014 Aug;22(8):1136-41. doi: 10.1016/j.joca.2014.06.008. Epub 2014 Jun 24.
There is evidence for an association between levels of urinary C-telopeptide fragments of type II collagen (uCTX-II) and risk of knee osteoarthritis (OA). The aim of this cohort study was to examine the association between uCTX-II levels and knee cartilage and bone changes in middle-aged women without clinical knee disease.
140 women, aged 40-67 years, with no significant knee pain, knee injury or any forms of arthritis, underwent knee magnetic resonance imaging (MRI) at baseline and 2 years later. Cartilage volume, cartilage defects, tibial plateau bone area and bone marrow lesions (BMLs) were measured using validated methods. Baseline uCTX-II was measured using enzyme-linked immunosorbent assay (ELISA).
For every one unit (natural logarithm transformed) increase in baseline uCTX-II level, there was an increase in the prevalence of medial tibiofemoral cartilage defects (Odds ratio (OR) 4.36, 95% confidence interval (CI) 1.58-12.04), medial (80.2 mm(2), 95% CI 9.3-151.1) and lateral (86.0 mm(2), 95% CI 33.3-138.7) tibial plateau bone area, and the prevalence of lateral tibiofemoral BMLs (OR 10.62, 95% CI 1.82-61.85). Baseline uCTX-II levels were not significantly associated with baseline tibial cartilage volume or changes in knee cartilage volume or defects or bone area over 2 years, although there was a trend for the deterioration of medial tibiofemoral BMLs (P = 0.06).
In middle-aged women without clinical knee disease, higher uCTX-II levels were associated with early detrimental structural changes at the knee (cartilage defects, tibial bone expansion and BMLs) at baseline but not over 2 years. Further work will be needed to determine its sensitivity to change and whether it predicts disease progression over longer time periods.
有证据表明，尿Ⅱ型胶原C端肽片段（uCTX-II）水平与膝关节骨关节炎（OA）风险之间存在关联。这项队列研究的目的是，在无临床膝关节疾病的中年女性中，研究uCTX-II水平与膝关节软骨及骨质变化之间的关联。
140名年龄在40 - 67岁之间、无明显膝关节疼痛、膝关节损伤或任何形式关节炎的女性，在基线期和2年后接受膝关节磁共振成像（MRI）检查。采用经过验证的方法测量软骨体积、软骨缺损、胫骨平台骨面积和骨髓病变（BMLs）。使用酶联免疫吸附测定（ELISA）法测量基线uCTX-II水平。
基线uCTX-II水平每增加一个单位（自然对数转换），内侧胫股关节软骨缺损的患病率就会增加（比值比（OR）4.36，95%置信区间（CI）1.58 - 12.04），内侧（80.2平方毫米，95% CI 9.3 - 151.1）和外侧（86.0平方毫米，95% CI 33.3 - 138.7）胫骨平台骨面积增加，外侧胫股关节BMLs的患病率增加（OR 10.62，95% CI 1.82 - 61.85）。基线uCTX-II水平与基线期胫骨软骨体积或2年内膝关节软骨体积、缺损或骨面积的变化无显著关联，尽管内侧胫股关节BMLs有恶化趋势（P = 0.06）。
在无临床膝关节疾病的中年女性中，较高的uCTX-II水平与基线期膝关节早期有害结构变化（软骨缺损、胫骨骨扩张和BMLs）相关，但与2年期间的变化无关。需要进一步研究以确定其对变化的敏感性，以及它是否能预测更长时间段内的疾病进展。
