Karlsson Magnus K, Karlsson Caroline, Magnusson Håkan, Cöster Maria, von Schewelov Tord, Nilsson Jan Åke, Brudin Lars, Rosengren Björn E
Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö and Department of Clinical Physiology, Kalmar Hospital, Kalmar, Sweden.
Open Orthop J. 2014 Dec 29;8:450-6. doi: 10.2174/1874325001408010450. eCollection 2014.
The aim of this study was to evaluate whether primary osteoarthritis (OA), independent of affected joint, is associated with a phenotype that is different from the phenotype in a normative cohort. Material and.
We included 274 patients with primary OA, 30 women and 32 men (mean age 66 years, range 42-84) with primary hip OA, 38 women and 74 men (mean age 61 years; range 34-85) with primary knee OA, 42 women and 19 men (men age 64 years, range 42-87) with primary ankle or foot OA and 20 women and 19 men (mean age 66 years, range 47-88) with primary hand or finger OA. Of all patients included with OA, 23% had hip OA, 41% knee OA, 22% ankle or foot OA and 14% hand or finger OA. Serving as references were 122 women and 118 men of the same ages who were population-based, included as a control cohort. We measured total body BMD (g/cm2) and proportion of fat and lean mass (%) with dual energy X-ray absorptiometry. Height, weight and BMI (kg/m2) were also assessed. We then calculated Z-scores (number of standard deviations difference from the mean value of the control cohort) in the OA patients and compared these between the groups.
Individuals with hand OA and controls had similar phenotype. Individuals with lower extremity OA, irrespective of the affected joint, had similar weight, BMI and BMD, but higher than in individuals with hand OA and controls (all p<0.05). Individuals with lower extremity OA had higher fat and lower lean mass than individuals with hand OA and controls (all p<0.001).
Individuals with primary OA in the lower extremity have a phenotype with higher BMD, higher BMI, proportionally higher fat content and lower lean body mass content. The different skeletal phenotypes in our patients with OA in the lower extremity and patients with hand OA indicate that separate pathophysiologic pathways may be responsible for primary OA in different joints.
本研究旨在评估原发性骨关节炎（OA）是否独立于受累关节，与不同于正常队列的表型相关。材料与方法：我们纳入了274例原发性OA患者，其中30名女性和32名男性（平均年龄66岁，范围42 - 84岁）患有原发性髋OA，38名女性和74名男性（平均年龄61岁；范围34 - 85岁）患有原发性膝OA，42名女性和19名男性（平均年龄64岁，范围42 - 87岁）患有原发性踝或足OA，20名女性和19名男性（平均年龄66岁，范围47 - 88岁）患有原发性手或手指OA。在所有纳入的OA患者中，23%患有髋OA，41%患有膝OA，22%患有踝或足OA，14%患有手或手指OA。作为对照的是122名女性和118名男性，他们是基于人群的同年龄段者，作为对照队列纳入。我们用双能X线吸收法测量全身骨密度（g/cm²）以及脂肪和瘦体重的比例（%）。还评估了身高、体重和体重指数（kg/m²）。然后我们计算OA患者的Z分数（与对照队列平均值相差的标准差数）并在组间进行比较。结果：手OA患者与对照组具有相似的表型。下肢OA患者，无论受累关节如何，体重、BMI和骨密度相似，但高于手OA患者和对照组（所有p<0.05）。下肢OA患者比手OA患者和对照组有更高的脂肪和更低的瘦体重（所有p<0.001）。结论：下肢原发性OA患者具有更高骨密度、更高BMI、比例更高的脂肪含量和更低的瘦体重含量的表型。我们下肢OA患者和手OA患者不同的骨骼表型表明，不同关节的原发性OA可能由不同的病理生理途径所致。
