简要报告：软骨厚度变化作为膝关节骨关节炎进展的影像学生物标志物：来自美国国立卫生研究院骨关节炎生物标志物联盟的资料。
Brief Report: Cartilage Thickness Change as an Imaging Biomarker of Knee Osteoarthritis Progression: Data From the Foundation for the National Institutes of Health Osteoarthritis Biomarkers Consortium.
机构信息
Institute of Anatomy, Paracelsus Medical University, Salzburg, Austria, and Chondrometrics GmbH, Ainring, Germany.
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
出版信息
Arthritis Rheumatol. 2015 Dec;67(12):3184-9. doi: 10.1002/art.39324.
OBJECTIVE
To investigate the association of cartilage thickness change over 24 months, as determined by magnetic resonance imaging (MRI), with knee osteoarthritis (OA) progression at 24-48 months.
METHODS
This nested case-control study included 600 knees with a baseline Kellgren/Lawrence (K/L) grade of 1-3 from 600 Osteoarthritis Initiative (OAI) participants. Case knees (n = 194) had both medial tibiofemoral radiographic joint space loss (≥0.7 mm) and a persistent increase in the Western Ontario and McMaster Universities Osteoarthritis Index pain score (≥9 on a 0-100 scale) 24-48 months from baseline. Control knees (n = 406) included 200 with neither radiographic nor pain progression, 103 with radiographic progression only, and 103 with pain progression only. Medial and lateral femorotibial cartilage was segmented from sagittal 3T MRIs at baseline, 12 months, and 24 months. Logistic regression was used to assess the association of change in cartilage thickness, with a focus on the central medial femorotibial compartment, and OA progression.
RESULTS
Central medial femorotibial compartment thickness loss was significantly associated with case status, with an odds ratio (OR) of 1.9 (95% confidence interval [95% CI] 1.6-2.3) (P < 0.0001). Association with case status reached P < 0.05 for both the central femur (OR 1.8 [95% CI 1.5-2.2]) and the central tibia (OR 1.6 [95% CI 1.3-1.9]). Lateral femorotibial compartment cartilage thickness loss, in contrast, was not significantly associated with case status. A reduction in central medial femorotibial compartment cartilage thickness was strongly associated with radiographic progression (OR 4.0 [95% CI 2.9-5.3]; P < 0.0001) and only weakly associated with pain progression (OR 1.3 [95% CI 1.1-1.6]; P < 0.01).
CONCLUSION
Our findings indicate that loss of medial femorotibial cartilage thickness over 24 months is associated with the combination of radiographic and pain progression in the knee, with a stronger association for radiographic progression.
目的
通过磁共振成像（MRI）检测到的软骨厚度在 24 个月内的变化，来研究其与 24-48 个月时膝关节骨关节炎（OA）进展的关系。
方法
本嵌套病例对照研究纳入了 600 名来自 Osteoarthritis Initiative（OAI）研究的参与者，这些参与者的基线 Kellgren/Lawrence（K/L）分级为 1-3 级，且均有膝关节内侧胫骨股骨放射学关节间隙损失（≥0.7 毫米）。病例组（n=194）在基线后 24-48 个月时，既出现了 Western Ontario and McMaster Universities Osteoarthritis Index 疼痛评分（0-100 分制中≥9 分）持续增加，又出现了内侧胫骨股骨放射学进展。对照组（n=406）中，200 名膝关节未出现放射学和疼痛进展，103 名膝关节仅出现放射学进展，103 名膝关节仅出现疼痛进展。基线、12 个月和 24 个月时，对矢状位 3T MRI 进行内侧和外侧股骨胫骨软骨分割。采用 logistic 回归评估软骨厚度变化与 OA 进展的相关性，重点关注中央内侧股骨胫骨间隙。
结果
中央内侧股骨胫骨间隙厚度损失与病例状态显著相关，比值比（OR）为 1.9（95%置信区间[95%CI]为 1.6-2.3）（P<0.0001）。中央股骨（OR 1.8[95%CI 1.5-2.2]）和中央胫骨（OR 1.6[95%CI 1.3-1.9]）的病例状态也达到了 P<0.05 的显著性水平。相比之下，外侧股骨胫骨间隙软骨厚度损失与病例状态无显著相关性。中央内侧股骨胫骨间隙软骨厚度的减少与放射学进展密切相关（OR 4.0[95%CI 2.9-5.3]；P<0.0001），与疼痛进展仅轻度相关（OR 1.3[95%CI 1.1-1.6]；P<0.01）。
结论
我们的研究结果表明，24 个月内内侧股骨胫骨软骨厚度的丧失与膝关节的放射学和疼痛进展相结合有关，与放射学进展的相关性更强。
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