高凯尔格伦-劳伦斯分级和骨髓病变可预测影像学关节间隙狭窄的恶化率；SEKOIA研究。
High Kellgren-Lawrence Grade and Bone Marrow Lesions Predict Worsening Rates of Radiographic Joint Space Narrowing; The SEKOIA Study.
作者信息
Edwards Mark H, Parsons Camille, Bruyère Olivier, Petit Dop Forence, Chapurlat Roland, Roemer Frank W, Guermazi Ali, Zaim Souhil, Genant Harry, Reginster Jean-Yves, Dennison Elaine M, Cooper Cyrus
机构信息
From the MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Department of Public Health and Health Economics, University of Liege, Liege, Belgium; Innovative Therapeutic Pole of Rheumatology, Servier, Surenes, France; INSERM UMR 1033, Service de Rhumatolgie et Pathologie Osseuse, Hôpital Edouard Herriot, Université de Lyon, Lyon, France; Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; Department of Radiology, University of Erlangen-Nuremburg, Erlangen, Germany; Synarc, San Francisco, California, USA; Department of Public Health and Health Economics, University of Liege; NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital; and NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.M.H. Edwards, MD, PhD; C. Parsons, MSc, MRC Lifecourse Epidemiology Unit, University of Southampton; O. Bruyère, PhD, Department of Public Health and Health Economics, University of Liege; F. Petit Dop, PhD, Innovative Therapeutic Pole of Rheumatology; R. Chapurlat, MD, PhD, INSERM UMR 1033, Service de Rhumatolgie et Pathologie Osseuse, Hôpital Edouard Herriot, Université de Lyon; F.W. Roemer, MD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; Department of Radiology, University of Erlangen-Nuremburg; A. Guermazi, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; S. Zaim, MD, Synarc; H. Genant, MD, Synarc; J-Y. Reginster, MD, PhD, Department of Public Health and Health Economics, University of Liege; E.M. Dennison, MD, PhD, MRC Lifecourse Epidemiology Unit, University of Southampton; Victoria University; C. Cooper, FMedSci, MRC Lifecourse Epidemiology Unit, University of Southampton; NIHR Biomedical
出版信息
J Rheumatol. 2016 Mar;43(3):657-65. doi: 10.3899/jrheum.150053. Epub 2016 Jan 15.
OBJECTIVE
Determinants of radiographic progression in osteoarthritis (OA) are poorly understood. We investigated which features on baseline magnetic resonance imaging (MRI) acted as predictors of change in joint space width (JSW).
METHODS
A total of 559 men and women over the age of 50 years with clinical knee OA [Kellgren-Lawrence (KL) grade 2-3] were recruited to the placebo arm of the SEKOIA study (98 centers; 18 countries). Minimal tibiofemoral joint space and KL grade on plain radiograph of the knee were assessed at baseline and at yearly followup up to 3 years. In a subset, serial knee MRI examinations were performed. Individuals with a bone marrow lesion (BML) ≥ grade 2 at the tibiofemoral joint at baseline were classified as BML-positive. Relationships between change in JSW and risk factors were assessed using linear regression.
RESULTS
The mean age of study participants was 62.8 (SD 7.5) years and 73% were female; 38.6% had BML. Mean baseline JSW was 3.65 mm. This reduced by 0.18 (0.30) mm/year in men and 0.13 (0.23) mm/year in women. Those with BML had a significantly higher rate of annualized change in JSW; this relationship remained robust after adjustment for age, sex, and baseline KL grade [β = -0.10 (95% CI -0.18, -0.02) mm/yr]. Age, sex, baseline KL grade, and other MRI findings did not influence the rate of change in JSW.
CONCLUSION
The rate of change in JSW was similar in men and women. BML on knee MRI predicted the rate of radiographic change in JSW. This relationship was independent of age, sex, and baseline KL grade.
目的
骨关节炎（OA）影像学进展的决定因素尚不清楚。我们研究了基线磁共振成像（MRI）上的哪些特征可作为关节间隙宽度（JSW）变化的预测指标。
方法
共有559名50岁以上患有临床膝关节OA[凯尔格伦-劳伦斯（KL）分级为2-3级]的男性和女性被纳入SEKOIA研究的安慰剂组（98个中心；18个国家）。在基线时以及长达3年的每年随访时，对膝关节X线平片上的最小胫股关节间隙和KL分级进行评估。在一个亚组中，进行了膝关节的系列MRI检查。基线时胫股关节骨髓损伤（BML）≥2级的个体被分类为BML阳性。使用线性回归评估JSW变化与危险因素之间的关系。
结果
研究参与者的平均年龄为62.8（标准差7.5）岁，73%为女性；38.6%有BML。平均基线JSW为3.65mm。男性每年减少0.18（0.30）mm，女性每年减少0.13（0.23）mm。有BML的个体JSW的年化变化率显著更高；在对年龄、性别和基线KL分级进行调整后，这种关系仍然很显著[β=-0.10（95%可信区间-0.18，-0.02）mm/年]。年龄、性别、基线KL分级和其他MRI结果均未影响JSW的变化率。
结论
JSW的变化率在男性和女性中相似。膝关节MRI上的BML可预测JSW的影像学变化率。这种关系独立于年龄、性别和基线KL分级。
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