Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.
Duke University School of Medicine, Durham, North Carolina.
Arthritis Care Res (Hoboken). 2017 Aug;69(8):1179-1191. doi: 10.1002/acr.23121. Epub 2017 Jul 10.
To determine the relationship between biochemical markers involved in bone turnover and bone features on imaging in knees with osteoarthritis (OA).
We analyzed data from the Foundation for the National Institutes of Health OA Biomarkers Consortium within the Osteoarthritis Initiative (n = 600). Bone marrow lesions (BMLs), osteophytes, and subchondral bone area (mm ) and shape (position on 3-D vector) were assessed on magnetic resonance images, and bone trabecular integrity (BTI) was assessed on radiographs. Serum and urinary markers (serum C-terminal crosslinked telopeptide of type I collagen [CTX-I], serum crosslinked N-telopeptide of type I collagen [NTX-I], urinary NTX-I, urinary C-terminal crosslinked telopeptide of type II collagen [CTX-II], and urinary CTX-Iα and CTX-Iβ) were measured. The associations between biochemical and imaging markers at baseline and over 24 months were assessed using regression models adjusted for covariates.
At baseline, most biochemical markers were associated with BMLs, with C statistics for the presence/absence of any BML ranging from 0.675 to 0.688. At baseline, urinary CTX-II was the marker most consistently associated with BMLs (with odds of having ≥5 subregions affected compared to no BML increasing by 1.92-fold [95% confidence interval (95% CI) 1.25, 2.96] per 1 SD of urinary CTX-II), large osteophytes (odds ratio 1.39 [95% CI 1.10, 1.77]), bone area and shape (highest partial R = 0.032), and changes in bone shape over 24 months (partial R range 0.008 to 0.024). Overall, biochemical markers were not predictive of changes in BMLs or osteophytes. Serum NTX-I was inversely associated with BTI of the vertical trabeculae (quadratic slope) in all analyses (highest partial R = 0.028).
We found multiple significant associations, albeit mostly weak ones. The role of systemic biochemical markers as predictors of individual bone anatomic features of single knees is limited based on our findings.
确定骨关节炎（OA）膝关节中涉及骨转换的生化标志物与影像学骨特征之间的关系。
我们分析了国家卫生研究院 OA 生物标志物联盟基金会在骨关节炎倡议（OAI）中的数据（n=600）。在磁共振图像上评估骨髓病变（BML）、骨赘和软骨下骨面积（mm）和形状（3D 向量上的位置），并在 X 光片上评估骨小梁完整性（BTI）。测量血清和尿液标志物（血清 I 型胶原 C 端交联肽[CTX-I]、血清 I 型胶原交联 N 端肽[NTX-I]、尿 NTX-I、尿 II 型胶原 C 端交联肽[CTX-II]和尿 CTX-Iα和 CTX-Iβ）。使用调整协变量的回归模型评估基线和 24 个月时生化和影像学标志物之间的相关性。
基线时，大多数生化标志物与 BML 相关，存在/不存在任何 BML 的 C 统计量范围为 0.675 至 0.688。基线时，尿 CTX-II 是与 BML 最一致相关的标志物（与无 BML 相比，每增加 1 个 SD 的尿 CTX-II，有≥5 个亚区受累的可能性增加 1.92 倍[95%置信区间（95%CI）1.25，2.96]）、大骨赘（优势比 1.39[95%CI 1.10，1.77]）、骨面积和形状（最高部分 R = 0.032）以及 24 个月内骨形状的变化（部分 R 范围 0.008 至 0.024）。总体而言，生化标志物不能预测 BML 或骨赘的变化。血清 NTX-I 在所有分析中与垂直小梁的 BTI 呈负相关（最高部分 R = 0.028）。
我们发现了多个有意义的关联，尽管大多数关联都很微弱。根据我们的发现，系统生化标志物作为单个膝关节个体骨骼解剖特征预测因子的作用是有限的。
