School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Rheumatology (Oxford). 2023 Apr 3;62(4):1645-1651. doi: 10.1093/rheumatology/keac469.
There is increasing evidence for the involvement of vascular disease in the pathogenesis of knee OA. Popliteal artery wall thickness can be used as a surrogate marker of atherosclerosis. We examined the association between popliteal artery wall thickness and knee cartilage volume in individuals with symptomatic knee OA.
This prospective cohort study analysed 176 participants from a randomized placebo-controlled trial examining the effect of atorvastatin on structural progression in knee OA. The participants underwent MRI of the study knee at baseline and 2-year follow-up. Popliteal artery wall thickness and tibial cartilage volume were measured from MRI using validated methods. The top quartile of the rate of tibial cartilage volume loss was defined as rapid progression.
At baseline, every 10% increase in popliteal artery wall thickness was associated with 120.8 mm3 (95% CI 5.4, 236.2, P = 0.04) lower of medial tibial cartilage volume and 151.9 mm3 (95% CI 12.1, 291.7, P = 0.03) lower of lateral tibial cartilage volume. Longitudinally, for every 10% increase in popliteal artery wall thickness, the annual rate of medial tibial cartilage volume loss was increased by 1.14% (95% CI 0.09%, 2.20%, P = 0.03), and there was a 2.28-fold (95% CI 1.07, 4.83, P = 0.03) risk of rapid progression of medial tibial cartilage loss, adjusted for age, sex, BMI, tibial bone area, smoking, vigorous physical activity, and intervention group allocation.
The findings support a role for vascular pathology in the progression of knee OA. Targeting atherosclerosis has the potential to improve outcomes in knee OA.
越来越多的证据表明血管疾病参与了膝骨关节炎的发病机制。腘动脉壁厚度可用作动脉粥样硬化的替代标志物。我们研究了有症状的膝骨关节炎患者中腘动脉壁厚度与膝关节软骨体积之间的关系。
这项前瞻性队列研究分析了一项随机安慰剂对照试验的 176 名参与者的数据，该试验研究了阿托伐他汀对膝骨关节炎结构进展的影响。参与者在基线和 2 年随访时接受了研究膝关节的 MRI 检查。使用经过验证的方法从 MRI 测量腘动脉壁厚度和胫骨软骨体积。将胫骨软骨体积损失率的最高四分位数定义为快速进展。
在基线时，腘动脉壁厚度每增加 10%，内侧胫骨软骨体积就会减少 120.8 mm3（95%CI 5.4, 236.2，P = 0.04），外侧胫骨软骨体积减少 151.9 mm3（95%CI 12.1, 291.7，P = 0.03）。纵向来看，腘动脉壁厚度每增加 10%，内侧胫骨软骨体积的年损失率就会增加 1.14%（95%CI 0.09%, 2.20%，P = 0.03），内侧胫骨软骨损失快速进展的风险增加 2.28 倍（95%CI 1.07, 4.83，P = 0.03），调整年龄、性别、BMI、胫骨骨面积、吸烟、剧烈体力活动和干预组分配后。
这些发现支持血管病理学在膝骨关节炎进展中的作用。针对动脉粥样硬化有可能改善膝骨关节炎的预后。
