Moradi Kamyar, Mohajer Bahram, Guermazi Ali, Hadidchi Roham, Mohammadi Soheil, Cao Xu, Wan Mei, Roemer Frank W, Demehri Shadpour
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD, 21287, USA.
Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Skeletal Radiol. 2025 Jan 31. doi: 10.1007/s00256-025-04878-6.
Knee subchondral bone marrow lesions (BMLs) are one of the hallmark features of structural osteoarthritis (OA) and are potential targets for statins' disease-modifying effect. We aimed to determine the association between statin use and longitudinal changes in magnetic resonance imaging (MRI)-based BML volume in participants without radiographic knee OA at baseline.
Using the Osteoarthritis Initiative (OAI) cohort, we classified participants' knees into two categories: statin users (those who consistently used statins from baseline to the fourth year of the cohort) and non-users. We employed a 1:1 ratio propensity score (PS) matching method, adjusting for factors including age, sex, race, BMI, smoking, alcohol use, physical activity, abdominal obesity, and diabetes mellitus. We measured quantitative BML volume using a validated deep learning (DL) algorithm, applied to baseline, year-2, and year-4 intermediate-weighted fat-saturated knee MRIs. The outcome was determined by the differences in the BML volume change between statin users and non-users over the 4-year period.
After adjusting for potential confounders, 1502 knees were included (751 statin users and 751 non-users; mean age 63.5 ± 8.7 years, 44.5% female). A Multilevel linear mixed-effects regression model showed that statin use is associated with a smaller increase in BML volume over 4 years (time-treatment interaction effect estimates, 95% confidence interval (CI) - 14.88 mm/year, - 23.04 to - 6.72, P < 0.001).
In participants without baseline knee OA, continuous statin use is associated with a reduced longitudinal worsening of BML volume in the tibiofemoral joint, a known structural damage marker linked to downstream OA incidence.
膝关节软骨下骨髓损伤（BMLs）是结构性骨关节炎（OA）的标志性特征之一，也是他汀类药物疾病修饰作用的潜在靶点。我们旨在确定在基线时无膝关节OA影像学表现的参与者中，他汀类药物使用与基于磁共振成像（MRI）的BML体积纵向变化之间的关联。
利用骨关节炎倡议（OAI）队列，我们将参与者的膝关节分为两类：他汀类药物使用者（从基线到队列第4年持续使用他汀类药物的人）和非使用者。我们采用1:1比例的倾向评分（PS）匹配方法，对年龄、性别、种族、体重指数、吸烟、饮酒、身体活动、腹部肥胖和糖尿病等因素进行调整。我们使用经过验证的深度学习（DL）算法测量定量BML体积，该算法应用于基线、第2年和第4年的中等加权脂肪饱和膝关节MRI。结果由他汀类药物使用者和非使用者在4年期间BML体积变化的差异确定。
在调整潜在混杂因素后，纳入了1502个膝关节（751个他汀类药物使用者和751个非使用者；平均年龄63.5±8.7岁，44.5%为女性）。一个多级线性混合效应回归模型显示，使用他汀类药物与4年内BML体积的较小增加相关（时间-治疗交互效应估计值，95%置信区间（CI）-14.88 mm/年，-23.04至-6.72，P<0.001）。
在无基线膝关节OA的参与者中，持续使用他汀类药物与胫股关节BML体积纵向恶化的减轻相关，BML是一种已知的与下游OA发病率相关的结构损伤标志物。
