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Publisher: Elsevier BV
Date: 09-2022
Publisher: Oxford University Press (OUP)
Date: 25-10-2019
DOI: 10.1093/RHEUMATOLOGY/KEZ498
Abstract: To describe associations of body composition, physical activity and physical performance with knee cartilage thickness and subchondral bone area in young adults. Body composition, physical activity and physical performance were measured 4–5 years prior to knee MRI. Cartilage thickness and bone area were measured quantitatively from MRI. Associations were assessed using linear regression analysis, with mediators being identified using mediation analysis. Participants (n = 186) were 31–41 years of age when the MRI was acquired and 48% were female. Greater lean mass was positively associated with cartilage thickness [β = 6.52 μm/kg (95% CI 0.86, 12.18)] and bone area [β = 13.37 mm2/kg (95% CI 5.43, 21.31)]. Physical performance measures were positively associated with cartilage thickness [long jump: β = 2.44 μm/cm (95% CI 0.70, 4.18) hand grip strength: 7.74 μm/kg (95% CI 1.50, 13.98) physical work capacity: 1.07 μm/W (95% CI 0.29, 1.85)] and bone area [long jump: β = 3.99 mm2/cm (95% CI 0.64, 7.34) hand grip strength: 19.06 mm2/kg (95% CI 7.21, 30.92) leg strength: 3.18 mm2/kg (95% CI 1.09, 5.28) physical work capacity: 3.15 mm2/W (95% CI 1.70, 4.60)]. Mediation analysis suggested these associations were mediated by lean mass (effect mediated: 27–95%). Greater lean mass and better physical performance measured 4–5 years prior were associated with greater knee cartilage thickness and subchondral bone area in young adults, and the associations of physical performance were largely mediated by lean mass. These findings suggest lean mass may play an important role in maintaining knee joint health in young adults.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Oxford University Press (OUP)
Date: 13-02-2020
DOI: 10.1080/14397595.2020.1724671
Abstract: Takayasu arteritis (TAK) is a chronic immune vasculitis in which Interleukin-6 (IL-6) receptors play a key role in pathogenesis. Tocilizumab (TCZ), an IL-6 receptor antagonist with a favorable safety and efficacy profile, has been tried as an option for patients with TAK. This systematic review analyzed the evidence from randomized control trials (RCT) assessing the safety and efficacy of TCZ in patients with TAK. MEDLINE, Embase, the Cochrane Library, and clinical trial registries were searched from inception to July 2018. We included RCT assessing the efficacy and safety of TCZ versus placebo/other comparators for the treatment of patients with TAK. The risk of bias (RoB) was assessed using Cochrane RoB tool. 2799 identified articles were screened as per abstract and title 42 selected full-texts articles were assessed for the potential inclusion. One trial, reported in two publications, comparing subcutaneous TCZ (162 mg/week) versus matching placebo in 36 patients with TAK was included. The relapse-free rate at 24 weeks was 50.6% and 22.9% in TCZ and placebo arm, respectively. The hazard ratio (HR) for time to first relapse was statistically significant in the per-protocol population (HR 0.34 [95.41% CI, 0.11-1.00] This systematic review finds the existing evidence from RCT on efficacy and safety profile of TCZ in TAK to be promising but limited. Additional evidence is required to draw a stronger conclusion.
Publisher: Springer Science and Business Media LLC
Date: 26-10-2015
Publisher: Wiley
Date: 26-08-2015
DOI: 10.1002/ACR.22588
Abstract: We aimed to determine the associations between childhood physical performance measures and tibial cartilage volume and tibial bone area in adults 25 years later. Participants (n = 330, ages 31-41 years, female 47%) were selected from the Australian Schools Health and Fitness Survey of 1985. The participants underwent T1-weighted fat-suppressed magnetic resonance imaging (MRI) of their knees. Tibial bone area and cartilage volume were measured from MRI. Childhood measures, including physical work capacity at 170 beats per minute (PWC170 ), leg strength, number of sit-ups, long-run, and short-run were measured in 1985. PWC170 and leg strength measures were repeated after 20 years in their adulthood. Linear regression analysis was used to determine the association of performance measures with cartilage volume. There were consistent positive associations of all childhood measures, including PWC170 (β = 0.38 cm(2) per 10 watts, 95% confidence interval [95% CI] 0.15, 0.60), leg strength, long-run, short-run, and sit-ups with adult medial and total tibial bone area. Similarly, there was an association of PWC170 and sit-ups with adult medial tibial cartilage volume. After further adjustment for tibial bone area, the association between PWC170 and medial and total (β = 0.08 cm(3) per 10 watts, 95% CI 0.02, 0.10) tibial cartilage volume decreased in magnitude but remained significant. Childhood physical performance measures, especially PWC170 , were associated with knee tibial bone area and cartilage volume in adulthood. The associations with cartilage volume appeared to be partially mediated by bone area. This suggests physical performance measures in childhood can independently influence adult knee structures.
Publisher: Cold Spring Harbor Laboratory
Date: 26-05-2021
DOI: 10.1101/2021.05.19.21257436
Abstract: Parkinson’s disease (PD) is a progressive nervous system disorder characterised by the loss of dopaminergic neurons leading to motor and non-motor symptoms. Accumulation of α-synuclein protein (SNCA) in the form of Lewy bodies has been observed in dopaminergic neurons of PD patients. Potential relationships between β-adrenergic drugs (agonists and antagonist) and SNCA synthesis in PD have been recently suggested. This study aims to systematically review the evidence from various epidemiological studies that analysed the association between beta-adrenoceptors (agonists and antagonists) and the risk of PD. Biomedical databases such as PubMed and Embase will be searched to identify the in idual studies that reported the relationship between beta-adrenoceptors and the risk of PD. JBI critical appraisal tool scale will be used to assess the quality of included studies. The primary outcome will be to compute the pooled risk of PD among beta-agonist and antagonist users. Furthermore, we will consider the pooled risk of PD based on study design, types of beta-agonist or antagonist exposure under secondary outcomes. RevMan 5, STATA 16, and ProMeta 3.0 will be used to conduct the statistical analysis.
Publisher: Korean Association of Internal Medicine
Date: 2022
Abstract: Background/Aims: Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA however, its efficacy and safety remain unclear. This systematic review and meta-analysis evaluate efficacy and safety of HCQ for the treatment of OA.Methods: MEDLINE, EMBASE, and Cochrane Central were searched from inception through June 2020. Two reviewers independently screened for randomized controlled trials (RCTs) comparing HCQ with placebo or other active-comparators for the treatment of knee, hand, or hip OA, extracted data, and performed Cochrane risk of bias assessments.Results: Six RCTs, four in hand OA, two in knee OA, consisting of 842 patients (436 in HCQ arm, 406 in control arm) were included. RCTs were conducted between 2012 and 2020, one each at UK, Netherlands, Germany, Italy, Iran, and Egypt follow-up period ranged 24 to 52 weeks. High-quality evidence showed no clinically important pain reduction with HCQ compared to placebo/active-control in hand OA (standardized mean difference [SMD], 0.14 95% confidence interval [CI], –0.20 to 0.48). Effect on pain reduction in knee and hand OA was small and non-significant (SMD, –0.09 95% CI, –0.44 to 0.25). High-quality evidence showed no improvement in dysfunction with HCQ compared to placebo in hand OA patients (SMD, 0.08 95% CI, –0.23 to 0.40). Effect on dysfunction improvement in knee and hand OA was modest and statistically non-significant (SMD, –0.20 95% CI,–0.57 to 0.18). No improvement in quality of life was observed in hand OA.Conclusions: HCQ has no benefit in reducing pain and improving physical function in hand or knee OA patients.
Publisher: Elsevier BV
Date: 03-2022
Publisher: Springer Science and Business Media LLC
Date: 2014
DOI: 10.1186/AR4496
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JOCA.2017.01.015
Abstract: To investigate the longitudinal association between endogenous sex hormones and knee osteoarthritis (OA) structures and pain. We examined 200 participants (mean age 63.0 ± 7.3 years) from a clinical trial of vitamin D supplement for symptomatic knee OA. Serum levels of estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG) were analyzed at baseline and 24 months later. Magnetic resonance imaging (MRI) scans of selected knee were obtained at both baseline and follow-up for the measurement of cartilage volume, cartilage defects, bone marrow lesions (BMLs) and effusion-synovitis volume. Knee pain was assessed using a 100 mm visual analogue scale (VAS). Longitudinal data were analyzed using linear mixed-effects model. One hundred and seven males and 93 females were included in this study. For females, after adjustment for age, body mass index (BMI), and vitamin D level, progesterone was positively associated with cartilage volume (β = 0.12 mm In women but not men, low serum levels of endogenous estradiol, progesterone and testosterone are associated with increased knee effusion-synovitis and possibly other OA-related structural changes. This may contribute to observed sex differences in knee OA.
Publisher: BMJ
Date: 15-05-2014
DOI: 10.1136/ANNRHEUMDIS-2013-205108
Abstract: The infrapatellar fat pad (IPFP) is of uncertain significance for knee osteoarthritis. The aim of this study was to describe the longitudinal associations between baseline IPFP maximal area and changes in knee pain, knee cartilage volume and cartilage defects in older adults. 356 community-dwelling male and female adults aged 50-80 years were measured at baseline and approximately 2.6 years later. T1-weighted or T2-weighted fat-suppressed MRI was used to assess maximal IPFP area, cartilage volume and cartilage defects at baseline and/or follow-up. Knee pain was assessed by the self-administered Western Ontario McMaster Osteoarthritis Index questionnaire. After adjustment for confounders, IPFP maximal area in women was significantly and negatively associated with changes in knee pain (β: -0.18 to -0.86 for total knee pain, pain at night while in bed, pain when sitting/lying and pain when standing upright, all p<0.05) but not with other knee pain subscales. IPFP maximal area in women was beneficially associated with change in tibial cartilage volume per annum (β: +1.56% per cm(2) at medial site +0.86% per cm(2) at lateral site, both p<0.05), but not with change in patellar cartilage volume. Further, it was significantly associated with reduced risks of increases in medial cartilage defects (relative risk: 0·46 at tibial site, relative risk: 0.59 at femoral site both p<0.05) but not with increases at other sites in women. No significant associations were found in men. While the associations are not fully consistent, IPFP maximal area appears to have a protective role for knee symptoms and cartilage damage in older female adults.
Publisher: Elsevier BV
Date: 09-2021
DOI: 10.1016/J.JOCA.2021.06.008
Abstract: To investigate the longitudinal association between MRI-detected osteophyte scores and progression of knee symptoms, and whether the association was modified in the presence of bone marrow lesions (BMLs) or effusion-synovitis. Data from Vitamin D Effects on Osteoarthritis (VIDEO) study, a randomized, double-blinded and placebo-controlled clinical trial in symptomatic knee osteoarthritis (OA) patients, were analyzed as an exploratory study. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess knee symptoms. Osteophytes, BMLs and effusion-synovitis were measured using MRI. 334 participants with MRI information and WOMAC score (baseline and follow-up) were included in the analyses, with 24.3% of them having knee pain increased 2 years later. Statistically significant interactions were found between MRI-detected osteophytes and BMLs or effusion-synovitis on increased knee symptoms. In participants with BMLs, higher baseline scores of MRI-detected osteophytes in most compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and effusion-synovitis. In participants with effusion-synovitis, higher baseline scores of MRI-detected osteophytes in almost all the compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and BMLs. In contrast, MRI-detected osteophyte scores were generally not associated with knee symptom progression in participants without baseline BMLs or effusion-synovitis. MRI-detected OPs are associated with increased total knee pain, weight-bearing knee pain, stiffness and physical dysfunction in participants presenting BMLs or effusion-synovitis, but not in participants lacking BMLs or effusion-synovitis. This suggests they could interact with bone or synovial abnormalities to induce symptoms in knee OA.
Publisher: Springer Science and Business Media LLC
Date: 27-01-2022
DOI: 10.1186/S13075-022-02719-8
Abstract: To describe the longitudinal associations between the morphological parameters of proximal tibiofibular joint (PTFJ) and joint structural changes in tibiofemoral compartments in patients with knee osteoarthritis (OA). The participants were selected from the Vitamin D Effects on Osteoarthritis (VIDEO) study. PTFJ morphological parameters were measured on coronal and sagittal MRI. The contacting area (S) of PTFJ and its projection areas onto the horizontal (load-bearing area, Sτ), sagittal (lateral stress-bolstering area, Sφ), and coronal plane (posterior stress-bolstering area, Sυ) were assessed. Knee structural abnormalities, including cartilage defects, bone marrow lesions (BMLs), and cartilage volume, were evaluated at baseline and after 2 years. Log binominal regression models and linear regression models were used to assess the associations between PTFJ morphological parameters and osteoarthritic structural changes. In the longitudinal analyses, the S (RR: 1.45) and Sτ (RR: 1.55) of PTFJ were significantly and positively associated with an increase in medial tibial (MT) cartilage defects. The Sτ (β: − 0.07), Sυ (β: − 0.07), and S (β: − 0.06) of PTFJ were significantly and negatively associated with changes in MT cartilage volume. The Sτ (RR: 1.55) of PTFJ was positively associated with an increase in MT BMLs, and Sφ (RR: 0.35) was negatively associated with an increase in medial femoral BMLs. This longitudinal study suggests that higher load-bearing area of PTFJ could be a risk factor for structural changes in medial tibiofemoral (MTF) compartment in knee OA. Clinicaltrials.gov Identifier: NCT01176344 Anzctr.org.au Identifier: ACTRN12610000495022 Date of registration: 7 May 2010
Publisher: Springer Science and Business Media LLC
Date: 11-09-2022
DOI: 10.1186/S13063-022-06715-W
Abstract: There is an unmet need for treatments for knee osteoarthritis (OA). Effusion-synovitis is a common inflammatory phenotype of knee OA and predicts knee pain and structural degradation. Anti-inflammatory therapies, such as diacerein, may be effective for this phenotype. While diacerein is recommended for alleviating pain in OA patients, evidence for its effectiveness is inconsistent, possibly because studies have not targeted patients with an inflammatory phenotype. Therefore, we will conduct a multi-centre, randomised, placebo-controlled double-blind trial to determine the effect of diacerein on changes in knee pain and effusion-synovitis over 24 weeks in patients with knee OA and magnetic resonance imaging (MRI)-defined effusion-synovitis. We will recruit 260 patients with clinical knee OA, significant knee pain, and MRI-detected effusion-synovitis in Hobart, Melbourne, Adelaide, and Perth, Australia. They will be randomly allocated to receive either diacerein (50mg twice daily) or identical placebo for 24 weeks. MRI of the study knee will be performed at screening and after 24 weeks of intervention. The primary outcome is improvement in knee pain at 24 weeks as assessed by a 100-mm visual analogue scale (VAS). Secondary outcomes include improvement in volumetric (ml) and semi-quantitative (Whole-Organ Magnetic Resonance Imaging Score, 0–3) measurements of effusion-synovitis using MRI over 24 weeks, and improvement in knee pain (VAS) at 4, 8, 12, 16, and 20 weeks. Intention-to-treat analyses of primary and secondary outcomes will be performed as the primary analyses. Per protocol analyses will be performed as the secondary analyses. This study will provide high-quality evidence to determine whether diacerein improves pain, changes disease trajectory, and slows disease progression in OA patients with effusion-synovitis. If diacerein proves effective, this has the potential to significantly benefit the substantial proportion (up to 60%) of knee OA patients with an inflammatory phenotype. Australian and New Zealand Clinical Trial Registry ACTRN12618001656224 . Registered on 08 October 2018.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JOCA.2017.01.007
Abstract: To describe cross-sectional and longitudinal associations between magnetic resonance imaging (MRI)-detected osteophytes (OPs) and knee structural abnormalities and knee pain in older adults. A prospective population-based cohort study of 895 participants aged 50-80 years (mean age 62 years, 50% female) was performed. T1-or T2-weighted fat suppressed MRI was used to assess knee OPs, cartilage volume, cartilage defects and bone marrow lesions (BMLs) at baseline and after 2.6 years. Radiographically-detected OPs were scored according to the Osteoarthritis Research Society International (OARSI) atlas. Knee pain was assessed using a self-administered questionnaire at baseline, 2.6 and 5 years later. 85% of participants had MRI-detected OPs at baseline, while 10% of participants had radiographically-detected OPs. Cross-sectionally, higher gardes of MRI-detected OPs in all compartments were significantly, independently and site-specifically associated with higher prevalences of cartilage defects and BMLs, lower cartilage volume and higher prevalence of knee pain. Longitudinally, higher gardes of baseline MRI-detected OPs site-specifically predicted greater risks of any increase in cartilage defects or BMLs, and loss of cartilage volume in medial and lateral tibiofemoral (LTF) and total compartments over 2.6 years in multivariable analyses. These significant associations were similar in those without radiographically-detected OPs. MTF and total OP scores were significantly associated with change in total knee pain over 2.6 and 5 years but these became non-significant after adjustment for cartilage defects and BMLs. MRI-detected knee OPs are common and appear to be clinically relevant to knee structural changes in older adults.
Publisher: The Journal of Rheumatology
Date: 07-2011
Abstract: To determine the association of knee bone size, cartilage volume, and body mass index (BMI) at baseline with knee cartilage loss over 2 years in younger or middle-aged adults. A total of 324 subjects (mean age 45 yrs, range 26–61) were measured at baseline and about 2 years later. Knee cartilage volume and bone size were determined using T1-weighted fat-saturated magnetic resonance imaging. In multivariable analysis, baseline knee bone size was negatively associated with annual change in knee cartilage volume at medial and lateral tibial sites (ß = −0.62% to −0.47%/cm 2 , all p 0.001). The associations disappeared at medial tibial site after adjustment for baseline cartilage volume and became of borderline statistical significance at lateral tibial site after adjustment for both baseline cartilage volume and osteophytes (ß = −0.29, p = 0.059). Baseline knee cartilage volume was consistently and negatively associated with annual change in knee cartilage volume at all 3 medial tibial, lateral tibial, and patellar sites (ß = −4.41% to −1.37%/ml, all p 0.001). Baseline BMI was negatively associated with an annual change in knee cartilage volume, but only in subjects within the upper tertile of baseline cartilage volume, even after adjusting for cartilage defects (ß = −0.16% to −0.34%/kg/m 2 , all p 0.05). Our study suggests that both higher baseline tibial bone area and knee cartilage volume (most likely due to cartilage swelling) are associated with greater knee cartilage loss over 2 years. A higher BMI was associated with greater knee cartilage loss only in subjects with higher baseline cartilage volume.
Publisher: American Medical Association (AMA)
Date: 21-04-2020
Publisher: MDPI AG
Date: 14-11-2022
DOI: 10.3390/BIOMEDICINES10112924
Abstract: Objective: To compare whether falls risk score and incident fracture over 10.7 years were different among three previously identified pain phenotypes. Methods: Data on 915 participants (mean age 63 years) from a population-based cohort study were studied at baseline and follow-ups at 2.6, 5.1 and 10.7 years. Three pain phenotypes were previously identified using the latent class analysis: Class 1: high prevalence of emotional problems and low prevalence of structural damage Class 2: high prevalence of structural damage and low prevalence of emotional problems Class 3: low prevalence of emotional problems and low prevalence of structural damage. Fractures were self-reported and falls risk score was measured using the Physiological Profile Assessment. Generalized estimating equations model and linear mixed-effects model were used to compare differences in incident fractures and falls risk score over 10.7 years between pain phenotypes, respectively. Results: There were 3 new hip, 19 vertebral, and 121 non-vertebral fractures, and 138 any site fractures during 10.7-year follow-up. Compared with Class 3, Class 1 had a higher risk of vertebral (relative risk (RR) = 2.44, 95% CI: 1.22–4.91), non-vertebral fractures (RR = 1.20, 95% CI: 1.01–1.42), and any site fractures (RR = 1.24, 95% CI: 1.04–1.46) after controlling for covariates, bone mineral density and falls risk score. Class 2 had a higher risk of non-vertebral and any site fracture relative to those in Class 3 (non-vertebral: RR = 1.41, 95% CI: 1.17–1.71 any site: RR = 1.44, 95% CI: 1.20–1.73), but not vertebral fracture. Compared with Class 3, Class 1 had a higher falls risk score at baseline (β = 0.16, 95% CI: 0.09–0.23) and over 10.7-year (β = 0.03, 95% CI: 0.01–0.04). Conclusions: Class 1 and/or Class 2 had a higher risk of incident fractures and falls risk score than Class 3, highlighting that targeted preventive strategies for fractures and falls are needed in pain population.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Springer Science and Business Media LLC
Date: 26-01-2016
Publisher: Springer Science and Business Media LLC
Date: 03-05-2021
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.JOCA.2017.02.804
Abstract: To develop a measure of knee joint effusion-synovitis volume and to examine the effect of vitamin D supplementation on effusion-synovitis in people with knee osteoarthritis (OA) and low vitamin D levels over 24 months. Symptomatic knee OA patients with low 25-(OH)D levels (12.5-60 nmol/l) were recruited for a multi-centre, randomised, placebo-controlled and double-blind trial. Participants (age 63 ± 7 years, 208 females) were allocated to either 50,000 IU monthly vitamin D The reproducibilities of effusion-synovitis volume measurement were high with ICCs ranging from 0.93 to 0.99. Over 24 months, effusion-synovitis volume remained stable in the vitamin D group but increased in placebos with a significant between-group difference (-1.94 ml, 95% confidence interval (CI): -3.54, -0.33). This effect was evident in those with baseline effusion-synovitis and with suprapatellar effusion-synovitis. The proportion with an increase in effusion-synovitis volume was lower in the vitamin D group than placebo (risk ratio (RR): 0.87, 95% CI: 0.77, 0.97). This highly reproducible effusion-synovitis volume measurement could be a promising outcome measure in OA trials. Vitamin D supplementation could retard the progression of effusion-synovitis which can potentially benefit people with an inflammatory OA phenotype.
Publisher: Cold Spring Harbor Laboratory
Date: 20-09-2021
DOI: 10.1101/2021.09.15.21263602
Abstract: Preecl sia is one of the common complications of pregnancy and is characterized by high blood pressure. Proton pump inhibitors (PPIs) are commonly used for the management of gastroesophageal reflux disease among pregnant women. Recently, multiple epidemiological studies suggested the association between PPIs use and the risk of preecl sia. This study aims to review the evidence and meta-analyse the pooled risk of preecl sia in PPI users from epidemiological studies. Databases-MEDLINE, Embase, Scopus, Web of Science Core Collection, Emcare, and CINAHL (EBSCO) as well as sources of grey literature, ProQuest Dissertations & Theses Global, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be searched to identify the epidemiological studies assessing the association between PPIs use and the risk of preecl sia. Study selection, data extraction, and quality assessment will be performed by two independent authors. The risk of bias among included studies will be evaluated by using the Newcastle-Ottawa scale. The pooled effect of PPIs use on the risk of preecl sia in pregnant women is the primary outcome of interest. Meta-analysis will be performed using Review Manager version 5.4.
Publisher: Springer Science and Business Media LLC
Date: 13-09-2016
Publisher: BMJ
Date: 31-07-2013
DOI: 10.1136/ANNRHEUMDIS-2013-203691
Abstract: To investigate cross-sectional and longitudinal associations between systemic bone mineral density (BMD), subchondral BMD (sBMD) and knee cartilage thickness in older adults with or without radiographic osteoarthritis (ROA). A prospective cohort of 158 randomly selected subjects (mean 63 years, 48% women) including 69 non-ROA and 89 ROA subjects were studied at baseline and 2.7 years later. Knee cartilage thickness was semi-automatically determined from T1-weighted fat-suppressed MRI. Knee cartilage volume was measured from MRI. Systemic BMD and sBMD were measured by dual-energy X-ray absorptiometry (DXA). Cross-sectionally, total body, total hip, spine BMD and/or lateral tibial sBMD were significantly and positively associated with femoral, lateral tibial and/or patellar cartilage thickness in subjects with ROA after adjustment for potential confounders. Longitudinally, a high total body BMD was associated with an increase in femoral cartilage thickness (β: 0.33 mm/g/cm(2), 95% CI 0.13 to 0.53) a high spine BMD was associated with increases in femoral and lateral tibial cartilage thickness (β: 0.25 mm/g/cm(2), 95% CI 0.10 to 0.41 and β: 0.18 mm/g/cm(2), 95% CI: 0.01 to 0.34, respectively) and a high medial tibial sBMD was associated with an increase in medial tibial cartilage thickness (β: 0.45 mm/g/cm(2), 95% CI 0.02 to 0.89) in subjects with ROA. In contrast, there were no significant associations between baseline systemic BMD, sBMD and cartilage volume loss, nor were there associations between BMD and cartilage thickness in subjects without ROA. Both systemic and subchondral BMD are positively associated with increased cartilage thickness in subjects with ROA, suggesting BMD may play a protective role against cartilage loss in knee OA.
Publisher: Cambridge University Press (CUP)
Date: 15-11-2018
Publisher: Springer Science and Business Media LLC
Date: 21-08-2012
DOI: 10.1038/IJO.2012.136
Abstract: To determine the associations between body composition at baseline and knee cartilage loss over 2.9 years in older adults. A total of 395 randomly selected subjects (mean 62 years, range 51-81, 50% female) were studied at baseline and 2.9 years later. T1-weighted fat-suppressed magnetic resonance imaging of the right knee was performed to determine knee cartilage volume and tibial bone area at baseline and follow-up. Height, weight and radiographic osteoarthritis were measured by standard protocols at baseline. Fat mass and lean mass were measured by dual-energy X-ray absorptiometry at baseline. Tibial cartilage volume decreased by 2.0-2.7% per annum. In multivariable analysis, annual change in medial cartilage volume was negatively and significantly associated with body mass index (β: -0.14% per kg m(-2), 95% confidence interval (CI): -0.25%, -0.02%), percentage total body fat (β: -0.19% per %, 95% CI: -0.30%, -0.07%) and percentage trunk fat (β: -0.10% per %, 95% CI: -0.19%, -0.02%), and positively associated with percentage lean mass (β: 0.20% per %, 95% CI: 0.08%, 0.32%). Change in lateral tibial cartilage volume was also significantly associated with percentage total body fat (β: -0.11% per %, 95% CI: -0.21%, -0.001%) and total lean mass (β: 0.13% per kg, 95% CI: 0.04%, 0.22%). These were independent of sex and age even though both were also significant predictors. Body fat adversely affects tibial cartilage loss over time, whereas lean mass is protective. Strategies aimed at reducing body fat but increasing lean mass may reduce knee cartilage loss in older people.
Publisher: Oxford University Press (OUP)
Date: 05-02-2021
DOI: 10.1093/RHEUMATOLOGY/KEAB092
Abstract: To describe the associations of blood pressure and arterial stiffness with knee cartilage volume in patients with knee OA. A secondary analysis was performed on the data from participants in a randomized controlled trial that identified the effects of vitamin D supplementation on knee structures and symptoms among patients with symptomatic knee OA. Brachial and central blood pressure, arterial stiffness indicators and knee cartilage volume were measured at baseline and the 2 year follow-up. Associations were assessed using generalized estimating equations. Among 231 participants (average age 63.2 years), 48.9% were females. Higher supine systolic and diastolic pressures were significantly associated with lower tibial cartilage volume (systolic: lateral β -6.23, medial β -5.14, total β -11.35 mm3/mmHg diastolic: lateral β -10.25, medial β -11.29, total β -21.50 mm3/mmHg). Higher supine systolic pressure was associated with lower femoral cartilage volume (lateral β -17.35, total β -28.31 mm3/mmHg). Central systolic pressure and arterial stiffness indicators (including pulse wave velocity, central pulse pressure and peripheral pulse pressure) were largely not associated with knee cartilage volume however, higher augmentation index was associated with lower tibial and femoral cartilage volume (tibial: medial β -8.24, total β -19.13 mm3/% femoral: lateral β -23.70, medial β -26.42, total β -50.12 mm3/%). Blood pressure and arterial stiffness are associated with knee cartilage volume at several sites in knee OA patients. This supports that blood pressure and arterial stiffness may involve in the progression of knee OA.
Publisher: Elsevier BV
Date: 10-2022
Publisher: Cambridge University Press (CUP)
Date: 25-06-2018
DOI: 10.1017/S0007114518001174
Abstract: The aim of this study was to determine whether vitamin D supplementation and maintaining vitamin D sufficiency are associated with changes in inflammatory and metabolic biomarkers in patients with knee osteoarthritis (OA) and vitamin D deficiency. A total of 413 participants with symptomatic knee OA and vitamin D deficiency were enrolled in a randomised, placebo-controlled trial and received 1·25 mg vitamin D 3 or placebo monthly for 24 months across two sites. In this post hoc analysis, 200 participants from one site (ninety-four from the placebo group and 106 from the vitamin D group mean age 63·1 ( sd 7·3) years, 53·3 % women) were randomly selected for measurement of serum levels of inflammatory and metabolic biomarkers at baseline and 24 months using immunoassays. In addition, participants were classified into two groups according to serum 25-hydroxyvitamin D (25(OH)D) levels at months 3 and 24: (1) not consistently sufficient (25(OH)D≤50 nmol/l at either month 3 or 24, n 61), and (2) consistently sufficient (25(OH)D nmol/l at both months 3 and 24, n 139). Compared with placebo, vitamin D supplementation had no significant effect on change in serum high-sensitive C-reactive protein, IL-6, IL-8, IL-10, leptin, adiponectin, resistin, adipsin and apelin. Being consistently vitamin D sufficient over 2 years was also not associated with changes in these biomarkers compared with not being consistently sufficient. Vitamin D supplementation and maintaining vitamin D sufficiency did not alter serum levels of inflammatory and metabolic biomarkers over 2 years in knee OA patients who were vitamin D insufficient, suggesting that they may not affect systemic inflammation in knee OA patients.
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.JOCA.2022.05.004
Abstract: To describe the burden of osteoarthritis (OA) in India from 1990 to 2019. Data from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used. The burden of OA -knee OA, hip OA, hand OA, and other OA- was estimated for India and its states from 1990 to 2019 through a systematic analysis of prevalence, incidence, years lived with disability (YLD), and disability-adjusted life years (DALY) using methods reported in GBD 2019 study. Around 23.46 million in iduals in India had OA in 1990 this increased to 62.35 million in 2019. The age-standardised prevalence of OA increased from 4,895 (95% uncertainty interval (UI):4,420-5,447) in 1990-5313 (95%UI:4,799-5,898) in 2019, per 100,000 persons. Similarly, DALYs due to OA increased from 0.79 million (95%UI:0.40-1.55) to 2.12 million (95%UI:1.07-4.23) while age-standardised DALYs increased from 164 (95%UI:83-325) to 180 (95%UI:91-361) per 100,000 persons from 1990 to 2019. OA was the 20 The burden and impact of OA in India are substantial and is increasing. Adopting suitable control and preventive community measures to reduce modifiable risk factors (obesity, injuries, occupational stress) are needed to reduce the current and future burden of OA in India.
Publisher: Cold Spring Harbor Laboratory
Date: 09-09-2020
DOI: 10.1101/2020.09.07.20190215
Abstract: Osteoarthritis (OA) is a common chronic joint disease with limited pharmacological management options. Boswellia extracts (BE) or formulations containing BE are generally considered as safe and offers a modest efficacy for the treatment of OA. Although previous systematic reviews have assessed the efficacy of BE in OA, these reviews had excluded trials assessing various formulations containing BE and excluded various combinations of BE. Hence, this study aims to systematically review the evidence from RCTs assessing the efficacy and safety of both BE and formulations containing BE for the treatment of OA. Biomedical databases such as PubMed, Embase, and Google Scholar will be searched to identify the RCTs of BE or formulations containing BE in patients with OA (hand, knee, hip, or any other OA). Cochrane risk of bias tool will be used to assess the quality of included studies. Review Manager 5 (Rev Man) and STATA Version 16 will be used to conduct the statistical analysis.
Publisher: Wiley
Date: 06-2021
DOI: 10.1002/ACR.24371
Abstract: The present study was undertaken to determine whether vitamin D supplementation or maintaining sufficient vitamin D level reduces foot pain over 2 years in patients with symptomatic knee osteoarthritis (OA). A post hoc study was conducted from a randomized, double‐blind, placebo‐controlled trial named the Vitamin D Effect on Osteoarthritis (VIDEO) study. Symptomatic knee OA patients with serum 25‐hydroxyvitamin D levels between 12.5 nmoles/liter and 60 nmoles/liter were included and randomly allocated to either monthly vitamin D 3 or placebo treatment (1:1) for 2 years. Manchester Foot Pain and Disability Index (MFPDI) was used to evaluate foot pain and disabling foot pain was defined as at least 1 of the 10 functional limitation items (items 1–9 and 11) being documented as on “most/every day(s)” in the last month. A repeated‐measures, mixed‐effects model was used to analyze the change of MFPDI scores between groups adjusting for potential confounders. A total of 413 patients with a mean age of 63.2 years (49.7% males) were enrolled and 340 completed the study. The mean MFPDI score was 22.8 ± 7.3, with 23.7% of participants having disabling foot pain at baseline. There were significant differences in MFPDI scores change between groups over 2 years, with more improvements in the vitamin D group than in the placebo group (–0.03 versus 1.30 P = 0.013) and more improvement in those maintaining sufficient vitamin D levels (n = 226) than those who did not (n = 114) (–0.09 versus 2.19 P = 0.001). Vitamin D supplementation and maintenance of sufficient vitamin D levels may improve foot pain in those with knee OA.
Publisher: Elsevier BV
Date: 2023
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.JOCA.2022.02.616
Abstract: To describe the associations between osteoarthritis (OA)-related biochemical markers (COMP, MMP-3, HA) and MRI-based imaging biomarkers in middle-aged adults over 10-13 years. Blood serum s les collected during the Childhood Determinants of Adult Health (CDAH)-1 study (year:2004-06 n = 156) and 10-13 year follow-up at CDAH-3 (n = 167) were analysed for COMP, MMP-3, and HA using non-isotopic ELISA. Knee MRI scans obtained during the CDAH-knee study (year:2008-10 n = 313) were assessed for cartilage volume and thickness, subchondral bone area, cartilage defects, and BML. In a multivariable linear regression model describing the association of baseline biochemical markers with MRI-markers (assessed after 4-years), we found a significant negative association of standardised COMP with medial femorotibial compartment cartilage thickness (β:-0.070 95%CI:-0.138,-0.001), and standardised MMP-3 with patellar cartilage volume (β:-141.548 95%CI:-254.917,-28.179) and total bone area (β:-0.729 95%CI:-1.340,-0.118). In multivariable Tobit regression model, there was a significant association of MRI-markers with biochemical markers (assessed after 6-9 years) a significant negative association of patellar cartilage volume (β:-0.001 95%CI:-0.002,-0.00004), and total bone area (β:-0.158 95%CI-0.307,-0.010) with MMP-3, and total cartilage volume (β:-0.001 95%CI:-0.001,-0.0001) and total bone area (β:-0.373 95%CI:-0.636,-0.111) with COMP. No significant associations were observed between MRI-based imaging biomarkers and HA. COMP and MMP-3 levels were negatively associated with knee cartilage thickness and volume assessed 4-years later, respectively. Knee cartilage volume and bone area were negatively associated with COMP and MMP-3 levels assessed 6-9 years later. These results suggest that OA-related biochemical markers and MRI-markers are interrelated in early OA.
Publisher: Springer Science and Business Media LLC
Date: 2014
DOI: 10.1186/AR4607
Publisher: Cold Spring Harbor Laboratory
Date: 30-07-2021
DOI: 10.1101/2021.07.27.21261192
Abstract: Acute kidney injury (AKI) is a complex disorder characterized by an abrupt decline in kidney function over a short period of time. Published epidemiological studies linked AKI with the development of dementia. This meta-analysis aims to understand the pooled risk of dementia in AKI patients compared to non-AKI patients. MEDLINE and Embase databases, and the grey literature in five sources were searched to identify the studies assessing the association of AKI with dementia. The Newcastle-Ottawa scale (NOS) will be used to determine the quality of included studies. The primary outcome of this study will be the risk of dementia among AKI patients compared to non-AKI patients. Subgroup analysis and sensitivity analysis will also be performed. Review Manager version 5.4.1 will be used to perform the meta-analysis.
Publisher: Wiley
Date: 10-2016
DOI: 10.1002/ACR.22871
Abstract: To describe the natural history of patellofemoral (PF) joint bone marrow lesions (BMLs) over 2.6 years and associations between changes in PF joint BMLs, knee pain, and knee cartilage morphology in older adults over 5 years. A prospective population-based cohort study of men and women ages 50-80 years (mean age 63 years, n = 406) was performed. PF joint BMLs, knee cartilage volume, and cartilage defect scores (range 0-4) were measured using the Whole-Organ Magnetic Resonance Imaging Score system at baseline and at 2.6 years. Knee pain was assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at baseline and at 5 years. At baseline, 27% (n = 109) had PF joint BMLs 24% of these increased (WOMAC score change of ≥1) at followup, 44% persisted, 32% decreased, and 21% resolved completely. Of those without PF joint BMLs at baseline, 20% of participants developed PF joint BMLs over 2.6 years. In multivariable analyses, a change in PF joint BMLs was deleteriously associated with a change in total knee pain (β = 0.67, 95% confidence interval [95% CI] 0.03, 1.31) and knee pain when going up/down stairs (β = 0.24, 95% CI 0.04, 0.44) over 5 years. Baseline PF joint and tibiofemoral joint cartilage volume were protective for PF joint BMLs (relative risk [RR] 0.69, 95% CI 0.52, 0.90 for PF joint), while baseline PF joint cartilage defects were associated with an increase in PF joint BMLs (RR 1.73, 95% CI 1.38, 2.17) over 2.6 years. TF joint cartilage defects were not associated with increases in PF joint BMLs. PF joint BMLs are not static, and change is clinically relevant. PF joint cartilage morphology predicts increases in PF joint BMLs.
Publisher: Elsevier BV
Date: 06-2022
Publisher: Springer Science and Business Media LLC
Date: 22-10-2018
DOI: 10.1038/S41366-018-0234-7
Abstract: To describe the associations of childhood and adulthood adiposity measures with knee cartilage thickness, volume and bone area in young adults. Childhood and adulthood adiposity measures (weight, height, waist circumference and hip circumference) of 186 participants were collected in 1985 (aged 7-15 years) and during 2004-2006 (aged 26-36 years). Knee magnetic resonance imaging was conducted during 2008-2010 (aged 31-41 years) and cartilage thickness, volume and bone area were measured using a quantitative approach (Chondrometrics, Germany). Linear regressions were used to examine the above associations. The prevalence of overweight was 7.6% in childhood and 42.1% in adulthood. Childhood weight (β = - 5.57 mm Childhood weight and BMI were negatively but adult weight was positively associated with adult bone area. Adult WHR and the change in WHR from childhood to adulthood were negatively associated with cartilage thickness, volume, and bone area. These suggest early-life adiposity measures may affect knee structures in young adults.
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.ARR.2022.101670
Abstract: Parkinson's Disease (PD) is a neurodegenerative disorder manifested by rest tremor, rigidity, bradykinesia, and postural instability. Recent pharmaco-epidemiological studies evaluating beta-adrenergic drug use and risk of PD have reported conflicting findings. This systematic review and meta-analyses evaluate the association between beta-adrenergic (agonists and antagonists) drugs' use and PD. An electronic literature search of eight databases was performed from inception to July 2021 to identify pharmaco-epidemiological studies (case-control and cohort) reporting the risk of PD in beta-adrenergic users compared to non-users. We used the generic inverse variance method and RevMan (5.3.5) to estimate pooled adjusted risk ratios (aRRs) of PD using a random-effects model. Of 3168 records, 15 studies (10 case-control five cohort) with 6508,877 participants, including 87,011 PD cases, were included. In the pooled analysis (n = 10) including any beta-antagonist users, compared with non-users, the aRR for PD was 1.19 (CI: 1.05,1.35) for any beta-agonist users (n = 8) aRR for PD was 0.87 (CI: 0.78,0.97). Propranolol users had a significantly increased risk of PD (aRR:1.91 CI:1.20,3.06), whereas salbutamol use was associated with reduced risk of PD (aRR:0.95 CI:0.92,0.99). Significant heterogeneity (I Beta-antagonist use was associated with a modestly increased risk of PD, whereas beta-agonist use was associated with a modest decreased risk of PD. Future epidemiological studies should address the issues of protopathic bias and indirect association using appropriate epidemiological methods.
Publisher: BMJ
Date: 10-2022
DOI: 10.1136/BMJOPEN-2022-062703
Abstract: Generic multiattribute utility instruments (MAUIs) are efficient tools for determining and enumerating health-related quality of life. MAUIs accomplish this by generating health state utilities (HSUs) via algorithms. Minimal important differences (MIDs) assist with the interpretation of HSUs by estimating minimum changes that are clinically significant. The overall goal of the proposed systematic review and meta-analysis is the development of comprehensive guidelines for MID estimation. This protocol defines a systematic review and meta-analysis of MIDs for generic MAUIs. The proposed research will involve a comprehensive investigation of 10 databases (EconLit, IDEAs database, INAHTA database, Medline, PsycINFO, Embase, Emcare, JBIEBP and CINAHL) from 1 June 2022 to 7 June 2022, and will be performed and reported in accordance with several validated guidelines, principally the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of papers, considered for inclusion in the review, will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, inter alia. Narrative analysis will involve identifying the characteristics of MIDs including methods of calculation, sources of heterogeneity, and validation. Meta-analysis will also be conducted. The descriptive element of meta-analysis will involve the generation of I 2 statistics and Galbraith plots of MID heterogeneity. Together with narrative analysis, this will allow sources of MID heterogeniety to be identified. A multilevel mixed model, estimated via restricted maximum likelihood estimation, will be constructed for the purposes of meta-regression. Meta-regression will attempt to enumerate the effects of sources of heterogeneity on MID estimates. Meta-analysis will be concluded with pooling of MIDs via a linear random-effects model. Ethics approval is not required for this review, as it will aggregate data from published literature. Methods of dissemination will include publication in a peer-reviewed journal, as well as presentation at conferences and seminars. CRD42021261821.
Publisher: Informa UK Limited
Date: 02-05-2021
DOI: 10.1080/14737167.2021.1916471
Abstract: Though cost-effectiveness analyses (CEAs) have evaluated continuous renal replacement therapy (RRTs) and intermittent RRTs in acute kidney injury (AKI) patients it is yet to establish which RRT technique is most cost-effective. We systematically reviewed the current evidence from CEAs of CRRT versus IRRT in patients with AKI. PubMed, EMBASE, and Cochrane databases searched for CEAs comparing two RRTs. Overall, seven CEAs, two from Brazil and one from US, Canada, Colombia, Belgium, and Argentina were included. Five CEAs used Markov model, three reported following CHEERS, none accounted indirect costs. Time horizon varied from 1-year-lifetime. Marginal QALY gain with CRRT compared to IRRT was reported across CEAs. Older CEAs found CRRT to be costlier and not cost-effective than IRRT (ICER 2019 US$: 152,671$/QALY) latest CEAs (industry-sponsored) reported CRRT to be cost-saving versus IRRT (-117,614$/QALY). Risk of mortality, dialysis dependence, and incidence of renal recovery were the key drivers of cost-effectiveness. CEAs of RRTs for AKI show conflicting findings with secular trends. Latest CEAs suggested CRRT to be cost-effective versus IRRT with dialysis dependence rate as major driver of cost-effectiveness. Future CEAs, preferably non-industry sponsored, may account for indirect costs to improve the generalizability of CEAs.
Publisher: Wiley
Date: 08-07-2020
DOI: 10.1002/JBMR.4044
Publisher: The Journal of Rheumatology
Date: 15-11-2015
Abstract: To describe the cross-sectional and longitudinal associations between knee regional effusion synovitis and knee pain in older adults. Data from a population-based random s le (n = 880, mean age 62 yrs, 50% women) were used. Baseline knee joint effusion synovitis was graded (0–3) using T2-weighted magnetic resonance imaging (MRI) in the suprapatellar pouch, central portion, posterior femoral recess, and subpopliteal recess. Effusion synovitis of the whole joint was defined as a score of ≥ 2 in any subregion. Other knee structural (including cartilage, bone marrow, and menisci) lesions were assessed by MRI at baseline. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire at baseline and 2.6 years later. Multivariable analyses were performed after adjustment for age, sex, body mass index, and other structural lesions. The prevalence of effusion synovitis was 67%. Suprapatellar pouch effusion synovitis was significantly and independently associated with increased total and nonweight-bearing knee pain in both cross-sectional and longitudinal analyses (for an increase in total knee pain of ≥ 5, RR 1.26 per grade, 95% CI 1.04–1.52), and increased weight-bearing knee pain in longitudinal analysis only. Effusion synovitis in posterior femoral recess and central portion were independently associated with increases in nonweight-bearing pain (RR 1.63 per grade, 95% CI 1.32–2.01 and RR 1.29 per grade, 95% CI 1.01–1.65, respectively) in longitudinal analyses only. Knee joint effusion synovitis has independent associations with knee pain in older adults. Suprapatellar pouch effusion synovitis is associated with nonweight-bearing and weight-bearing knee pain, while posterior femoral recess and central portion effusion synovitis are only associated with nonweight-bearing pain.
Publisher: BMJ
Date: 17-12-2013
DOI: 10.1136/ANNRHEUMDIS-2013-204161
Abstract: To describe the associations between overweight measures in childhood and knee pain, stiffness and dysfunction among adults 25 years later. Subjects broadly representative of the Australian population (n=449, aged 31-41 years, female 48%) were selected from the Australian Schools Health and Fitness Survey of 1985. Height, weight and knee injury were recorded and knee pain was assessed using the Western Ontario and McMaster Universities osteoarthritis index (WOMAC). Childhood height, weight and knee injury had been measured according to standard protocols 25 years earlier and body mass index (BMI) and percentage overweight were calculated. The prevalence of knee pain was 34% and overweight in childhood and adulthood was 7% and 48%, respectively. Overall, there were no significant associations between childhood overweight measures and total WOMAC knee pain, stiffness and dysfunction scores in adulthood. However, in men, overweight in childhood was associated with adulthood WOMAC pain (relative risk (RR) 1.72, 95% CI 1.11 to 2.69) and childhood weight and BMI were associated with WOMAC stiffness and dysfunction. Childhood weight, BMI and overweight were all associated with the presence of adulthood walking knee pain in men and the whole s le. Most of these associations were independent of adult overweight measures. Subjects who were overweight in both childhood and adult life had a significant increase in the risk and prevalence of adulthood walking pain (RR=2.42, 95% CI 1.06 to 5.53). Childhood overweight measures were significantly associated with adulthood knee mechanical joint pain, stiffness and dysfunction among men, independent of adult overweight, suggesting that childhood overweight may lead to later knee symptoms in men.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Wiley
Date: 13-10-2021
DOI: 10.1111/JEBM.12456
Publisher: Springer Science and Business Media LLC
Date: 12-10-2016
Publisher: Wiley
Date: 19-04-2013
DOI: 10.1111/CEN.12101
Abstract: Obesity is characterized by hyperleptinaemia, which is associated with diabetes, hypertension and coronary heart disease. The aim of this study was to determine if body fat and muscle measures predict the natural increase in leptin over 2·6 years in older adults. A total of 190 subjects (50% females) aged between 50 and 79 years were selected to perform the serum measurements for leptin. Height and weight were measured and body mass index (BMI) was calculated. Fat and lean mass of the whole body and the trunk were acquired through dual-energy X-ray absorptiometry (DXA). Leg muscle strength and handgrip strength were measured using dynamometry. In multivariable analyses, leg muscle strength was negatively associated with both baseline leptin (β: -0·05 μg/l per kg, 95% CI: -0·08, -0·02) and follow-up leptin (β: -0·04 μg/l per kg, 95% CI: -0·07, -0·01). BMI, and percentage total fat and trunk fat and their respective change per annum (cpa) were significantly and positively associated with leptin. Lean mass was negatively associated with baseline leptin. Gender-specific analyses produced similar associations between leg muscle strength, fat measures and follow-up leptin in males and females. Besides positive associations between body fat, trunk fat and leptin, we found that leg muscle strength was negatively associated with leptin after 2·6 years in a s le of older population. This suggests that interventions to maintain or increase muscle strength may have a protective effect on hyperleptinaemia.
Publisher: Wiley
Date: 20-02-2023
DOI: 10.1002/ACR.24964
Abstract: To investigate associations of dietary vitamin K intake with changes in knee symptoms and structures in patients with knee OA. Participants with symptomatic knee OA were enrolled (n=259) and followed up for 2 years (n=212). Baseline dietary vitamin K intake was calculated from a validated food frequency questionnaire. Knee symptoms were assessed by using the Western Ontario and McMaster University Index of osteoarthritis (WOMAC) scores. Knee cartilage defects, bone marrow lesions and effusion-synovitis volume were measured from MRI scans. Univariable and multivariable linear regressions were used for analyses. Higher vitamin K intake quartile was significantly associated with greater decrease in total WOMAC score and dysfunction score over 24 months. The subgroup analyses showed in patients with severe baseline VAS pain, higher vitamin K intake quartile was associated with more improvement in all WOMAC scores. There were no overall significant associations between vitamin K intake and changes in MRI features. In sub-group analysis, vitamin K intake was negatively associated with changes in tibiofemoral, patellar and total cartilage defects in participants with severe baseline radiographic grade, and was negatively associated with change in total and patellar cartilage defects in participants with severe baseline VAS pain and in female patients. The association of higher vitamin K intake with decreased knee symptoms over 24 months in patients with knee OA suggests that clinical trials examining the effect of vitamin K supplementation for knee OA symptoms are warranted. Whether there is an effect on knee structure is unclear. This article is protected by copyright. All rights reserved.
Publisher: BMJ
Date: 04-2020
DOI: 10.1136/BMJOPEN-2019-035302
Abstract: Observational data suggest that vitamin D deficiency is associated with the onset and progression of knee osteoarthritis (OA). However, randomised controlled trials (RCTs) to date investigating the efficacy of vitamin D supplementation in knee OA have reported conflicting results. Further research is needed to clarify the effects of vitamin D on patient-reported outcomes and determine whether there are patient subgroups who may benefit from the supplementation. The aim of this in idual patient data (IPD) meta-analysis is to identify patient-level predictors of treatment response to vitamin D supplementation on pain and physical function. A systematic literature search will be conducted for RCTs of vitamin D supplementation on knee OA. Authors of original RCTs will be contacted to obtain the IPD. The primary outcomes will include long-term (≥12 months) pain and physical function. Secondary outcomes will include medium-term (≥6 months and months) and short-term ( months) pain and physical function, as well as patient global assessment, quality of life and adverse events. Potential treatment effect modifiers to be examined in the subgroup analyses include age, gender, body mass index, baseline knee pain severity and physical function, baseline vitamin D level, radiographic stage, presence of bone marrow lesions on MRI, presence of clinical signs of local inflammation and concomitant depressive symptoms. Both one-step and two-step modelling methods will be used to determine the possible modifiable effect of each subgroup of interest. Research ethical or governance approval is exempt for this study as no new data are being collected. This study will be the first IPD meta-analysis to clarify the effect of vitamin D supplementation on clinical symptoms in different subgroups of patients with knee OA. The findings will be disseminated through peer-review publications and conference presentations. CRD42018107740.
Publisher: BMJ
Date: 06-2016
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJOPEN-2021-056382
Abstract: Knee osteoarthritis (KOA) is a highly prevalent disabling joint disease. Intra-articular stem cell therapy is increasingly being used for treating KOA with little high-quality evidence to support its use. The aim of this study is to investigate the efficacy, safety and cost-effectiveness of allogeneic mesenchymal stem cells (Cymerus MSCs) for treating symptomatic tibiofemoral KOA and improving knee structure over 24 months. The Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis study is a phase III, multi-centre, parallel, superiority, randomised, double-blind, placebo-controlled trial, which will be conducted in Sydney and Hobart, Australia. 440 participants (220 per arm) aged over 40 years with painful KOA and mild to moderate structural change on X-ray (Kellgren and Lawrence grade 2 or 3) with medial minimum joint space width between 1 and 4 mm in the study knee will be recruited from the community and randomly allocated to receive either intra-articular MSCs or saline at baseline, week 3 and week 52. The coprimary outcomes will be the proportion of participants achieving patient-acceptable symptom state for knee pain at 24 months and quantitative central medial femorotibial compartment cartilage thickness change from baseline to 24 months. Main secondary outcomes include change in knee pain, Patient Global Assessment, physical function, quality of life and other structural changes. Additional data for cost-effectiveness analysis will also be recorded. Adverse events will be monitored throughout the study. The primary analysis will be conducted using modified intention-to-treat. This protocol has been approved by The University of Sydney (USYD) Human Research Ethics Committee (HREC) #: 2020/119 and The University of Tasmania (UTAS) HREC #: H0021868. All participants will be required to provide informed consent. Dissemination will occur through conferences, social media, and scientific publications. Australian New Zealand Clinical Trials Registry (ACTRN12620000870954) U1111-1234-4897.
Publisher: Springer Science and Business Media LLC
Date: 09-06-2020
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.JPEDS.2019.05.031
Abstract: To describe the association between fractures sustained at different stages of growth and bone measures in early adulthood. Participants (n = 201) in southern Tasmania were at birth at a higher risk of sudden infant death syndrome they were followed to age 25. Outcomes were areal bone mineral density at the spine, hip, and total body (by dual-energy x-ray absorptiometry) and trabecular and cortical bone measures at the radius and tibia (by high-resolution peripheral quantitative computed tomography). Fractures were self-reported and confirmed by radiographs at 8, 16, and 25 years of age. Multivariable linear regression was used to analyze the association of the occurrence of prepubertal (<9 years of age), pubertal (9-16 years of age), and postpubertal (17-25 years of age) fractures with all bone measures. Over 25 years, 99 participants had at least 1 fracture. For high-resolution peripheral quantitative computed tomography measures at age 25, prepubertal fractures were negatively associated with cortical and trabecular volumetric bone mineral density and most microarchitecture measures at both the tibia and radius. Prepubertal fractures had a significant association with smaller increase of areal bone mineral density from age 8 to 16 years and at 25 years of age compared with participants with no fractures. Pubertal fractures had no association with any bone measures and postpubertal fractures were only associated with a lower trabecular number at the tibia. Prepubertal fractures are negatively associated with areal bone mineral density increases during growth and high-resolution peripheral quantitative computed tomography bone measures in young adulthood. There is little evidence that fractures occurring from age 8 years onward with bone measures in young adulthood, implying that prepubertal fractures may be associated with bone deficits later in life.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2021
DOI: 10.1186/S12891-020-03875-1
Abstract: To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Three hundred ninety-seven participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 ± 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. The presence and incidence of depression was 25.4 and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA. ClinicalTrials.gov identifier: NCT01176344 . Anzctr.org.au identifier: ACTRN12610000495022 .
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.JAMDA.2018.09.006
Abstract: To determine the effect of vitamin D supplementation and maintaining sufficient serum vitamin D on depressive symptoms in patients with knee osteoarthritis (OA) and vitamin D deficiency. A prespecified secondary analysis of a multicentre, randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to receive oral vitamin D This clinical trial was conducted in participants with symptomatic knee OA and vitamin D deficiency from June 2010 to December 2013 in Tasmania and Victoria, Australia. The primary outcome was the depressive symptoms change over 24 months, which was measured using the Patient Health Questionnaire (PHQ-9, 0-27). Of 599 participants who were screened for eligibility, 413 participants were enrolled (mean age: 63.2 years 50.3% female) and 340 participants (intervention n = 181, placebo n = 159, 82.3% retention rate) completed the study. The baseline prevalence of depression (PHQ-9 score ≥5) was 25.4%. Depressive symptoms improved more in the vitamin D supplementation group compared to the placebo group [β: -0.66, 95% confidence interval (CI): -1.22 to -0.11, P for difference = .02] and in the participants who maintained vitamin D sufficiency compared to those who did not (β: -0.73, 95% CI: -1.41 to -0.05, P for difference = .04) over 24 months. These findings suggest that vitamin D supplementation and maintaining adequate vitamin D levels over 24 months may be beneficial for depressive symptoms in patients with knee OA.
Publisher: Springer Science and Business Media LLC
Date: 14-01-2020
DOI: 10.1186/S13063-019-3915-1
Abstract: Knee osteoarthritis (OA) is a common and important cause of pain and disability, but interventions aimed at modifying structures visible on imaging have been disappointing. While OA affects the whole joint, synovitis and effusion have been recognised as having a role in the pathogenesis of OA. Krill oil reduces knee pain and systemic inflammation and could be used for targeting inflammatory mechanisms of OA. We will recruit 260 patients with clinical knee OA, significant knee pain and effusion-synovitis present on MRI in five Australian cities (Hobart, Melbourne, Sydney, Adelaide and Perth). These patients will be randomly allocated to the two arms of the study, receiving 2 g/day krill oil or inert placebo daily for 6 months. MRI of the study knee will be performed at screening and after 6 months. Knee symptoms, function and MRI structural abnormalities will be assessed using validated methods. Safety data will be recorded. Primary outcomes are absolute change in knee pain (assessed by visual analog score) and change in size of knee effusion-synovitis over 24 weeks. Secondary outcomes include improvement in knee pain over 4, 8, 12, 16 and 20 weeks. The primary analyses will be intention-to-treat analyses of primary and secondary outcomes. Per protocol analyses adjusting for missing data and for treatment compliance will be performed as the secondary analyses. This study will provide high-quality evidence to assess whether krill oil 2 g/day reduces pain and effusion-synovitis size in older adults with clinical knee OA and knee effusion-synovitis. If krill oil is effective and confirmed to be safe, we will provide compelling evidence that krill oil improves pain and function, changes disease trajectory and slows disease progression in OA. Given the lack of approved therapies for slowing disease progression in OA, and moderate cost of krill oil, these findings will be readily translated into clinical practice. Australian New Zealand Clinical Trials Registry, ACTRN12616000726459 . Registered on 02 June 2016. Universal Trial Number (UTN) U1111–1181-7087.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JOCA.2017.09.005
Abstract: To describe prevalence of osteophytes (OPs) detected only by magnetic resonance imaging (MRI) but not by standard X-ray in older adults and to evaluate longitudinal associations with knee structural changes. 837 participants were randomly selected from the local community and had MRI scans to assess knee OPs and other structures. OPs detected only by MRI but not by standard X-ray were defined as MRI-detected early OPs (MRI-OPs for short). OPs detected by both MRI and X-ray were defined as established-OPs. The prevalence of MRI-OPs was 50% while the prevalence of established-OPs was 10% and no-OPs was 40% at total tibiofemoral (TF) compartment at baseline. Compared with no-OPs, participants with MRI-OPs had greater risks of increased cartilage defects in all TF compartments (RR 1.37, 95%CI 1.07-1.74) and bone marrow lesions (BMLs) only in medial TF compartment (RR 1.49, 95%CI 1.06-2.11), after adjustment for age, sex, BMI, cartilage defects, BMLs and/or joint space narrowing participants with established-OPs had greater cartilage volume loss at total (β -2.02, 95%CI -3.86, -0.17) and lateral tibial sites (β -5.63, 95%CI -9.93, -1.32), greater risks of increased cartilage defects in total (RR 1.66, 95%CI 1.15-2.40) and medial TF compartments (RR 1.49, 95%CI 1.20-1.69) and BMLs in all TF compartments (RR 1.88, 95%CI 1.22-2.89), after adjustment for covariates. MRI-OPs were associated with changes in knee structures, and the associations were similar but not as prominent as those for established-OPs. These suggest MRI-OPs may have a role to play in knee early-stage osteoarthritic progression.
Publisher: Elsevier BV
Date: 07-2021
Publisher: MDPI AG
Date: 10-08-2022
DOI: 10.3390/JCM11164675
Abstract: Evidence from preclinical studies suggests a preventive effect of proton pump inhibitors (PPIs) in preecl sia. Recently, several epidemiological studies have described a conflicting association between the use of PPIs during pregnancy and preecl sia risk. This study aimed to evaluate the association between PPI use and the risk of preecl sia. We searched databases, including MEDLINE, Embase, Scopus, Web of Science Core Collection, Emcare, CINAHL, and the relevant grey literature from inception until 13 September 2021. Studies reporting the preecl sia risk with the use of PPIs were eligible for inclusion. Literature screening, data extraction, and the risk of bias assessment were performed independently by two investigators. Random-effect meta-analysis was performed to generate relative risks (RR) and 95% confidence intervals (CI). The risk of preecl sia and preterm preecl sia among women receiving PPIs during pregnancy were the primary outcomes of interest. This meta-analysis comprised three studies involving 4,877,565 pregnant women, of whom 119,017 were PPI users. The included studies were judged to have a low risk of bias. The risk of preecl sia among pregnant women who received PPIs anytime during pregnancy was significantly increased (RR 1.27 (95% CI: 1.23–1.31)), although the increase was trivial in absolute terms (2 per 1000). The subgroup analysis revealed that the risk was increased in each of the three trimesters. The risk of preterm preecl sia among pregnant women receiving PPIs anytime during pregnancy was not significantly increased (RR 1.04 (95% CI: 0.70–1.55)). The certainty evaluated by GRADE in these estimates was low. PPI use may be associated with a trivial increase in the risk of preecl sia in pregnant women. There is no evidence supporting that PPI use decreases the risk of preecl sia or preterm preecl sia.
Publisher: Springer Science and Business Media LLC
Date: 12-10-2022
DOI: 10.1007/S10067-022-06402-W
Abstract: Colchicine, an approved treatment for gout, has been trialed in many diseases including osteoarthritis (OA) due to its anti-inflammatory effects. However, its efficacy and safety remain unclear in OA. This systematic review and meta-analysis evaluated the efficacy and safety of colchicine for the treatment of OA. PubMed, Web of Science, Scopus, and Cochrane Central were searched from inception through September 2022. Two reviewers independently screened for randomized controlled trials (RCTs) comparing colchicine with placebo or other active comparators for the treatment of OA (knee, hand, or hip OA), extracted data, and performed Cochrane risk of bias assessments. Nine RCTs for the knee OA and one for the hand OA were identified, consisting of 847 patients (429 in colchicine arms, 409 in control arms). The studies were conducted between 2002 and 2021 with follow-up periods ranging from 2 to 12 months, in India, Iran, Turkey, Australia, Singapore, and Iraq. Moderate-quality evidence showed no clinically important pain reduction with colchicine compared to control (standardized mean difference [SMD], 0.17 95% confidence interval [CI], − 0.55, 0.22). Moderate-quality evidence showed no improvement in function with colchicine compared to control in knee OA patients (SMD, − 0.37 95% CI, − 0.87, 0.13). Colchicine showed an acceptable safety profile with AEs/SAEs comparable to control. Current evidence does not suggest a benefit of colchicine in reducing pain and improving physical function in the overall cohort of hand/knee OA patients. Future trials should focus on the subgroups of OA patients with local or systemic inflammation and/or mineralization who might benefit from colchicine. Key Points • Colchicine is an approved treatment for gout that has been trialed in many diseases including osteoarthritis (OA) due to its anti-inflammatory effects. However, the benefit and harms of colchicine in OA remain unclear. • Current evidence from randomized control trials does not suggest a benefit of colchicine in reducing pain and improving physical function for the treatment of OA patients. • Future trials of colchicine in OA should focus on the subgroups of OA patients with local or systemic inflammation and/or mineralization who might benefit from colchicine.
Publisher: MDPI AG
Date: 26-09-2021
DOI: 10.3390/JCM10194390
Abstract: Acute kidney injury (AKI) is associated with several adverse outcomes, including new or progressive chronic kidney disease, end-stage kidney disease, and mortality. Epidemiological studies have reported an association between AKI and dementia as a long-term adverse outcome. This meta-analysis was aimed to understand the association between AKI and dementia risk. A literature search was performed in MEDLINE and Embase databases, from inception to July 2021, to identify epidemiological studies reporting the association between AKI and dementia risk. Title and abstract followed by the full-text of retrieved articles were screened, data were extracted, and quality was assessed, using the Newcastle–Ottawa scale by two investigators independently. The primary outcome was to compute the pooled risk of dementia in AKI patients. Subgroup analysis was also performed based on age and co-morbidities. Certainty of evidence was assessed using the GRADE approach. Statistical analysis was performed using Review Manager 5.4 software. Four studies (cohort (n = 3) and case–control (n = 1)) with a total of 429,211 patients, of which 211,749 had AKI, were identified. The mean age of the patients and the follow-up period were 64.15 ± 16.09 years and 8.9 years, respectively. Included studies were of moderate to high quality. The pooled estimate revealed a significantly higher risk of dementia in AKI patients with an overall relative risk/risk ratio (RR) of 1.92 (95% CI: 1.52–2.43), p ≤ 0.00001. Dementia risk increases by 10% with one year increase in age with an RR of 1.10 (95% CI: 1.09–1.11), p 0.00001. Subgroup analysis based on stroke as a co-morbid condition also revealed significantly higher dementia risk in AKI patients (RR 2.30 (95% CI: 1.62–3.28), p = 0.009). All-cause mortality risk was also significantly higher in AKI patients with dementia with a pooled RR of 2.11 (95% CI: 1.20–3.70), p = 0.009. The strength of the evidence was of very low certainty as per the GRADE assessment. Patients with AKI have a higher risk of dementia. Further large epidemiological studies are needed to confirm the mechanistic association.
Publisher: MDPI AG
Date: 25-08-2021
DOI: 10.3390/DIAGNOSTICS11091531
Abstract: Background: Residual/reconverted red bone marrow (RBM) in adult knees is occasionally observed on routine knee magnetic resonance imaging (MRI). We aimed to identify its prevalence, distribution, and associations with lifestyle factors, knee structural abnormalities, and knee symptoms in young adults. Methods: Participants (n = 327 aged = 31–41 years) were selected from the Childhood Determinants of Adult Health (CDAH) knee study. They underwent T1-weighted and proton-density-weighted fat-suppressed MRI scans of knees. Residual/reconverted RBM in distal femur and proximal tibia were graded semi-quantitatively (grades: 0–3) based on the percentage area occupied. Knee structural abnormalities were graded semi-quantitatively using previously published MRI scoring systems. Knee symptoms (pain, stiffness, and dysfunction) were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale during CDAH knee study (year: 2008–2010) and at 6–9-year follow-up during the CDAH-3 study (year: 2014–2019). Associations between definite RBM (grade ≥ 2) and lifestyle factors, knee symptoms, and structural abnormalities were described using log-binomial regressions. Results: Definite RBM was seen in females only, in 29 out of 154 cases (18.8%), with femoral involvement preceding tibial involvement. Definite RBM was associated with increased BMI (PR = 1.09/kg/m2 95% CI: 1.03, 1.16), overweight status (PR = 2.19 95% CI: 1.07, 4.51), and WOMAC knee pain (PR = 1.75 95% CI: 1.11, 2.74) in cross-section analysis. However, there was no association between RBM and knee-pain after seven years (PR = 1.15 95% CI: 0.66, 2.00). There were no associations between RBM and knee structural abnormalities. Conclusion: Presence of definite RBM in young adult knees was observed in females only. Definite RBM was associated with overweight measures, and the modest association with knee pain may not be causally related.
Publisher: Elsevier BV
Date: 09-2020
Publisher: BMJ
Date: 23-05-2022
DOI: 10.1136/ANNRHEUMDIS-2022-EULAR.458
Abstract: Colchicine, an approved treatment for gout, has been trialled in many diseases, including osteoarthritis (OA), due to its anti-inflammatory effects. However, its efficacy and safety remain unclear in OA. This systematic review and meta-analysis evaluated the efficacy and safety of colchicine for the treatment of OA. 1 PubMed, Web of Science, Scopus, and Cochrane Central were searched from inception through November 2020. Two reviewers independently screened for randomised controlled trials (RCTs) comparing colchicine with placebo or other active-comparators for the treatment of OA (knee, hand, or hip OA), extracted data, and performed Cochrane risk of bias assessments. The search retrieved 391 articles after removing duplicates, and 16 full-text articles were reviewed for eligibility (Figure 1 A ). Ten RCTs, nine in knee OA, one in hand OA, consisting of 847 patients (429 in colchicine arm, 409 in control arm) were included. RCTs were conducted between 2002 and 2021 three in India, two in Iran and Turkey, and one each in Australia, Singapore, and Iraq follow-up period ranged 2 to 12 months. Moderate-quality evidence showed no clinically important pain reduction with colchicine compared to placebo in knee/hand OA patients (standardised mean difference [SMD], -0.17 95% confidence interval [CI], -0.55 to 0.22) (Figure 1 B ). Moderate-quality evidence showed no improvement in dysfunction with colchicine compared to placebo in knee OA patients (SMD, -0.37 95% CI, -0.87 to 0.13). Colchicine showed an acceptable safety profile with AEs/SAEs comparable to placebo (Figure 1 C ) Current evidence does not conclusively suggest a benefit of colchicine in reducing pain and improving physical function in hand/knee OA patients. Future trials should focus on the sub-groups of OA patients with local or systemic evidence of inflammation and/or mineralisation who may benefit from colchicine. [1]Rheumatology (Oxford). 2018 Jan 1 (suppl_1):i4-i11. None declared
Publisher: Cold Spring Harbor Laboratory
Date: 11-05-2020
DOI: 10.1101/2020.05.06.20092726
Abstract: Turmeric extracts have been used as a remedy for treating arthritis in traditional medicine. Recent years have witnessed the rise of different extracts from turmeric and randomised clinical trials (RCTs) evaluating the efficacy and safety of these extracts for the treatment of knee osteoarthritis (OA). This planned systematic review and meta-analysis aims to assess the efficacy and safety of turmeric extracts for the treatment of knee OA. Biomedical databases such as PubMed, Scopus, and Embase will be searched for RCTs reporting safety and efficacy of turmeric extracts for the treatment of knee OA. Cochrane risk of bias tool will be used to assess the methodological quality of the included studies, and a meta-analysis will be performed to pool the effect estimates.
Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism
Date: 27-05-2019
Publisher: Elsevier BV
Date: 08-2023
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.JOCA.2018.05.008
Abstract: To describe the associations between childhood adiposity measures and adulthood knee cartilage defects and bone marrow lesions (BMLs) measured 25 years later. 327 participants from the Australian Schools Health and Fitness Survey (ASHFS) of 1985 (aged 7-15 years) were followed up 25 years later (aged 31-41 years). Childhood measures (weight, height and skinfolds) were collected in 1985. Body mass index (BMI), overweight status and fat mass were calculated. Participants underwent 1.5 T knee magnetic resonance imaging (MRI) during 2008-2010, and cartilage defects and BMLs were scored from knee MRI scans. Log binomial regressions were used to examine the associations. Among 327 participants (47.1% females), 21 (6.4%) were overweight in childhood. Childhood adiposity measures were associated with the increased risk of adulthood patellar cartilage defects (Weight relative risk (RR) 1.05/kg, 95% confidence interval (CI) 1.01-1.09 BMI 1.10/kg/m Childhood adiposity measures were associated with the increased risk of adulthood patellar cartilage defects and, to a lesser extent, BMLs, independent of adulthood adiposity measures. These results suggest that adiposity in childhood has long-term effects on patellar structural abnormalities in young adults.
Publisher: Wiley
Date: 13-10-2022
Publisher: BMJ
Date: 03-11-2015
Publisher: MDPI AG
Date: 18-11-2021
DOI: 10.3390/JOF7110985
Abstract: Mucormycosis, a secondary fungal infection, gained much attention in the ongoing COVID-19 pandemic. This deadly infection has a high all-cause mortality rate and imposes a significant economic, epidemiological, and humanistic burden on the patients and healthcare system. Evidence from the published epidemiological studies showed the varying prevalence of COVID-19-associated mucormycosis (CAM). This study aims to compute the pooled prevalence of CAM and other associated clinical outcomes. MEDLINE, Embase, Cochrane COVID-19 Study Register, and WHO COVID-19 databases were scanned to retrieve the relevant articles until August 2021. All studies reporting the prevalence of mucormycosis among COVID-19 patients were eligible for inclusion. Two investigators independently screened the articles against the selection criteria, extracted the data, and performed the quality assessment using the JBI tool. The pooled prevalence of CAM was the primary outcome, and the pooled prevalence of diabetes, steroid exposure, and the mortality rate were the secondary outcomes of interest. Comprehensive Meta-Analysis software version 2 was used for performing the meta-analysis. This meta-analysis comprised six studies with a pooled s le size of 52,916 COVID-19 patients with a mean age of 62.12 ± 9.69 years. The mean duration of mucormycosis onset was 14.59 ± 6.88 days after the COVID-19 diagnosis. The pooled prevalence of CAM (seven cases per 1000 patients) was 50 times higher than the highest recorded background of mucormycosis (0.14 cases per 1000 patients). A high mortality rate was found among CAM patients with a pooled prevalence rate of 29.6% (95% CI: 17.2–45.9%). Optimal glycemic control and the judicious use of steroids should be the approach for tackling rising CAM cases.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.SEMARTHRIT.2019.10.001
Abstract: To describe the associations of glucose homeostasis and metabolic syndrome (MetS) measures with knee cartilage defects and cartilage volume in young adults. Fasting blood biochemistry, waist circumference and blood pressure measures were collected 4-5 years prior to knee magnetic resonance imaging (MRI) scans. Blood measures included levels of glucose, insulin, triglyceride and high-density lipoprotein cholesterol (HDL-C). Homeostatic model assessment 2-insulin resistance (HOMA2-IR), HOMA2-beta cell function (HOMA2-β), HOMA2-insulin sensitivity (HOMA-S) and MetS were calculated or defined. Knee cartilage defects and cartilage volume were measured from MRI scans. Data were analysed using log binomial or linear regressions. Among 328 participants (47.3% were females, aged 26-36 years at baseline), 40 (12.7%) had hyperglycaemia and 21 (6.7%) had MetS. Glucose homeostasis measures (except fasting glucose) were associated with tibiofemoral cartilage defects (fasting insulin: relative risk (RR) 1.05, 95% confidence interval (CI) 1.01 to 1.08 HOMA2-IR: 1.44, 1.08 to 1.92 HOMA2-β: 2.59, 1.33 to 5.07 HOMA2-S: 0.36, 0.18 to 0.72), but not patellar cartilage defects. There were no associations between glucose homeostasis measures and knee cartilage volume. High waist circumference (RR 2.32, 95% CI 1.18 to 4.54) and low HDL-C (RR 1.99, 95% CI 1.08 to 3.69) were associated with tibiofemoral cartilage defects, but no other associations were observed between MetS or its components and cartilage defects or volume. Insulin resistance, high waist circumference and low HDL-C were associated with higher risk of tibiofemoral cartilage defects, suggesting glucose homeostasis and some MetS components may affect early cartilage damage in young adults.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2021
Publisher: Cold Spring Harbor Laboratory
Date: 26-07-2020
DOI: 10.1101/2020.07.20.20157669
Abstract: Hydroxychloroquine (HCQ) is a conventional disease-modifying antirheumatic drug (DMARD), which is considered as relatively safe, and offers a modest efficacy profile for the treatment of inflammatory rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. In view of the anecdotal evidence on its immunomodulatory and anti-inflammatory properties, HCQ has been used as an off-label option in patients with osteoarthritis (OA), mainly for the treatment of inflammatory OA. Recently, many investigators have evaluated the safety and efficacy of HCQ for the treatment of OA in various randomized control trials (RCTs). While most RCTs have evaluated the HCQ in inflammatory OA (erosive hand OA), there are studies constituting knee OA patients as well. Currently, there are no systematic reviews that have summarized the evidence on the efficacy and safety of HCQ in OA population. Hence, this study aims to systematically review the evidence from RCTs assessing the efficacy and safety of HCQ for the treatment of OA. Biomedical databases such as PubMed, Embase, and Google Scholar will be searched to identify the RCTs of HCQ in patients with OA (hand, knee, hip, or any other OA). Cochrane risk of bias tool will be used to assess the quality of included studies. Review Manager 5 (Rev Man) and STATA Version 16 will be used to conduct the statistical analysis.
Publisher: Elsevier BV
Date: 04-2021
DOI: 10.1016/J.JOCA.2020.12.023
Abstract: To examine the cross-sectional and longitudinal associations of dietary patterns with knee symptoms and structures in patients with knee osteoarthritis (OA). Participants with symptomatic knee OA were recruited from a randomised, placebo-controlled trial conducted in Tasmania (N = 259) and Victoria (N = 133). Diet was assessed by the Anti-Cancer Council of Victoria food frequency questionnaire. Factor analysis was used to identify dietary patterns. Knee symptoms were assessed using Western Ontario and McMaster Universities Arthritis Index (WOMAC) and structures using MRI. Multivariable linear regressions were used to examine associations. Three dietary patterns ("high-fat", "healthy" and "mixed") were identified in whole s le. Participants with higher "healthy pattern" score had lower total WOMAC, pain, function and stiffness scores at baseline but the associations were not significant over 24 months. Three ("western", "vegetable and meat" and "mediterranean") and two ("processed" and "vegetable") patterns were identified in Tasmania and Victoria, respectively. Cross-sectionally, only "mediterranean pattern" and "vegetable pattern" scores were significantly and negatively associated with total WOMAC or function scores. Longitudinally, participants with higher "western pattern" had worsening function (β: 0.35, 95%CI: 0.03, 0.67) and total WOMAC (β: 0.40, 95%CI: 0.07, 0.72) scores furthermore, "vegetable pattern" was associated with decreased WOMAC stiffness score (β: -0.47, 95%CI: -0.93, -0.02). In contrast, dietary patterns were largely not associated with structural changes. Some healthy dietary patterns were associated with reduced joint symptoms but dietary patterns were not associated with joint structure in this s le with knee OA. Further studies are required to confirm these findings.
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.JOCA.2022.10.014
Abstract: To develop and validate a nomogram to detect improved knee pain in osteoarthritis (OA) by integrating magnetic resonance imaging (MRI) radiomics signature of subchondral bone and clinical characteristics. Participants were selected from the Vitamin D Effects on Osteoarthritis (VIDEO) study. The primary outcome was 20% improvement of knee pain score over 2 years in participants administrated either vitamin D or placebo. Radiomics features of subchondral bone and clinical characteristics from 216 participants were extracted and analyzed. The participants were randomly split into the training and validation cohorts at a ratio of 8:2. Least absolute shrinkage and selection operator (LASSO) regression was used to select features and generate radiomics signatures. The optimal radiomics signature and clinical indicators were fitted into a nomogram using multivariable logistic regression model. The nomogram showed favorable discrimination performance [AUC The radiomics-based nomogram comprising the MR radiomics signature and clinical variables achieves a favorable predictive efficacy and accuracy in differentiating improvement in knee pain among OA patients. This proof-of-concept study provides a promising way to predict clinically meaningful outcomes.
Publisher: MDPI AG
Date: 12-10-2022
DOI: 10.3390/JFMK7040084
Abstract: Osteoarthritis (OA) is a common joint disorder for which there is no cure. Current treatments are suboptimal. Exercise is a core treatment for knee OA, with muscle strengthening exercise commonly recommended. Yoga is a mind-body exercise intervention that can improve flexibility, muscle strength, balance, and fitness and potentially reduce symptoms of OA. However, there is a scarcity of robust, high-quality conclusive evidence on the efficacy of yoga in knee OA. We are currently conducting the first randomised comparative effectiveness and cost-effectiveness trial of a yoga program compared with a strengthening exercise program in patients with symptomatic knee OA. This study protocol describes the design and conduct of this trial. The YOGA study is a phase III, single-centre, parallel, superiority, randomised, active-controlled trial which will be conducted in Hobart, Australia. One hundred and twenty-six participants (63 in each arm) aged over 40 years with symptomatic knee OA will be recruited from the community and randomly allocated to receive either a 24-week yoga program (3×/week) or a strengthening exercise program (3×/week). The primary outcome will be change in knee pain over 12 weeks, assessed using a 100 mm visual analogue scale (VAS). The secondary outcomes include change in knee pain, patient global assessment, physical function, quality of life, gait speed, biomarkers, and others over 12 and 24 weeks. We will also assess whether the presence of neuropathic pain moderates the effects of yoga compared to strengthening exercise. Additional data, such as cost and resource utilization, will be collected for the cost-effectiveness analysis. The primary analysis will be conducted using an intention-to-treat approach. Adverse events will be monitored throughout the study. Once completed, this trial will contribute to the knowledge of whether yoga can be used as a simple, effective, low-cost option for the management of knee OA, thus saving economic costs in the healthcare system.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.JOCA.2017.05.013
Abstract: To describe the cross-sectional associations between proximal tibiofibular joint (PTFJ) type configurations and knee joint structural abnormalities in older adults. A total of 967 community-based participants were studied. T1-weighted fat-suppressed magnetic resonance image (MRI) with spoiled gradient recalled echo sequence was utilized to assess the PTFJ type configurations. Knee cartilage volume, cartilage defects, bone marrow lesions and osteophytes were measured. Linear regression and binary logistic regression analyses were used to examine the associations between PTFJ type configurations and knee joint cartilage volume as well as knee structural abnormalities, respectively, after adjustment for potential confounders. Seven PTFJ types including plane (49.4%), trochoid (31.9%), double trochoid (4.3%), saddle (5.4%), condylar (5.3%), trochlear (3.5%) and ball & socket (0.2%) were observed. Plane type was used as the comparator. In multivariable analyses, irregular joint types (comprising the five uncommon joint types) were associated negatively with cartilage volume, and positively with knee cartilage defects, bone marrow lesions and osteophytes in the lateral (but not medial) compartments. In contrast, trochoid type was only associated with reduced femoral cartilage volume, but not with knee cartilage defects, bone marrow lesions and osteophytes. Irregular PTFJ joint shapes are associated with osteoarthritic changes in the lateral, but not medial, tibiofemoral compartment in older adults. The causal relationship needs to be examined in future longitudinal studies.
Publisher: The Journal of Rheumatology
Date: 09-2017
Abstract: To describe the associations between effusion-synovitis and joint structural abnormalities in patients with knee osteoarthritis (OA) over 24 months. A posthoc analysis using data from a randomized controlled trial in 413 patients with symptomatic OA (aged 63 ± 7 yrs, 208 women). Knee effusion-synovitis volume and score, cartilage defects, cartilage volume, and bone marrow lesions (BML) were assessed using magnetic resonance imaging. Joint space narrowing (JSN) and osteophytes were assessed using radiograph. Least significant change criterion was used to define change in effusion-synovitis volume. Knee symptoms were assessed by Western Ontario and McMaster University OA Index. Multivariable linear/logistic regression and multilevel generalized mixed-effects models were used in longitudinal analyses. Total effusion-synovitis volume increased modestly from baseline (8.0 ± 8.5 ml) to followup (9.0 ± 10.5 ml). Baseline BML, cartilage defect, JSN, and osteophyte scores were positively associated with change in effusion-synovitis volume (p 0.05). Baseline cartilage defects and JSN were also associated with change in effusion-synovitis score (p 0.05). However, neither baseline effusion-synovitis score nor volume consistently predicted change in the above structures except cartilage volume. In the mixed-effects models, knee effusion-synovitis was positively associated with BML (volume: β = 1.19 ml/grade score: OR = 1.75/grade) and cartilage defects (volume: β = 1.87 ml/grade score: OR = 2.22/grade), while negatively associated with cartilage volume loss. Change in effusion-synovitis volume was positively correlated with changes in knee pain and stiffness scores (p 0.05). Knee cartilage and subchondral bone abnormalities predicted change in effusion-synovitis, but effusion-synovitis did not predict knee structural changes. These findings suggest that synovial inflammation is likely the result of joint structural abnormalities in established OA. ClinicalTrials.gov identifier: NCT01176344 . Australian New Zealand Clinical Trials Registry: ACTRN12610000495022.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Cold Spring Harbor Laboratory
Date: 25-05-2020
DOI: 10.1101/2020.05.24.20112250
Abstract: Knee osteoarthritis (OA) is the most common form of OA which affects knee joints and there is currently no disease-modifying treatment available for OA. Therefore, an ideal strategy to prevent the development of OA is to identify and intervene at the modifiable risk factors for the development and progression of OA. Early-life factors such as obesity and malalignment may affect the mechanical aspect of the knee (i.e. alterations in normal knee kinematics) and could be the risk factor for the development of knee OA in later life. Identifying early-life (gestational factors, congenital defects, childhood, adolescence, early adulthood) factors which affect the development of knee OA in later stages of the life may help to develop targeted prevention programs in early-life itself to prevent the development of knee OA. Hence, this systematic review protocol provides the method to be used to comprehensively summarise the existing evidence on early life modifiable risk factors associated with the development and progression of knee OA.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.JOCA.2014.05.018
Abstract: To describe cross-sectional associations between mass effect or signal intensity alteration of the suprapatellar fat pad (SPFP) with knee symptoms and structure in older adults. A cross-sectional s le of 904 randomly selected subjects (mean 62.4 years, 49.9% female) was studied. T1- or T2-weighted fat suppressed magnetic resonance imaging (MRI) was used to assess mass effect or signal intensity alteration of SPFP, cartilage volume, cartilage defects, and bone marrow lesions (BMLs). Knee pain was assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. The Osteoarthritis Research Society International (OARSI) atlas was used to assess knee osteophyte, joint space narrowing (JSN) and radiographic osteoarthritis (ROA). Univariable and multivariable linear or logistic regression analyses were used to examine the associations. After adjustment for confounders including age, sex, body mass index (BMI), disease status, tibial bone area and/or ROA, the presence of SPFP mass effect was significantly associated with any knee pain (OR: 2.39 95% confidence interval (CI): 1.54, 3.70) and ROA (OR: 2.10 95% CI: 1.33, 3.31) but not with cartilage volume, cartilage defects or BMLs. The presence of SPFP signal intensity alteration was significantly associated with any knee pain (OR: 1.90 95% CI: 1.43, 2.53), ROA (OR: 1.83 95% CI: 1.37, 2.45), any BMLs (OR: 1.55 95% CI: 1.17, 2.06) but not with cartilage volume and cartilage defects. Significant associations with knee pain and BMLs were more evident in subjects with ROA. Presence of SPFP mass effect and/or signal intensity alteration combined was associated with any tibial cartilage defects (OR: 1.45 95% CI: 1.04, 2.04). SPFP mass effect and/or signal intensity alterations are deleteriously associated with knee pain, radiographic OA and BMLs in this cross-sectional study, suggesting that SPFP abnormalities may contribute to pain and structural abnormalities in the knee.
Publisher: Springer Science and Business Media LLC
Date: 24-01-2023
DOI: 10.1007/S10067-022-06477-5
Abstract: To determine the feasibility of a randomized controlled trial (RCT) examining outdoor walking on knee osteoarthritis (KOA) clinical outcomes and magnetic resonance imaging (MRI) structural changes. This was a 24-week parallel two-arm pilot RCT in Tasmania, Australia. KOA participants were randomized to either a walking plus usual care group or a usual care control group. The walking group trained 3 days/week. The primary outcome was feasibility assessed by changes being required to the study design, recruitment, randomization, program adherence, safety, and retention. Exploratory outcomes were changes in symptoms, physical performance/activity, and MRI measures. Forty participants (mean age 66 years (SD 1.4) and 60% female) were randomized to walking ( n = 24) or usual care ( n = 16). Simple randomization resulted in a difference in numbers randomized to the two groups. During the study, class sizes were reduced from 10 to 8 participants to improve supervision, and exclusion criteria were added to facilitate program adherence. In the walking group, total program adherence was 70.0% and retention 70.8% at 24 weeks. The walking group had a higher number of mild adverse events and experienced clinically important improvements in symptoms (e.g., visual analogue scale (VAS) knee pain change in the walking group: − 38.7 mm [95% CI − 47.1 to − 30.3] versus usual care group: 4.3 mm [− 4.9 to 13.4]). This study supports the feasibility of a full-scale RCT given acceptable adherence, retention, randomization, and safety, and recruitment challenges have been identified. Large symptomatic benefits support the clinical usefulness of a subsequent trial. 12618001097235. Key Points • This pilot study is the first to investigate the effects of an outdoor walking program on knee osteoarthritis clinical outcomes and MRI joint structure, and it indicates that a full-scale RCT is feasible. • The outdoor walking program (plus usual care) resulted in large improvements in self-reported knee osteoarthritis symptoms compared to usual care alone. • The study identified recruitment challenges, and the manuscript explores these in more details and provides recommendations for future studies.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.JOCA.2015.02.018
Abstract: To examine the cross-sectional and longitudinal associations of patellar bone marrow lesion (BMLs) with knee pain, cartilage defects and cartilage volume in older adults. A total of 904 randomly selected subjects (mean 62.4 years, 49.9% female) were studied. Fat suppressed T1-weighted spoiled gradient recall and T2-weighted fast spin echo magnetic resonance imaging (MRI) sequences were used to assess cartilage volume, cartilage defects and/or BMLs at baseline (n = 904) and 2.6 (range: 1.4-4.8) years' follow-up (n = 414). Knee pain was assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire at baseline (n = 904) and follow-up (n = 790). The prevalence of any patellar BMLs was 19% and was higher in those with tibiofemoral BMLs. In multivariable analyses, patellar BMLs were positively associated with any knee pain at baseline and an increase in knee pain when going up/down stairs (odds ratio (OR): 1.67, 95% confidence interval (CI): 1.08, 2.59) but not with other knee pain subscales. Patella BMLs were also associated with patellar cartilage defects both at baseline and change over time (OR: 1.76, 95% CI: 1.00, 3.70) but not tibiofemoral defects. Patellar BMLs were negatively associated with baseline and change in patella cartilage volume (β: -2.10%, 95% CI: -3.39%, -0.80%). These associations remained significant after further adjustment for tibiofemoral BMLs. Patellar BMLs were consistently associated with increased knee pain especially going up/down stairs, increased patellar cartilage defects, and decreased patellar cartilage volume cross-sectionally and longitudinally, suggesting a predominantly compartment specific role for patellar BMLs.
Publisher: Elsevier BV
Date: 06-2017
Publisher: Elsevier BV
Date: 06-2023
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.SEMARTHRIT.2015.10.006
Abstract: The aim of this study was to describe the longitudinal relationship between adiposity and change in knee pain. A total of 1099 participants aged 50-79 were randomly selected from the local community in Southern Tasmania, of which 767 were followed up on average 5.1 years later. Knee pain was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at each time point. Consistent knee pain was defined as knee pain at all three time-points. The five pain subscales were grouped into weight-bearing pain and non-weight-bearing pain according to the nature of pain. Body fat and lean mass were assessed using dual energy x-ray absorptiometry (DXA). Baseline body mass index (BMI) and body fat mass were deleteriously associated with consistent knee pain over follow-up. BMI was consistently associated with increases in weight-bearing and non-weight-bearing pain. Fat mass was associated with an increase in non-weight-bearing pain. In mixed-model analyses, WOMAC total pain score was associated with BMI (β = 1.27) and body fat mass (β = 1.17). The association of lean mass was not significant after adjustment for fat mass. BMI is the most consistent correlate of knee pain in older adults. Fat mass is associated with non-weight-bearing knee pain suggesting systemic mechanisms are involved.
Publisher: Cold Spring Harbor Laboratory
Date: 20-11-2020
DOI: 10.1101/2020.11.20.20226589
Abstract: Colchicine, in the form of Colchicum autumnale , has been used to treat joint swelling for centuries. The anti-inflammatory action o colchicine and the higher prevalence of calcium pyrophosphate crystal deposition (CPPD) in osteoarthritis (OA) joints have led to th use of colchicine as a potential treatment for OA, however, the quality of the evidence on this regards is still limited. The curren protocol aims to conduct a systematic review and meta-analysis proving the efficacy and safety of colchicine for the treatment of adul patients with OA. For that purpose, Scopus®, Web of Sciences®, Medline® and Cochrane Library® will be inspected for the availabl trials testing the efficacy and safety of colchicine for the treatment of any type of OA (e.g., hand, knee or hip). Cochrane tool will b used to assess the risk of bias of included trials. A meta-analysis of dichotomous (e.g., adverse events) or continuous data (e.g., mea difference in pain scale) will be performed depending on the data reporting. Review Manager 5 (RevMan) and RStudio Version 1.2.133 will be used to conduct the statistical analysis.
Publisher: BMJ
Date: 26-11-2015
DOI: 10.1136/ANNRHEUMDIS-2015-208360
Abstract: To describe the associations between infrapatellar fat pad (IPFP) signal intensity alteration at baseline and knee symptoms and structural changes in older adults. A total of 874 subjects (mean 62.1 years, 50.1% female) selected randomly from local community were studied at baseline and 770 were followed up (only 357 had MRI at follow-up) over 2.6 years. T1-weighted or T2-weighted fat suppressed MRI was used to assess IPFP signal intensity alteration (0-3), cartilage volume, cartilage defects and bone marrow lesions (BMLs) at baseline and 2.6 years later. Knee pain was assessed by self-administered Western Ontario and McMaster Osteoarthritis Index questionnaire. Radiographic osteoarthritis (OA) was assessed. In cross-sectional analyses, IPFP signal intensity alteration was significantly and positively associated with total knee pain as well as knee cartilage defects, BMLs and knee radiographic OA and negatively associated with patellar cartilage volume after adjustment for age, sex, body mass index and/or radiographic OA. Longitudinally, baseline signal intensity alteration within IPFP was significantly and positively associated with increases in knee pain when going upstairs/downstairs as well as increases in tibiofemoral cartilage defects and BMLs, and negatively associated with change in lateral tibial cartilage volume in multivariable analyses. IPFP signal intensity alteration at baseline was associated with knee structural abnormalities and clinical symptoms cross-sectionally and longitudinally in older adults, suggesting that it may serve as an important imaging biomarker in knee OA.
Publisher: Elsevier BV
Date: 08-2022
Publisher: American Medical Association (AMA)
Date: 08-03-2016
Abstract: Observational studies suggest that vitamin D supplementation is associated with benefits for knee osteoarthritis, but current trial evidence is contradictory. To compare the effects of vitamin D supplementation vs placebo on knee pain and knee cartilage volume in patients with symptomatic knee osteoarthritis and low vitamin D levels. A multicenter randomized, double-blind, placebo-controlled clinical trial in Tasmania and Victoria, Australia. Participants with symptomatic knee osteoarthritis and low 25-hydroxyvitamin D (12.5-60 nmol/L) were enrolled from June 2010 to December 2011. The trial was completed in December 2013. Participants were randomly assigned to receive monthly treatment with oral vitamin D3 (50,000 IU n = 209) or an identical placebo (n = 204) for 2 years. Primary outcomes were change in tibial cartilage volume (assessed using magnetic resonance imaging [MRI]) and change in the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score (0 [no pain] to 500 [worst pain]) from baseline to month 24. Secondary outcomes were cartilage defects and bone marrow lesions (assessed using MRI). Of 413 enrolled participants (mean age, 63.2 years 50% women), 340 (82.3%) completed the study. The level of 25-hydroxyvitamin D increased more in the vitamin D group (40.6 nmol/L) than in the placebo group (6.7 nmol/L) (P < .001) over 2 years. There were no significant differences in annual change of tibial cartilage volume or WOMAC pain score. There were no significant differences in change of tibiofemoral cartilage defects or change in tibiofemoral bone marrow lesions. Adverse events (≥ 1 per patient) occurred in 56 participants in the vitamin D group and in 37 participants in the placebo group (P = .04). [table: see text]. Among patients with symptomatic knee osteoarthritis and low serum 25-hydroxyvitamin D levels, vitamin D supplementation, compared with placebo, did not result in significant differences in change in MRI-measured tibial cartilage volume or WOMAC knee pain score over 2 years. These findings do not support the use of vitamin D supplementation for preventing tibial cartilage loss or improving WOMAC knee pain in patients with knee osteoarthritis. clinicaltrials.gov Identifier: NCT01176344 anzctr.org.au Identifier: ACTRN12610000495022.
Publisher: Wiley
Date: 06-09-2016
DOI: 10.1002/ACR.22834
Abstract: To describe associations between serum high-sensitivity C-reactive protein (hsCRP), knee bone marrow lesions (BMLs), and knee pain, cross-sectionally and longitudinally, in patients with knee osteoarthritis (OA). Patients (n = 192) with symptomatic knee OA (mean age 63 years, range 50-79, women 53%) were assessed at baseline and after 24 months. Serum hsCRP was measured using enzyme-linked immunosorbent assay. Knee BMLs were scored using the modified Whole-Organ Magnetic Resonance Imaging (MRI) Score from T2-weighted fat-supressed fast spin-echo MRI. Knee pain was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. Quartiles of baseline serum hsCRP were associated with the presence of knee BMLs (prevalence ratio 1.07 per quartile [95% confidence interval (95% CI) 1.00, 1.15]) and total knee pain scores (β 13.66 per quartile [95% CI 2.26, 25.07]) in multivariable analyses. Longitudinally, higher baseline hsCRP was associated with an increase in BML score (risk ratio 1.37 per quartile [95% CI 1.10, 1.70]), and change in hsCRP was positively associated with change in BML score (β 0.19 [95% CI 0.05, 0.34]) in adjusted analyses. Baseline hsCRP was not associated with change in total knee pain, but change in hsCRP was positively and significantly associated with change in total knee pain (β 4.71 [95% CI 0.48, 8.94]). This became nonsignificant after adjustment for changes in BML score. In patients with knee OA, serum hsCRP is associated with knee BML scores and, to a lesser extent, pain both cross-sectionally and longitudinally, suggesting that inflammation is linked with BMLs and their associated pain.
Publisher: Wiley
Date: 11-07-2023
Abstract: There is increasing use of complementary and alternative medicines (CAMs) alone or as an adjuvant therapy to conventional medicines in osteoarthritis (OA) patients. This study aimed to describe the prevalence and correlates of the use of CAMs among community‐dwelling older adults. Data from the Tasmania Older Adult Cohort Study (TASOAC, n = 1099) were used to describe the prevalence of CAM use. Correlates of CAM use were assessed by comparing CAM users and non‐users. To further assess correlates of CAM use, participants with at least one joint with pain were classified into four categories: CAM‐only, analgesics‐only, co‐therapy, and “neither CAMs nor analgesics” (NCNA). In all, 385 (35.0%) of our participants reported use of CAM s, among which vitamins/minerals were used most (22.6%, n = 232). Compared with CAM non‐users, CAM users were more likely to be female, were less likely to be overweight, were better educated, had more joints with OA , had fewer WOMAC scores, and did more steps per day. Among participants with any joint pain, the CAM‐only group were less likely to be overweight, consumed more alcohol, had higher quality of life, had more steps per day, and had fewer pain‐related symptoms compared with the analgesic‐only group. Complementary and alternative medicines were commonly used among Tasmanian older adults, with 35% of the population using CAMs either alone or in combination with conventional analgesics. CAM users were more likely to be female, be better educated, have more joints with OA, and had healthier lifestyles, including lower body mass index and higher number of steps per day.
Publisher: Wiley
Date: 24-03-2016
DOI: 10.1002/ACR.22715
Abstract: To describe the associations between body composition and hormonal and inflammatory factors measured 5 years prior and tibial cartilage volume in young adults, and to explore if these factors contribute to the sex difference in tibial cartilage volume. Subjects broadly representative of the young adult Australian population (n = 328, ages 31-41 years, 47.3% women) were selected. They underwent T1-weighted fat-suppressed magnetic resonance imaging (MRI) of their knees. Tibial cartilage volume was measured from MRI. Sex hormone binding globulin (SHBG) and testosterone in a subset of women and C-reactive protein (CRP) level and fibrinogen in both sexes were measured 5 years prior. Body mass index (BMI), fat mass, and lean mass were calculated from height, weight, and skinfolds. In multivariable analyses, correlates of tibial cartilage volume included lean body mass (β = 26.4 mm(3) 95% confidence interval [95% CI] 13.6, 39.1), fat mass (β = -11.8 mm(3) 95% CI -22.2, -1.4), and fibrinogen (β = -146.4 mm(3) 95% CI -276.4, -16.4), but not BMI, testosterone, or CRP level. In women, SHBG was positively associated with tibial cartilage volume (β = 0.67 mm(3) 95% CI 0.14, 1.20) and Free Androgen Index was negatively associated with lateral tibial cartilage volume (β = -0.04 mm(3) 95% CI -0.07, 0.00). Men had 13% more tibial cartilage volume (500 mm(3) ) than women. The magnitude of this association decreased by 38%, 20%, and 37% after adjustment for lean body mass, fat mass, and fibrinogen, respectively. Body composition, sex hormones, and fibrinogen correlate with knee cartilage volume in young adult life. Sex difference in knee cartilage volume is contributed largely by variations in body composition and/or fibrinogen.
Publisher: Cambridge University Press (CUP)
Date: 14-07-2022
DOI: 10.1017/S0007114521002658
Abstract: We aimed to describe associations between diet quality in adolescence and adulthood and knee symptoms in adulthood. Two hundred seventy-five participants had adolescent diet measurements, 399 had adult diet measurements and 240 had diet measurements in both time points. Diet quality was assessed by Dietary Guidelines Index (DGI), reflecting adherence to Australian Dietary Guidelines. Knee symptoms were collected using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analysed using zero-inflated negative binomial regressions. The overall adolescent DGI was not associated with adult knee symptoms, although lower intake of discretionary foods (e.g. cream, alcohol, bacon and cake) in adolescence was associated with lower pain (mean ratio (MR) 0·96) and dysfunction (MR 0·94). The overall adult DGI was not associated with knee symptoms however, limiting saturated fat was associated with lower WOMAC (Pain: MR 0·93 stiffness: MR 0·93 dysfunction: MR 0·91), drinking water was associated with lower stiffness (MR 0·90) and fruit intake was associated with lower dysfunction (MR 0·90). Higher DGI for dairy products in adulthood was associated with higher WOMAC (Pain: MR 1·07 stiffness: MR 1·13 dysfunction: MR 1·11). Additionally, the score increases from adolescence to adulthood were not associated with adult knee symptoms, except for associations between score increase in limiting saturated fat and lower stiffness (MR 0·89) and between score increase in fruit intake and lower dysfunction (MR 0·92). In conclusion, the overall diet quality in adolescence and adulthood was not associated with knee symptoms in adulthood. However, some diet components may affect later knee symptoms.
Publisher: BMJ
Date: 27-09-2013
DOI: 10.1136/ANNRHEUMDIS-2013-203308
Abstract: To investigate cross-sectional and longitudinal associations between serum leptin levels and knee cartilage thickness in older adults. A prospective cohort of 163 randomly selected subjects (mean 63 years, range 52–78, 46% women) was studied. Knee cartilage thickness at medial tibial, lateral tibial, femoral and patellar sites was determined using T1-weighted fat-suppressed MRI. Serum leptin levels were measured by radioimmunoassay. Radiographic osteoarthritis, body fat (%), trunk fat (%), weight and height were measured, and body mass index (BMI) was calculated. Cross-sectionally, serum levels of leptin were negatively associated with femoral (β: −0.013, 95% CI −0.022 to −0.003), medial tibial (β: −0.009, 95% CI −0.018 to −0.001), lateral tibial (β: −0.012, 95% CI −0.021 to −0.003) and patellar (β: −0.014, 95% CI −0.026 to −0.002) cartilage thickness after adjustment for covariates. Moreover, BMI, trunk fat and total body fat were negatively associated with cartilage thickness, and the significant associations disappeared after further adjustment for leptin. Longitudinally, both baseline leptin and change in leptin were associated with greater changes in medial tibial cartilage thickness (β: −0.004, 95% CI −0.007 to −0.001 and β: −0.009, 95% CI −0.018 to −0.001, respectively) in multivariable analyses. Serum levels of leptin are independently and consistently associated with reduced cartilage thickness cross-sectionally and longitudinally. In addition, the associations between adiposity measures and cartilage thickness are mediated by leptin, suggesting leptin may play a key role in cartilage thinning.
Publisher: American College of Physicians
Date: 12-2020
DOI: 10.7326/M20-0990
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.JOCA.2016.10.024
Abstract: To describe cross-sectional and longitudinal associations between serum levels of interleukin (IL) - 6, IL-17A, IL-17F, IL-23 and knee bone marrow lesions (BMLs) in patients with knee osteoarthritis (OA). Patients (n = 192) with symptomatic knee OA (mean 63 years, range 50-79, female 53%) were assessed at baseline and after 24 months. At each time point, serum IL-6, IL-17A, IL-17F and IL-23 were measured using Bio-Plex Baseline IL-6 (quarters) were significantly associated with total knee BMLs (P < 0.01 for the trend) as well as associated with an increase in BML score (P = 0.05 for the trend), after adjustment for confounders. Baseline IL-17F and IL-23 (highest quarters vs others) was associated with an increase in BML score in females (P = 0.04 for IL-17F P = 0.01 for IL-23), but not in males, in multivariable analyses. In contrast, IL-17A was not significantly associated with BMLs in either females or males. IL-6 is associated with increased knee BMLs in both females and males with OA. Serum IL-17F and IL-23 predicted increased knee BML scores in females only, suggesting that inflammation is involved in BML pathogenesis in knee OA, especially in women. ClinicalTrials.gov identifier: NCT01176344 Australian New Zealand Clinical Trials Registry: ACTRN12610000495022.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 05-2021
No related organisations have been discovered for Benny Samuel Eathakkattu Antony.
Start Date: 2016
End Date: 2016
Funder: Menzies Institute for Medical Research
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