期刊
CARTILAGE
卷 11, 期 1, 页码 38-46出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/1947603518777577
关键词
osteoarthritis; knee; obesity; depression; biomarker; pain
类别
资金
- National Institutes of Health (NIH), a branch of the Department of Health and Human Services [N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262]
- Merck Research Laboratories
- Novartis Pharmaceuticals Corporation
- GlaxoSmithKline
- Pfizer, Inc.
- AbbVie
- Amgen
- Arthritis Foundation
- Artialis
- Bioiberica
- BioVendor
- DePuy
- Flexion Therapeutics
- GSK
- IBEX
- IDS
- Merck Serono
- Quidel
- Rottapharm \ Madaus
- Sanofi
- Stryker
- Pivotal OAI MRI Analyses (POMA) study, NIH [HHSN2682010000 21C]
- Osteoarthritis Research Society International
Objective To compare the progression of biochemical biomarkers of osteoarthritis (OA), knee pain, and function between nonobese patients (NON), obese patients without depression (OBESE), and obese patients with comorbid depression (O + D). Design Utilizing the FNIH OA Biomarkers Consortium dataset, we categorized knee OA patients into NON, OBESE, and O + D groups based on body mass index and Center for Epidemiological Studies-Depression (CES-D) scores. Subjective symptoms (Knee injury and Osteoarthritis Outcome Score Quality of Life subscale (KOOS QOL), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Physical Function scores, and the Short Form-12 (SF-12) Physical Component Score [PCS]) and objective measures of cartilage degradation and bone remodeling (urinary CTXII and CTXI alpha) were compared among groups at baseline and 2-year follow-up. Results Of the 600 patients, 282 (47%) were NON, 285 (47.5%) OBESE, and 33 (5.5%) O + D. The O + D group had significantly worse pain and function both at baseline and 2-year follow-up (P < 0.001 for all comparisons) as evidenced by self-reported measures on KOOS QOL, WOMAC Pain, WOMAC Physical Function, and SF-12 PCS. The O + D group also demonstrated significant increases in CTXII (P = 0.01) and CTXI alpha (P = 0.005), whereas the NON and OBESE groups did not. Conclusions The combination of inferior knee pain, physical function, and significantly greater increases in biomarkers of cartilage degradation and bony remodelling suggest a more rapid progression for obese OA patients with comorbid depression. The link between systemic disease, inflammatory burden, and progressive cartilage degradation is in line with increasing concerns about a degenerative synovial environment in early osteoarthritic knees that progress to treatment failure with biologic restoration procedures.
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