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The value of cartilage biomarkers in progressive knee osteoarthritis: cross-sectional and 6-year follow-up study in middle-aged subjects

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Abstract

To determine the possible diagnostic and prognostic value of cartilage biomarkers in early-stage progressive and nonprogressive knee osteoarthritis (OA) in a population-based cohort of middle-aged subjects with chronic knee pain. Design tibiofemoral (TF) and patellofemoral (PF) radiographs were graded in 128 subjects (mean age at baseline, 45 ± 6.2 years) in 2002, 2005, and 2008. Cartilage degradation was assessed by urinary C-telopeptide fragments of type II collagen (uCTx-II), synthesis by serum type II A procollagen N-terminal propeptide (sPIIANP), and articular tissue turnover in general by cartilage oligomeric matrix protein (sCOMP). Several diagnostic associations were found between all studied biomarkers and progressive osteophytosis. COMP and CTx-II had a predictive value for subsequent progressive osteophytosis in multiple knee compartments and in case of CTx-II—also for progressive JSN. Over the first 3 years (2002–2005), significant associations were observed between COMP and progressive osteophytosis, whereas 3 years later (2005–2008) between CTx-II and progressive JSN. Thus, the associations between cartilage markers (COMP, CTx-II) and progression of radiographic OA features—osteophytes and JSN—were different between 2002–2005 and 2005–2008. Logistic regression revealed that for every unit increase in COMP level, there was 33 % higher risk for TF osteophyte progression. During early-stage OA, the presence and progression of osteophytosis is accompanied by increased level of cartilage biomarkers. This is the first study to demonstrate biochemical differences over the course of knee OA, illustrating a phasic nonpersistent character of OA with periods of progression and stabilization.

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Acknowledgments

We are grateful to the family doctor Ülle Hansen and her team for remarkable consistency and success with subject recruitment and to Mare Vähi, Maret Vija, and Helja Karo for statistical assistance. We thank AnaMar Medical and Immunodiagnostic Systems for providing reagents for laboratory work. This study was supported by an ECTS/Czech Society Young Investigator Grant. AnaMar Medical and Immunodiagnostic System partly supported this study by providing laboratory kits for biochemical measurements. Neither of the above was involved in the study design, analysis, and interpretation of data nor in writing the manuscript.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Clinic of Internal Medicine, University of Tartu, L.Puusepa 6-222, Tartu, 51014, Estonia

    Jaanika Kumm

  2. Clinic of Radiology, University of Tartu, L.Puusepa 8-G.1R 176, Tartu, 51014, Estonia

    Jaanika Kumm

  3. Clinic of Sports Medicine and Rehabilitation, University of Tartu, L.Puusepa 1A-2082, Tartu, 50405, Estonia

    Ann Tamm

  4. Clinic of Radiology, University of Tartu, Lunini 6-109, Tartu, 51014, Estonia

    Mare Lintrop

  5. Clinic of Internal Medicine, University of Tartu, L.Puusepa 6-159, Tartu, 51014, Estonia

    Agu Tamm

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  1. Jaanika Kumm
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Correspondence to Jaanika Kumm.

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Kumm, J., Tamm, A., Lintrop, M. et al. The value of cartilage biomarkers in progressive knee osteoarthritis: cross-sectional and 6-year follow-up study in middle-aged subjects. Rheumatol Int 33, 903–911 (2013). https://doi.org/10.1007/s00296-012-2463-8

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  • DOI: https://doi.org/10.1007/s00296-012-2463-8

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