Systemic bone mineral density and its change in relation to progression of knee osteoarthritis: a longitudinal study.
Lee, Ji Yeon.
2012
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Abstract: Background: Bone and cartilage are closely associated in Osteoarthritis (OA) pathophysiology. Increased bone mineral density (BMD) has been observed to be associated with OA in cross-sectional studies but data on the longitudinal relationship between BMD and knee OA progression are few and inconsistent. Methods:We used observational cohort data from the Vitamin D for Knee Osteoarthritis ... read moretrial to examine the relationship of BMD, and change in BMD, to progression of knee OA, as measured by cartilage outcomes. We obtained bilateral femoral neck BMDs as well as knee MRIs in each subject at baseline and subsequently at 12 and 24 months. We measured change in total cartilage volume, tibial and femoral cartilage thickness by manual cartilage segmentation of two sequential knee MRIs in each subject. We computed the associations of baseline BMD and BMD change with the cartilage outcomes, adjusting for baseline age, gender, BMI, malalignment and vitamin D treatment using multivariable linear regression models. We validated model fit and assumptions using diagnostic plots. Results:127 subjects were included in the analyses. There were no significant associations between baseline BMD and any of the cartilage outcomes. However, longitudinal BMD loss of 0.1 g/cm was associated with cartilage volume loss (=1.25, p=0.02) and tibial cartilage thickness loss per year (=0.028, p=0.03). BMD loss of a magnitude greater than least significant change was associated with average of 1.02% cartilage volume loss (p=0.005), 0.014mm of femoral cartilage thickness loss (p=0.04) as well as 0.021mm of tibial cartilage thickness loss per year (p=0.009), compared with those without BMD change. Conclusions: Longitudinal BMD loss could be associated with progression of cartilage loss in knee OA. This could be explained by direct biological interaction between the structures on a biomechanical or autocrine basis, or these could be concurrent manifestations of a more systemic process relating to aging. Further work to clarify the basis of this relationship would be informative and potentially lead to novel therapeutic interventions for knee OA progression.
Thesis (M.S.)--Tufts University, 2012.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Timothy McAlindon.
Committee: William Harvey, Lori Lyn Price, and Jessica Paulus.
Keywords: Health sciences, and Epidemiology.read less - ID:
- 3n204908c
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