Gonartrotik Kıkırdak Dejenerasyonunun Metabolik Sendrom ve İnflamatuar İndikatörler İle İlişkisi: Yeni Bir Bakış

Yıl 2021, , 144 - 149, 30.08.2021

Aziz Atik , Eren Altun

https://doi.org/10.30565/medalanya.882840

Cited By: 2

Öz

Amaç: Yüksek vücut kitle indeksi (BMI), merkezi obezite, yüksek yoğunluklu lipoprotein (HDL) seviyesi düşüklüğü, yüksek trigliserid, yüksek tansiyon ve hiperglisemi gibi bir dizi metabolik anormalliğin kombinasyonu metabolik sendrom (MetS) olarak tanımlanır. Bu çalışma metabolik sendrom bileşenlerinin eklem dejenerasyonuna etkisini ve sistemik iltihabi cevapla son evre osteoartritin klinik gidişatı arasındaki ilişkiyi araştırmayı amaçlamaktadır.

Gereç ve Yöntem: Primer diz osteoartriti sebebiyle total diz artroplastisi uygulanan elliyedi hasta, metabolik sendrom tanı kriterlerine göre sınıflandırıldı ve Uluslarasarası Osteoartrit Araştırma Grubu (Osteoarthritis Research Society International - OARSI) skorlama sistemine göre medial ve lateral tibial plato örnekleri histopatolojik olarak evrelendi.

Bulgular: 33 hastaya sağ (% 57.9), 24 hastaya sol (% 42.1) total diz artroplastisi uygulandı. Ortalama yaş 68.46 ± 6.88 idi (57-85). Ortalama BMI değeri 30.31 ± 5.26 idi (20.2 - 48). Uluslarası Diabet Kuruluşu’nun (International Diabetes Foundation - IDF) 2005 metabolik sendrom tanı kriterlerine göre; % 31.5 (n = 18) hastada metabolik sendrom yokken, % 68.4 (n = 39) hastada vardı. Tibial plato OARSI skorlarıyla metabolik sendrom tanı kriterleri arasında istatistiksel anlamlı bir ilişki bulunamadı (p> 0.05). Ayrıca OARSI skorlarıyla opere taraf, hipertansiyon ve BMI arasında da istatistiksel anlamlı bir ilişki yoktu (p> 0.05).

Sonuç: Metabolik sendrom bileşenleri adipokinler yoluyla osteoartrit gelişimini başlatıcı etkiye sahip olabilse de, tibia plato kıkırdağı dejenerasyonu ile proinflamatuar mediatörler arasında artritik sürecin son evresine kadar devam eden bir ilişki tespit edemedik. 

Anahtar Kelimeler

diz, osteoartrit, metabolik sendrom, kıkırdak dejenerasyonu, inflamatuar mediatör

Destekleyen Kurum

yok

Proje Numarası

yok

The Relationship of Inflammatory Indicators and Metabolic Syndrome with Gonarthrotic Cartilage Degeneration: A Novel Glance

Öz

Aim: The combination of a number of metabolic abnormalities such as high body mass index (BMI), central obesity, low high-density lipoprotein (HDL), high triglycerides, high blood pressure, and hyperglycemia is defined as metabolic syndrome (MetS). This study aimed to clarify the effect of metabolic syndrome components on joint degeneration and investigate the relationship between systemic inflammatory response and end-stage osteoarthritis clinical course.

Material and Methods: Fifty-seven patients, who underwent total knee arthroplasty due to primary knee osteoarthritis, were classified according to metabolic syndrome diagnosis criteria. Their medial and lateral tibial plateau specimens were graded histopathologically according to Osteoarthritis Research Society International scoring system (OARSI).

Results: 33 patients were performed right total arthroplasty (57.9%), 24 were performed left (42.1%). The mean age was 68.46 ± 6.88 (range 57 to 85). The mean BMI value was 30.31 ± 5.26 (range 20.2 to 48). According to the International Diabetes Foundation (IDF) 2005 metabolic syndrome (MetS) diagnostic criteria; 31.5% (n = 18) of the patients did not have MetS, while 68.4% (n = 39) had. There was no statistically significant relationship between tibial plateau OARSI scores and metabolic syndrome (p> 0.05). Besides, these OARSI scores and the operation side, hypertension, and BMI had no statistically significant relationship (p> 0.05).

Conclusions: Metabolic syndrome components may play a role in initiating the osteoarthritic process via adipokines, but we could not identify certain effects of pro-inflammatory mediator components on tibial plateau cartilage degeneration with histopathological scores till end-stage arthritic progress. 

Anahtar Kelimeler

Knee, Osteoarthritis, Metabolic Syndrome, Cartilage Degeneration, Inflammatory Mediators

Proje Numarası

yok

Kaynakça

• 1. Gabay C, Kushner I. Acute-Phase Proteins and Other Systemic Responses to Inflammation. N Engl J Med. 1999;340(6):448-54. DOI: 10.1056/NEJM199902113400607.
• 2. Aslan A, Aydogan NH, Ilhan M, Ozerdemoglu RA, Altuntas I, et al. The effect of different intraarticular drug applications to the antioxidation system and lipid peroxidation in gonarthrosis. Eur J Ther. 2012;18:1-6 DOI: 10.5455/GMJ-30-2011-55.
• 3. Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler and Thromb. 2005;12(6):295-300. DOI: 10.5551/jat.12.295.
• 4. Alberti KG, Zimmet P, Shaw J, Group IDFETFC. The metabolic syndrome--a new worldwide definition. Lancet. 2005;366 (9491):1059-62. DOI: 10.1016/S0140-6736(05)67402-8.
• 5. Gökoğlu F, Gürsoy H, Borman P, Özyılkın E, Yorgancıoğlu R. The metabolic syndrome in patients with osteoarthrıtıs. J PMR Sci. 2008;2:46-52.
• 6. Güven SC, Özdemir O, Dinçer F. The Relationship Between Osteoarthritis and Obesity. J PMR Sci. 2016;19 (1):76-84
• 7. Gosset M, Berenbaum F, Levy A, Pigenet A, Thirion S, et al. Mechanical stress and prostaglandin E2 synthesis in cartilage. Biorheology. 2008; 45(3-4):301-20. DOI: 10.3233/BIR-2008-0494
• 8. Sellam J, Berenbaum F. The role of synovitis in pathophysiology and clinical symptoms of osteoarthritis. Nat Rev Rheumatol. 2010,6.11:625-35. DOI: 10.1038/nrrheum.2010.159
• 9. Orlowsky EW, Kraus VB. The role of innate immunity in osteoarthritis: when our first line of defense goes on the offensive. J Rheumatol. 2015;42(3):363-71. DOI: 10.3899/jrheum.140382
• 10. Pritzker KPH, Gay S, Jimenez SA, Ostergaard K, Pelletier JP, et al. Osteoarthritis cartilage histopathology: grading and staging. Osteoarthritis and Cartilage. 2006;14(1):13-29. DOI: 10.1016/j.joca.2005.07.014
• 11. Yusuf E, Nelissen RG, Ioan-Facsinay A, Stojanovic-Susulic V, DeGroot J, et al. Association between weight or body mass index and hand osteoarthritis: A systematic review. Ann Rheum Dis. 2010;69(4):761-5. DOI: 10.1136/ard.2008.106930
• 12. Xie C, Chen Q. Adipokines: New Therapeutic Target for Osteoarthritis? Curr Rheumatol Rep. 2019;21(12):71. DOI: 10.1007/s11926-019-0868-z
• 13. Wang T, He C. Pro-inflammatory cytokines: the link between obesity and osteoarthritis. Cytokine Growth Factor Rev. 2018;44:38-50. DOI: 10.1016/j.cytogfr.2018.10.002
• 14. Conde J, Scotece M, Lopez V, Gomez R, Lago F, et al. Adipokines: novel players in rheumatic diseases. Discov Med. 2013;15(81):73-83. PMID: 23449109
• 15. Tan W, Wang F, Zhang M, Guo D, Zhang Q, et al. High Adiponectin and Adiponectin Receptor 1 Expression in Synovial Fluids and Synovial Tissues of Patients with Rheumatoid Arthritis. Semin Arthritis Rheum. 2009;38(6):420-7. DOI: 10.1016/j.semarthrit.2008.01.017
• 16. Gosset M, Berenbaum F, Salvat C, Sautet A, Pigenet A, et al. Crucial Role of Visfatin / Pre – B Cell Colony-Enhancing Factor in Matrix Degradation and Prostaglandin E 2 Synthesis in Chondrocytes Possible Influence on Osteoarthritis. Arthritis Rheum. 2008;58(5):1399-409. DOI: 10.1002/art.23431
• 17. Zhuo Q, Yang W, Chen J, Wang Y. Metabolic syndrome meets osteoarthritis. Nat Rev Rheumatol. 2012,8(12):729-37. DOI: 10.1038/nrrheum.2012.135
• 18. Gao YH, Zhao CW, Liu B, Dong N, Ding L, et al. An update on the association between metabolic syndrome and osteoarthritis and on the potential role of leptin in osteoarthritis. Cytokine. 2020;129:155043. DOI: 10.1016/j.cyto.2020.155043
• 19. Afifi AEA, Shaat RM, Gharbia OM, Boghdadi YE, Eshmawy MME, et al. Osteoarthritis of knee joint in metabolic syndrome. Clin Rheumatol. 2018;37(10):2855-61. DOI: 10.1007/s10067-018-4201-4
• 20. Puenpatom RA, Victor TW. Increased prevalence of metabolic syndrome in individuals with osteoarthritis: An analysis of NHANES III data. Postgrad Med. 2009;121(6):9-20. DOI: 10.3810/pgm.2009.11.2073
• 21. Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, et al. Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: A 3-year follow-up of the ROAD study. Osteoarthritis Cartilage. 2012;20(11):1217-26. DOI: 10.1016/j.joca.2012.06.006
• 22. Konstari S, Sääksjärvi K, Heliövaara M, Rissanen H, Knekt P, et al. Associations of Metabolic Syndrome and Its Components with the Risk of Incident Knee Osteoarthritis Leading to Hospitalization: A 32-Year Follow-up Study. Cartilage. 2019:1947603519894731. DOI: 10.1177/1947603519894731
• 23. Francisco V, Pérez T, Pino J, López V, Franco E, et al. Biomechanics, obesity, and osteoarthritis. The role of adipokines: When the levee breaks. J Orthop Res. 2018;36(2):594-604. DOI: 10.1002/jor.23788