Metabolic Syndrome and Its Effects on Cartilage Degeneration vs Regeneration: A Pilot Study Using Osteoarthritis Biomark
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ORIGINAL ARTICLE
Metabolic Syndrome and Its Effects on Cartilage Degeneration vs Regeneration: A Pilot Study Using Osteoarthritis Biomarkers Rajath Siddaramanna Onkarappa1,2 · Devendra Kumar Chauhan2 · Biman Saikia3 · Adil Karim3 · Rajendra Kumar Kanojia3 Received: 7 January 2020 / Accepted: 18 May 2020 © Indian Orthopaedics Association 2020
Abstract Background Osteoarthritis (OA) of the knee is one of the leading causes of disability characterized by degeneration of hyaline cartilage combined with reparative processes. Its strong association with metabolic syndrome is postulated to be due to both mechanical and biochemical factors. Our study aims to study differential effect of metabolic risk factors on cartilage degeneration and regeneration at biomarker level. Design After screening 281 patients presenting with knee pain, 41 patients who met the selection criteria were included and were divided into metabolic (MetS) OA and non-metabolic (Non-MetS) OA phenotypes using National Cholesterol Education Programme—Adult Treatment Panel—III (NCEP-ATP-III) criteria for metabolic syndrome. Serum Cartilage Oligomeric Matrix Protein (COMP) and Procollagen type IIA N terminal Propeptide (PIIANP) levels were used as tools to assess cartilage degeneration and regeneration, respectively. Results 22 among 41 patients (53.66%) had metabolic syndrome. Covariates like age, gender, Kellgren Lawrence (KL) grades were comparable in both groups. MetS-OA group showed significant increase in serum COMP levels (p = 0.03) with no significant effect on serum PIIANP levels (p = 0.46). Hypertriglyceridemia showed independent association with both cartilage anabolism (p = 0.03) and catabolism (p = 0.03). Conclusion Metabolic syndrome, though has no effect on cartilage regeneration tends to shift cartilage homeostasis towards degeneration with hypertriglyceridemia showing significant independent effect on cartilage metabolism. Keywords Osteoarthritis · Biomarker · Metabolic syndrome · Cartilage metabolism · COMP · PIIANP
Introduction
* Rajendra Kumar Kanojia [email protected] Rajath Siddaramanna Onkarappa [email protected] Devendra Kumar Chauhan [email protected] Biman Saikia [email protected] 1
Department of Orthopaedics, PGIMER, Chandigarh 160012, India
2
Department of Orthopaedics, PGIMER, Chandigarh, India
3
PGIMER, Sector 12, Chandigarh 160012, India
Metabolic syndrome (MetS) is a group of disorders that includes hyperglycemia, dyslipidemia (increase triglyceride or reduced HDL/increased LDL), central obesity and hypertension. Presence of any three out of these five parameters is defined as MetS as per NCEP ATP-III guideline [1]. In context to the musculoskeletal disorder, the osteoarthritis (OA) of the knee is particularly found to have strong association. OA of the knee joint is the most prevailing rheumatological condition significantly affecting the activity of daily living in > 40 year old population. It is characterized by pain, swelling, deformity and stiffness of joint. In general, it
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