The Study Of Adiponectin In Early Diagnosis Of Osteoarthritis And Its Correlation With Articular Degeneration

Objective: With the ageing time coming,the population of old people is growing larger and larger.OA is a chronic disease with high incidence among people with obesity which bring heavy burden to the society and family.Recent studies have shown that adiponectin is largely involved in the pathogenesis and progression of osteoarthritis(OA).Although the data above showed altered adiponectin expression plays an important role with radiographic progression or cartilage damage,no data have been conducted to show the correlation between serum or SF concentrations of adiponectin and symptomatic severity of OA.Because of the emerging role of adiponectin in OA,we sought to figure out the association between serum and SF levels of adiponectin with knee OA at different stages of symptomatic severity.Adiponectin could be used as a marker for symptomatic severity in knee OA patients.Methods:1 Study Subjects142 patients diagnosed with knee OA and 45 controls were received regular body check and recruited into this study.The OA patients were divided into three groups based on the Kellgren-Lawrence(KL)grading scale.2 Inclusive CriteriaDiagnosis of knee OA was determined according to the American College of Rheumatology criteria for OA.Written informed consent was obtained from the patients and healthy volunteers prior to their participation in this study.3 Exclusive CriteriaParticipants were excluded if they suffered from systemic inflammatory or autoimmune disorders,RA,posttraumatic arthritis,joint infection,gout,enteropathic arthritis,trauma,malignant disease.Patients with histories of corticosteroid medications or injections were also excluded.4 Test indexThe symptomatic severity extent of the disease was determined utilizing the Western Ontario Mc Master Universities Osteoarthritis Index(WOMAC)score.The radiographic progression of OA was identified according to the Kellgren-Lawrence(KL)grading scale read by two experienced radiologists.5 Laboratory methodsSF and Serum levels of adiponectin of patients were evaluated by enzyme-linked immunosorbent assay.Synovial fluid was extracted from the affected knee,centrifuged to remove cells and joint debris,and stored at-80°C until the day of measurement.6 Statistical analysesData normality was determined using the Kolmogoro-Smirnov test.Basic statistics between patients and controls were compared by Chisquare tests,unpaired Student's t-tests,where appropriate.Correlations between serum and synovial fluid with WOMAC scores were calculated by Pearson or Spearman's rank correlation coefficient(r)and multivariate linear regression analyses.Data were expressed as mean ± standard deviation(SD)or median(interquartile range).P < 0.05 was considered statistically significant for differences and correlations.Results:1 Age,gender,height,weight and body mass index had no significant difference for the control and OA patients(P>0.05).There was significant difference of WOMAC pain scores(P<0.05),WOMAC stiffness scores,WOMAC physical function scores,WOMAC total scores between three groups of OA patients(P<0.05).2 Adiponectin levels were positively correlated with WOMAC pain,function scores and total scores in SF.WOMAC stiffness scores did not associated with adiponectin concentrations in SF.SF Adiponectin levels were significantly correlated with K-L grading in knee OA patients.Adiponectin levels in serum had no significant association with all WOMAC indexes,including pain scores,stiffness scores,function scores and total scores in OA patients.The serum adiponectin levels and K-L grading did not reach significance.Conclusions: Adiponectin levels in the joint fluid of KOA patients was negatively related to the WOMAC score,and negatively correlated with X-ray K-L classification.Joint fluid adiponectin has protective effect on the pathogenesis of OA process.The low level of adiponectin has a greater risk of OA.The joint fluid adiponectin level is helpful to identify the degree of pathological changes,which also be used for early diagnosis of OA.Adiponectin be used as a kind of potential biomarkers to assess the severity of symptoms of OA.