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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #307554

Title: Relationship of bone mineral density to progression of knee osteoarthritis

Author
item Lee, Ji Y - Tufts - New England Medical Center
item Harvey, William - Tufts - New England Medical Center
item Price, Lori - Tufts - New England Medical Center
item Paulus, Jessica - Tufts - New England Medical Center
item Dawson-hughes, Bess - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item Mcalindon, Timothy - Tufts - New England Medical Center

Submitted to: Arthritis and Rheumatism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/20/2013
Publication Date: 6/1/2013
Citation: Lee, J., Harvey, W.F., Price, L.L., Paulus, J.K., Dawson-Hughes, B., Mcalindon, T.E. 2013. Relationship of bone mineral density to progression of knee osteoarthritis. Arthritis and Rheumatism. 65(6):1541-1546.

Interpretive Summary: The objective of this study was to evaluate the long-term relationship between bone mineral density (BMD) and BMD changes and the progression of knee osteoarthritis (OA). We used observational cohort data from the Vitamin D for Knee Osteoarthritis trial. A total of 127 subjects were eligible for analysis. BMD values for the upper thighbone were taken on both sides, and magnetic resonance imaging (MRI) scans of the knee in each subject were obtained at baseline and subsequently at 12 months and 24 months. These MRI scans were used to obtain measures of cartilage volume and cartilage thickness at the shin and thigh. These measures were used to create models examining the association between the change in BMD and the cartilage outcomes of the participants, adjusting for age, sex, body mass index, malalignment, and vitamin D treatment. The results of the study showed that BMD loss is associated with progressive cartilage loss in knees with OA. Further work to clarify the basis of this relationship could reveal novel therapeutic targets for knee OA.

Technical Abstract: Objective. To evaluate the longitudinal relationship between bone mineral density (BMD) and BMD changes and the progression of knee osteoarthritis (OA), as measured by cartilage outcomes. Methods. We used observational cohort data from the Vitamin D for Knee Osteoarthritis trial. Bilateral femoral neck BMD values as well as knee magnetic resonance imaging (MRI) scans in each subject were obtained at baseline and subsequently at 12 months and 24 months. The change in total cartilage volume and tibial and femoral cartilage thickness was measured by manual cartilage segmentation of 2 sequential knee MRI scans in each subject. Multivariable linear regression models were used to examine the associations of baseline BMD and BMD change with the cartilage outcomes, adjusting for baseline age, sex, body mass index, malalignment, and vitamin D treatment. Model fit and assumptions were validated. Results. A total of 127 subjects were eligible for analysis. Longitudinal BMD loss was associated with loss of cartilage volume (beta = 1.25 per 0.1 gm/cm2, P =0.02) and loss of tibial cartilage thickness (beta = 0.028, P = 0.03). BMD loss of a magnitude greater than the least significant change (<4.7%) was associated with 1.02% cartilage volume loss per year (P = 0.005),0.014 mm femoral cartilage thickness loss (P = 0.04), and 0.021 mm tibial cartilage thickness loss per year (P = 0.009). There were no significant associations between baseline BMD and any of the cartilage outcomes. Conclusion. Longitudinal BMD loss is associated with progressive cartilage loss in knees with OA. Further work to clarify the basis of this relationship could reveal novel therapeutic targets for knee OA.