Study on the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, dickkopf-1, sclerostin_West China Medical Journal

Authors：

WU Xiaohui , WANG Cuiping , LI Min , QIN Xuefei , WU Jia , YU Wenjing , SHA Hu , WANG Lei ,  LIANG Yi

Department of Rheumatology, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LIANG Yi, Email: noll777@qq.com

Keywords：

Osteoprotegerin; Sclerostin; Bone marrow edema; Knee osteoarthritis

DOI：

10.7507/1002-0179.201910036

Video：

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Objective To investigate the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, DKK-1 (dickkopf-1), sclerostin. Methods A total of 100 elderly patients with knee osteoarthritis in Sichuan Province Orthopedic Hospital from September 2017 to December 2018 were selected and divided into bone marrow edema group (50 cases) and non-bone marrow edema group (50 cases). The patients’ basic data, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores and Visual Analogue Scale scores were collected. The patients’ serum osteoprotegerin, DKK-1, sclerostin, C-reactive protein, and erythrocyte sedimentation rate were tested, and the differences between the two groups were compared. The correlation of the detection indicators and bone marrow edema and its clinical indicators was explored. Results There was no significant difference in age, gender, course of disease, C-reactive protein and erythrocyte sedimentation rate between the two groups (P>0.05). WOMAC scores (76.1±5.4 vs. 67.5±6.6), Visual Analogue Scale scores (8.4±1.1 vs. 5.5±0.9), proportion of synovitis (84.0% vs. 52.0%), osteoprotegerin [(1.3±1.1) vs. (0.6±0.5) μg/L], DKK-1 [(18.4±16.9) vs. (6.9±6.0) μg/L] and sclerostin [(147.3±119.4) vs. (99.7±70.7) pg/mL] in the bone marrow edema group were higher than those in the non-bone marrow edema group (P<0.05). There was no statistically significant correlation of the bone marrow edema volume score and degree score and serum osteoprotegerin of patients in the bone marrow edema group (P>0.05). The bone marrow edema volume score and degree score of patients in the bone marrow edema group were positively correlated with serum DKK-1 (volume score r_s=0.464, P=0.001; degree score r_s=0.379, P=0.007) and sclerostin (volume score r_s=0.316, P=0.025; degree score r_s=0.461, P=0.003). Conclusion In elderly patients with knee osteoarthritis and bone marrow edema, the local bone metabolism indicators of osteoprotegerin, DKK-1 and sclerostin are up-regulated, especially DKK-1 and sclerostin are related to the severity of bone marrow edema.

Citation： WU Xiaohui, WANG Cuiping, LI Min, QIN Xuefei, WU Jia, YU Wenjing, SHA Hu, WANG Lei, LIANG Yi. Study on the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, dickkopf-1, sclerostin. West China Medical Journal, 2021, 36(11): 1545-1549. doi: 10.7507/1002-0179.201910036 Copy

1.	趙籥陶, 董娟, 李晶, 等. 老年人衰弱與骨關節炎的研究進展. 中華老年醫學雜志, 2019, 38(1): 102-104.
2.	李敏, 梁翼, 吳曉惠, 等. 伴骨髓水腫的膝骨關節炎患者白細胞介素-1β白細胞介素-6 腫瘤壞死因子-α的相關性研究. 中華風濕病學雜志, 2012, 16(2): 107-110.
3.	李敏, 吳俊華, 吳曉惠, 等. 伴骨髓水腫的膝骨關節炎與血管內皮因子、缺氧誘導因子 1α的相關性研究. 中華臨床醫師雜志(電子版), 2015(20): 3696-3699.
4.	李強, 周國慶, 鄧紫婷, 等. 復元膠囊對膝骨關節炎大鼠 IL-1β、OPG 和 OPGL mRNA 表達的影響. 中國老年學雜志, 2014, 34(14): 3930-3933.
5.	Chen M, Hu X, Wu M, et al. Serum levels of OPG, RANKL, and RANKL/OPG ratio in patients with ankylosing spondylitis: a systematic review and meta-analysis. Immunol Invest, 2019, 48(5): 490-504.
6.	張陽洋, 高艷虹. Sclerostin 單克隆抗體治療骨質疏松的研究進展. 中國骨質疏松雜志, 2017, 23(10): 1376-1380.
7.	張揮武, 李敏. 標本兼顧中西醫結合治療伴骨髓水腫膝骨關節炎的臨床療效及其與護骨素、Dickkopf-1、硬骨素的相關性研究. 四川中醫, 2020, 38(7): 149-153.
8.	中華醫學會骨科學分會關節外科學組. 骨關節炎診療指南(2018 年版). 中華骨科雜志, 2018, 38(12): 705-715.
9.	Copsey B, Thompson JY, Vadher K, et al. Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials. Qual Life Res, 2019, 28(2): 335-343.
10.	張志毅, 段新旺, 古潔若, 等. 歐洲骨質疏松和骨關節炎臨床及經濟學協會(ESCEO)和中國骨關節炎領域專家聯合發表聲明: ESCEO 膝骨關節炎治療規則應同樣適用于中國患者. 中國實用內科雜志, 2016, 36(9): 762-772.
11.	Zhou X, Lin X, Xiong Y, et al. Chondroprotective effects of palmatine on osteoarthritis in vivo and in vitro: a possible mechanism of inhibiting the Wnt/β-catenin and Hedgehog signaling pathways. Int Immunopharmacol, 2016, 34: 129-138.
12.	Zarei A, Hulley PA, Sabokbar A, et al. Co-expression of DKK-1 and sclerostin in subchondral bone of the proximal femoral heads from osteoarthritic hips. Calcif Tissue Int, 2017, 100(6): 609-618.
13.	Tian J, Gao SG, Li YS, et al. The β-catenin/TCF-4 pathway regulates the expression of OPN in human osteoarthritic chondrocytes. J Orthop Surg Res, 2020, 15(1): 344.
14.	Lane NE, Nevitt MC, Lui LY, et al. Wnt signaling antagonists are potential prognostic biomarkers for the progression of radiographic hip osteoarthritis in elderly Caucasian women. Arthritis Rheum, 2007, 56(10): 3319-3325.
15.	Han J, Gao W, Su D, et al. Gypenoside inhibits RANKL-induced osteoclastogenesis by regulating NF-κB, AKT, and MAPK signaling pathways. J Cell Biochem, 2018, 119(9): 7310-7318.
16.	李敏, 吳曉惠, 尹耕, 等. RANKL/OPG 系統、Dickkopf-1 與類風濕關節炎骨髓水腫的相關研究. 四川大學學報(醫學版), 2015, 46(2): 276-279.
17.	Kovács B, Vajda E, Nagy EE. Regulatory effects and interactions of the Wnt and OPG-RANKL-RANK signaling at the bone-cartilage interface in osteoarthritis. Int J Mol Sci, 2019, 20(18): 4653.
18.	Weivoda MM, Youssef SJ, Oursler MJ. Sclerostin expression and functions beyond the osteocyte. Bone, 2017, 96: 45-50.
19.	Apostu D, Lucaciu O, Mester A, et al. Systemic drugs with impact on osteoarthritis. Drug Metab Rev, 2019, 51(4): 498-523.
20.	石磊, 尹自龍, 王林, 等. 唑來膦酸對老年骨質疏松性骨折及骨關節炎患者骨代謝的影響. 中華老年醫學雜志, 2015, 34(7): 782-785.
21.	Miller RE, Block JA, Malfait AM. What is new in pain modification in osteoarthritis?. Rheumatology (Oxford), 2018, 57(suppl 4): iv99-iv107.
22.	李敏, 梁翼, 余文景, 等. 鹽酸氨基葡萄糖聯合雙醋瑞因在伴骨髓水腫的膝骨關節炎的療效評估. 華西醫學, 2012, 27(12): 1764-1767.

1. 趙籥陶, 董娟, 李晶, 等. 老年人衰弱與骨關節炎的研究進展. 中華老年醫學雜志, 2019, 38(1): 102-104.
2. 李敏, 梁翼, 吳曉惠, 等. 伴骨髓水腫的膝骨關節炎患者白細胞介素-1β白細胞介素-6 腫瘤壞死因子-α的相關性研究. 中華風濕病學雜志, 2012, 16(2): 107-110.
3. 李敏, 吳俊華, 吳曉惠, 等. 伴骨髓水腫的膝骨關節炎與血管內皮因子、缺氧誘導因子 1α的相關性研究. 中華臨床醫師雜志(電子版), 2015(20): 3696-3699.
4. 李強, 周國慶, 鄧紫婷, 等. 復元膠囊對膝骨關節炎大鼠 IL-1β、OPG 和 OPGL mRNA 表達的影響. 中國老年學雜志, 2014, 34(14): 3930-3933.
5. Chen M, Hu X, Wu M, et al. Serum levels of OPG, RANKL, and RANKL/OPG ratio in patients with ankylosing spondylitis: a systematic review and meta-analysis. Immunol Invest, 2019, 48(5): 490-504.
6. 張陽洋, 高艷虹. Sclerostin 單克隆抗體治療骨質疏松的研究進展. 中國骨質疏松雜志, 2017, 23(10): 1376-1380.
7. 張揮武, 李敏. 標本兼顧中西醫結合治療伴骨髓水腫膝骨關節炎的臨床療效及其與護骨素、Dickkopf-1、硬骨素的相關性研究. 四川中醫, 2020, 38(7): 149-153.
8. 中華醫學會骨科學分會關節外科學組. 骨關節炎診療指南(2018 年版). 中華骨科雜志, 2018, 38(12): 705-715.
9. Copsey B, Thompson JY, Vadher K, et al. Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials. Qual Life Res, 2019, 28(2): 335-343.
10. 張志毅, 段新旺, 古潔若, 等. 歐洲骨質疏松和骨關節炎臨床及經濟學協會(ESCEO)和中國骨關節炎領域專家聯合發表聲明: ESCEO 膝骨關節炎治療規則應同樣適用于中國患者. 中國實用內科雜志, 2016, 36(9): 762-772.
11. Zhou X, Lin X, Xiong Y, et al. Chondroprotective effects of palmatine on osteoarthritis in vivo and in vitro: a possible mechanism of inhibiting the Wnt/β-catenin and Hedgehog signaling pathways. Int Immunopharmacol, 2016, 34: 129-138.
12. Zarei A, Hulley PA, Sabokbar A, et al. Co-expression of DKK-1 and sclerostin in subchondral bone of the proximal femoral heads from osteoarthritic hips. Calcif Tissue Int, 2017, 100(6): 609-618.
13. Tian J, Gao SG, Li YS, et al. The β-catenin/TCF-4 pathway regulates the expression of OPN in human osteoarthritic chondrocytes. J Orthop Surg Res, 2020, 15(1): 344.
14. Lane NE, Nevitt MC, Lui LY, et al. Wnt signaling antagonists are potential prognostic biomarkers for the progression of radiographic hip osteoarthritis in elderly Caucasian women. Arthritis Rheum, 2007, 56(10): 3319-3325.
15. Han J, Gao W, Su D, et al. Gypenoside inhibits RANKL-induced osteoclastogenesis by regulating NF-κB, AKT, and MAPK signaling pathways. J Cell Biochem, 2018, 119(9): 7310-7318.
16. 李敏, 吳曉惠, 尹耕, 等. RANKL/OPG 系統、Dickkopf-1 與類風濕關節炎骨髓水腫的相關研究. 四川大學學報(醫學版), 2015, 46(2): 276-279.
17. Kovács B, Vajda E, Nagy EE. Regulatory effects and interactions of the Wnt and OPG-RANKL-RANK signaling at the bone-cartilage interface in osteoarthritis. Int J Mol Sci, 2019, 20(18): 4653.
18. Weivoda MM, Youssef SJ, Oursler MJ. Sclerostin expression and functions beyond the osteocyte. Bone, 2017, 96: 45-50.
19. Apostu D, Lucaciu O, Mester A, et al. Systemic drugs with impact on osteoarthritis. Drug Metab Rev, 2019, 51(4): 498-523.
20. 石磊, 尹自龍, 王林, 等. 唑來膦酸對老年骨質疏松性骨折及骨關節炎患者骨代謝的影響. 中華老年醫學雜志, 2015, 34(7): 782-785.
21. Miller RE, Block JA, Malfait AM. What is new in pain modification in osteoarthritis?. Rheumatology (Oxford), 2018, 57(suppl 4): iv99-iv107.
22. 李敏, 梁翼, 余文景, 等. 鹽酸氨基葡萄糖聯合雙醋瑞因在伴骨髓水腫的膝骨關節炎的療效評估. 華西醫學, 2012, 27(12): 1764-1767.

West China Medical Journal

Study on the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, dickkopf-1, sclerostin

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