Association of Cross Linked C-Telopeptide II Collagen and Hyaluronic Acid with Knee Osteoarthritis Severity

John Butar Butar, Zola Wijayanti, Beatrix Tjahyana, Veli Sunggono, Hori Hariyanto

Abstract


BACKGROUND: This study was carried out to investigate the association of Cross Linked C-Telopeptide Type I & II Collagen (CTX-I and II) and hyaluronic acid (HA) with knee osteoarthritis (OA) severity.

METHODS: Sixty menopause women with primary knee OA were enrolled in this study during their visits to the Outpatient Department. Patients with knee pain during weight bearing, active or passive range of motion, or tenderness with Kellgren-Lawrence (KL) grade of more than I were included. Patients with injury, inflammatory and metabolic diseases were excluded. Patients were put in a 10-hour fasting prior to withdrawal of morning blood samples for examinations of HA, CTX-I, interleukin 1 beta (IL-1β), and high sensitivity C reactive protein (hs-CRP) level. Second void morning urine specimens were taken for CTXII assessment. HA, CTX-I and II levels were measured by enzyme-linked immunosorbent assay.

RESULTS: Sixty menopausal female patients were included in this study, 35 with KL grade II, 17 grade III, and 8 grade IV. Means of CTX-II were significantly different between subjects KL grade IV and III (p=0.021). Correlation of KL grade was significant with CTX-II (p=0.001, r=0.412) and HA (p=0.0411, r=0.269). KL grades were not significantly associated with CTX-I (p=0.8364, r=-0.0272); IL-1β (p=0.5773, r=0.0853) and hs-CRP (p=0.2625, r=0.1470).

CONCLUSION: CTX-II and HA were associated with severity of knee OA, suggesting that CTX-II and HA can be used as marker for knee OA severity.

KEYWORDS: CTX-II, hyaluronic acid, otestoarthritis, knee


Full Text:

PDF

References


Abramson SB, Attur M. Developments in the scientific understanding of osteoarthritis. Arthritis Res Ther. 2009; 11: 227, CrossRef.

Meulenbelt I, Kloppenburg M, Kroon HM, Houwing-Duistermaat JJ, Garnero P, Hellio Le Graverand MP, et al. Urinary CTX-II levels are associated with radiographic subtypes of osteoarthritis in hip, knee, hand, and facet joints in subject with familial osteoarthritis at multiple sites: the GARP study. Ann Rheum Dis. 2006; 65: 360-5, CrossRef.

Patra D, Sandell LJ. Recent advances in biomarkers in osteoarthritis. Curr Opin Rheumatol. 2011; 23: 465-70, CrossRef.

Cibere J, Zhang H, Garnero P, Poole AR, Lobanok T, Saxne T, et al. Association of biomarkers with pre-radiographically defined and radiographically defined knee osteoarthritis in a population based study. Arthritis Rheum. 2009; 60: 1372-80, CrossRef.

Solignac M. Biological markers for osteoarthritis: data from the ECHODIAH cohort. Presse Med. 2004; 33: 13-5, PMID.

Jordan KM, Syddall HE, Garnero P, Gineyts E, Dennison EM, Sayer AA, et al. Urinary CTX-II and glucosyl-galactosyl-pyridinoline are associated with the presence and severity of radiographic knee osteoarthritis in men. Ann Rheum Dis. 2006; 65: 871-7, CrossRef.

Goldberg RL, Huff JP, Lenz ME, Glickman P, Katz R, Thonar EJ. Elevated plasma levels of hyaluronate in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum. 1991; 34: 799-807, CrossRef.

Hedin PJ, Weitoft T, Hedin H, Engström-Laurent A, Saxne T. Serum concentrations of hyaluronan and proteoglycan in joint disease. J Rheumatol. 1991; 18: 1601-5, PMID.

Sharif M, George E, Shepstone L, Knudson W, Thonar EJ, Cushnaghan J, et al. Serum hyaluronic acid level as a predictor of disease progression in osteoarthritis of the knee. Arthritis Rheum. 1995; 38(6): 760-7, CrossRef.

Nagaya H, Ymagata T, Ymagata S, Iyoda K, Ito H, Hasegawa Y, et al. Examination of synovial fluid and serum hyaluronidase activity as a joint marker in rheumatoid arthritis and osteoarthritis patients (by zymography). Ann Rheum Dis. 1999; 58: 186-8, CrossRef.

Pavelka K, Forejtová S, Olejárová M, Gatterová J, Senolt L, Spacek P, et al. Hyaluronic acid levels may have predictive value for the progression of knee osteoarthritis. Osteoarthritis Cartilage. 2004; 12: 277-83, CrossRef.

Jung YO, Do JH, Kang HJ, Yoo SA, Yoon CH, Kim HA, et al. Correlation of sonographic severity with biochemical markers of synovium and cartilage in knee osteoarthritis patients. Clin Exp Rheumatol. 2006; 24: 253-9, PMID.

Anitua E, Sanchez M, de la Fuente M, Azofra J, Zalduendo M, Aquirre JJ, et al. Relationship between investigative biomarkers and radiographic grading in patients with knee osteoarthritis. Int J Rheumatol. 2009; 2009: 747432, CrossRef.

Inoue R, Ishibashi Y, Tsuda E, Yamamoto Y, Matsuzaka M, Takahashi I, et al. Knee osteoarthritis, knee joint pain and aging in relation to increasing serum hyaluronan level in the Japanese population. Osteoarthritis Cartilage. 2011; 19: 51-7, CrossRef.

Golightly YM, Marshall SW, Kraus VB, Renner JB, Villaveces A, Casteel C, et al. Biomarkers of incident radiographic knee osteoarthritis: do they vary by chronic knee symptoms? Arthritis Rheum. 2011; 63: 2276-83, CrossRef.

Kalai E, Bahlous A, Charni N, Bouzid K, Sahli H, Chelly N, et al. Increased urinary type II collagen C-telopeptide levels in Tunisian patients with knee osteoarthritis. Clin Lab. 2012; 58: 209-15, PMID.

Criscione LG, Elliot AL, Stabler T, Jordan JM, Pieper CF, Kraus VB. Variation of serum hyaluronan with activity in individuals with knee osteoarthritis. Osteoarthritis Cartilage. 2005; 13: 837-40, CrossRef.

Kong SY, Stabler TV, Criscione LG, Elliott AL, Jordan JM, Kraus VB. Diurnal variation of serum and urine biomarkers in patients with radiographic knee osteoarthritis. Arthritis Rheum. 2006; 54: 2496-504, CrossRef.

Madan-Sharma R, Kloppenburg M, Kornaat PR, Botha-Scheepers SA, Le Graverand MP, Bloem JL, et al. Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later? Skeletal Radiol. 2008; 37: 805-11, CrossRef.

Bauer DC, Haunter DJ, Abramson SB, Attur M, Corr M, Felson D, et al. Classification of osteoarthritis biomarkers: a proposed approach. Osteoarthritis and Cartilage. 2006; 14: 723-7, CrossRef.

Rousseau JCh, Garnero P. Biological markers in osteoarthritis. Bone. 2012; 51: 265-77, CrossRef.

Christgau S, Garnero P, Fledelius C, Moniz C, Ensig M, Gineyts E, et al. Collagen type II C-telopeptide fragments as an index of cartilage degradation. Bone. 2001; 29: 209-15, CrossRef.

Reijman M, Hazes JM, Bierma-Zeinstra SM, Koes BW, Christgau S, Christiansen C, et al. A new marker for osteoarthritis: crosssectional and longitudinal approach. Arthritis Rheum. 2004; 50: 2471-8, CrossRef.

Kong SY, Stabler TV, Criscione LG, Elliott AL, Jordan JM, Kraus VB. Diurnal variation of serum and urine biomarkers in patients with radiographic knee osteoarthritis. Arthritis Rheum. 2006; 54: 2496- 504, CrossRef.

van Spil WE, Jansen NW, Bijlsma JW, Reijman M, DeGroof J, Welsing PM, et al. Clusters within a wide spectrum of biochemical markers for osteoarthritis: data from CHECK, a large cohort of individuals with very early symptomatic osteoarthritis. Osteoarthritis Cartilage. 2012; 20: 745-54, CrossRef.




DOI: https://doi.org/10.18585/inabj.v5i3.69

Indexed by:

                 

                  

               

     

 

The Prodia Education and Research Institute