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. 2013 Dec;65(12):1942-50.
doi: 10.1002/acr.22093.

Association of metabolic risk factors with cartilage degradation assessed by T2 relaxation time at the knee: data from the osteoarthritis initiative

P M Jungmann  1 , M S Kraus, H Alizai, L Nardo, T Baum, M C Nevitt, C E McCulloch, G B Joseph, J A Lynch, T M Link
Affiliations

Association of metabolic risk factors with cartilage degradation assessed by T2 relaxation time at the knee: data from the osteoarthritis initiative

P M Jungmann et al. Arthritis Care Res (Hoboken). 2013 Dec.

Abstract

Objective: To evaluate the association of metabolic risk factors with severity and 2-year progression of early degenerative cartilage changes at the knee, measured with T2 relaxation times in middle-aged subjects from the Osteoarthritis Initiative.

Methods: Cartilage segmentation and T2 map generation were performed in knee 3T magnetic resonance images from 403 subjects ages 45-60 years without radiographic osteoarthritis (OA). The influence of risk factors on baseline T2 and longitudinal progression of T2 was analyzed using linear regression, adjusting for age, sex, and other OA risk factors.

Results: Four metabolic risk factors, i.e., high abdominal circumference (P < 0.001), hypertension (P = 0.041), high fat consumption (P = 0.023), and self-reported diabetes mellitus (P = 0.010), were individually associated with higher baseline T2. When the 4 metabolic risk factors were considered in a multivariate regression model, higher T2 remained significantly associated with abdominal circumference (P < 0.001) and diabetes mellitus (P = 0.026), and there was a trend for high fat consumption (P = 0.096). For the individual risk factors, only diabetes mellitus remained associated with higher baseline T2 after adjustment for body mass index (BMI). After adjustment for BMI, baseline T2 increased in a dose-response manner with the number of metabolic risk factors present (P = 0.032 for linear trend), and subjects with ≥3 metabolic factors (versus <3) had significantly higher baseline T2 (mean difference 1.2 msec [95% confidence interval 0.3, 2.1]; P = 0.011). Metabolic risk factors were not significantly associated with increases in T2 during followup.

Conclusion: Metabolic risk factors are associated with higher T2, suggesting that increased cartilage degeneration may be caused by modifiable metabolic disorders.

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Conflict of interest statement

Conflict of Interest:

There is no conflict of interest for any of the authors.

Figures

Figure 1
Figure 1
Flow-chart of the selected subjects from the OAI.
Figure 2
Figure 2
A: Adjusted mean baseline global T2 relaxation times (ms; ±SEM) for subgroups with increasing numbers of metabolic risk factors (0–4), adjusted for other OA risk factors and a continuous measure of BMI. T2 increased stepwise with increasing number of metabolic risk factors from 32.8±0.2ms for none to 36.3±2.0ms for four risk factors. For the number of metabolic risk factors present, (0–4), P<0.001 without adjustment for BMI and P=0.032 with adjustment for BMI. Other OA risk factors are age, gender, Herbeden’s nodes, family history of joint replacement, previous knee surgery and previous knee injury. Underneath representative cartilage T2 color maps overlaid on the first-echo images of the MSME sequence of each group. Blue color indicates low, red color high cartilage T2. Subjects without any metabolic risk factor showed lower T2 than subjects with metabolic risk factors in an increasing manner. B: Progression of T2 relaxation times (%; ±SEM) over two years for subgroups with increasing numbers of metabolic risk factors. Analyses as described for A. For the number of metabolic risk factors present, (0–4), P<0.071 without adjustment for BMI and P=0.191 with adjustment for BMI.
See this image and copyright information in PMC

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