High-Density Lipoprotein Cholesterol and Apolipoprotein A1 in Synovial Fluid: Potential Predictors of Disease Severity of Primary Knee Osteoarthritis

Abstract

Objectives The aim of this study was to detect levels of common lipid species in serum and synovial fluid (SF) of primary knee osteoarthritis (OA) patients and investigate their correlations with disease severity. Materials and Methods The study enrolled 184 OA patients receiving arthroscopic debridement or total knee arthroplasty and 180 healthy controls between April 2012 and March 2018. Total triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB) levels were analyzed in serum and SF of OA patients, and in serum of healthy individuals. The Noyes rating criteria, Kellgren-Lawrence (KL) grading system, and Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores were, respectively, used to assess cartilage damage, radiographic severity, and symptomatic severity of OA. Results No significant differences were found in serum TG and ApoB levels between the 2 groups, while OA patients had higher TC and LDL-C levels and lower HDL-C and ApoA1 levels ( P < 0.05). Pearson correlation analysis revealed SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage scores, KL grades as well as WOMAC scores ( P < 0.05), which were still significant after adjusting for confounding factors ( P < 0.05). Receiver operating characteristic curve analysis revealed SF HDL-C (area under the curve [AUC]: 0.816) and ApoA1 (AUC: 0.793) were also good predictors of advanced-stage OA ( P < 0.001). Conclusion SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage, radiographic severity, and symptomatic severity of primary knee OA, emerging as potential biomarkers for radiographic advanced-stage OA, which may serve as predictors of disease severity.

Vitamin D Metabolic Pathway Components in Orthopedic Patientes—Systematic Review

“…However, after lipid adjustment, the concentrations were similar to the baseline values. Similar studies were conducted by Zhang et al (2021) [ 23 ] who analyzed both high-density lipoprotein cholesterol and apolipoprotein A1 in the synovial fluid as potential prognostic factors for the severity of primary osteoarthritis of the knee. The study included 184 patients with osteoarthritis who received arthroscopic debridement or total knee arthroplasty, and 180 healthy controls.…”

“…Any significant differences were not determined in serum TG and ApoB concentrations between both groups, while primary knee osteoarthritis patients had higher TC and LDL-C levels, and lower HDL-C and ApoA1 levels ( p < 0.05). HDL-C and ApoA1 levels in synovial fluid were negatively correlated with cartilage damage, radiographic severity, and symptomatic severity of primary knee OA; therefore, the authors suggest that these factors be considered potential biological markers [ 23 ].…”

Effect of blood lipids and lipid-lowering therapies on osteoarthritis risk: A Mendelian randomization study

“…Interestingly, administration of atorvastatin can suppress the development of both OA and atherosclerosis, whereas ezetimibe only has an effect on atherosclerosis. It was found that lipid deposits in osteoarthritic cartilage and chondrocytes at an early stage of OA, which may trigger the development of OA (32). In addition, oxidized LDL participates in cartilage destruction by activating synovial cells, thereby promoting the release of growth factors and proinflammatory cytokines (30).…”

The effect of pentosan polysulfate sodium for improving dyslipidaemia and knee pain in people with knee osteoarthritis: A pilot study

“…Although the exact mechanism of dyslipidemia in the pathogenesis of OA is still missing, the hypothesis is that lipid deposition in the joint may trigger OA development, on the basis of findings that substantial lipid deposits in osteoarthritic cartilage and chondrocytes at an early stage of OA before apparent histological changes [ 20 ]. Also, higher total and non-HDL cholesterol were associated with increased cartilage degeneration [ 21 ].…”