New developments in osteoarthritis. Sex differences in magnetic resonance imaging-based biomarkers and in those of joint metabolism

Maleki-Fischbach, Mehrnaz; Jordan, Joanne M.

doi:10.1186/ar3091

Cited by 44 publications

(43 citation statements)

References 69 publications

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“…These sex differences also were found prior to the onset of radiographic knee OA (TFOA KL grade <2) and were present regardless of adjustment for covariates in knees without PF or TFOA. Indeed, Maleki-Fischbach and Jordan 26 suggested that more studies need to specifically examine sex differences in various assessments of OA, and whether risk factors for OA act similarly in both men and women, rather than simply controlling for sex.…”

Section: Discussionmentioning

confidence: 99%

Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

Glass

Segal

Sluka

et al. 2014

Osteoarthritis and Cartilage

105

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Objective To determine whether women experience greater knee pain severity than men at equivalent levels of radiographic knee osteoarthritis (OA). Design and Methods A cross-sectional analysis of 2712 individuals (60% women) without knee replacement or a recent steroid injection. Sex differences in pain severity at each KL grade were assessed by knee using VAS scale and WOMAC with and without adjustment for age, analgesic use, BMI, clinic site, comorbid conditions, depression score, education, race, and widespread pain (WSP) using generalized estimating equations. Effect sizes (Cohen’s d) were also calculated. Analyses were repeated in those with and without patellofemoral OA (PFOA). Results Women reported higher VAS pain at all KL grades in unadjusted analyses (d=0.21–0.31, p<0.0001–0.0038) and in analyses adjusted for all covariates except WSP (d=0.16–0.22, p<0.0001–0.0472). Pain severity differences further decreased with adjustment for WSP (d=0.10–0.18) and were significant for KL grade ≤2 (p=0.0015) and 2 (p=0.0200). Presence compared with absence of WSP was associated with significantly greater knee pain at all KL grades (d=0.32–0.52, p<0.0001–0.0008). In knees with PFOA, VAS pain severity sex differences were greater at each KL grade (d=0.45–0.62, p=0.0006–0.0030) and remained significant for all KL grades in adjusted analyses (d=0.31–0.57, p=0.0013–0.0361). Results using WOMAC were similar. Conclusions Women reported greater knee pain than men regardless of KL grade, though effect sizes were generally small. These differences increased in the presence of PFOA. The strong contribution of WSP to sex differences in knee pain suggests that central sensitivity plays a role in these differences.

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Section: Discussionmentioning

confidence: 99%

Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

Glass

Segal

Sluka

et al. 2014

Osteoarthritis and Cartilage

105

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“…30 A review of sex differences in MRI features of OA and biomarkers of joint metabolism noted variable findings. 31 Women may have thinner and more reduced volume of knee cartilage than men (even after taking into account differences in height, weight, and bone size), whether women have a more accelerated rate of cartilage volume loss than men is not clear.…”

Section: Risk Factors For Radiographic Oamentioning

confidence: 99%

Epidemiology of Osteoarthritis

Neogi¹,

Zhang²

2013

Rheumatic Disease Clinics of North America

562

421

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Osteoarthritis (OA) is the most common form of arthritis in the US, and a leading cause of disability. It is typically defined in epidemiologic studies on the basis of radiographic findings and consideration of symptoms. Its incidence and prevalence are rising, likely related to the aging of the population and increasing obesity. Risk factors for OA include a number of person-level factors, such as age, sex, obesity, and genetics, as well as joint-specific factors that are likely reflective of abnormal loading of the joints. A number of methodologic challenges exist in studying OA that can hamper our ability to identify pertinent relationships.

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“…A gender dimorphism exists for the impact of OA on pain and quality of life such that women report higher levels of pain and greater reductions in quality of life than men 14,15 . A review of magnetic resonance imaging (MRI) comparisons of men and women highlights variability in findings but concludes that women appear to have lower knee cartilage volume than men 16 . Despite similar KL grades, as compared to men, women exhibit higher levels of the bone resorption biomarker, serum C-terminal telopeptide of collage type I (CTX-I), and the cartilage degradation biomarker, urine C-terminal telopeptide of collage type II (CTX-II) 17 .…”

mentioning

confidence: 99%

“…Despite similar KL grades, as compared to men, women exhibit higher levels of the bone resorption biomarker, serum C-terminal telopeptide of collage type I (CTX-I), and the cartilage degradation biomarker, urine C-terminal telopeptide of collage type II (CTX-II) 17 . In contrast, men exhibit higher levels of serum hyaluronan (HA), an indicator of synovial inflammation suggesting gender-specific pathogenic mechanisms 16 . Gender differences in OA have been attributed to differences in sex hormones, as lower levels of estradiol and its catabolic metabolite, urinary 2-hydroxyestrone are associated with the development of knee OA 18 .…”

mentioning

confidence: 99%