Objectives
The aim of this study was to identify biomarkers for radiographic osteoarthritis severity and progression acting within the inflammation and metabolic pathways.
Methods
For 3,517 Rotterdam Study participants, 184 plasma protein levels were measured using Olink inflammation and cardiometabolic panels. We studied associations with severity and progression of knee, hip, hand osteoarthritis, and a composite overall OA burden-score by multivariable regression models, adjusting for age, sex, cell counts and BMI.
Results
We found 18 significantly associated proteins for overall osteoarthritis burden, of which 5 stayed significant after multiple testing correction: circulating Cartilage acidic protein 1 (CRTAC1), Cartilage oligomeric matrix protein (COMP), Thrombospondin 4 (THBS4), Interleukin 18 receptor 1 (IL18R1) and Tumor necrosis factor ligand superfamily member 14 (TNFSF14). These proteins were also associated with progression of knee OA, with the exception of IL18R1. The strongest association was found for the level of CRTAC1 with 1 SD increase in protein level resulting in an increase of 0.09 (95%CI : 0.06–0.12) in overall osteoarthritis KLsum-score (p= 2.9x10−8), in the model adjusted for age, sex, BMI and cell counts. This association was also present with severity of osteoarthritis in all three joints, progression of knee osteoarthritis and was independent of BMI. We observed a stronger association for CRTAC1 with osteoarthritis than for the well-known osteoarthritis-biomarker COMP.
Conclusion
We identified several compelling biomarkers reflecting overall osteoarthritis burden and increased risk for osteoarthritis progression. CRTAC1 was the most compelling and robust biomarker for osteoarthritis severity and progression. Such a biomarker may be used for disease monitoring.