Vascular cell adhesion molecule 1 as a predictor of severe osteoarthritis of the hip and knee joints

Abstract

Objective. Osteoarthritis (OA) is a leading cause of pain and physical disability in middle-aged and older individuals. We undertook this study to determine predictors of the development of severe OA, apart from age and overweight.Methods. Joint replacement surgery due to severe hip or knee OA was recorded over a 15-year period in the prospective Bruneck cohort study. Demographic characteristics and lifestyle and biochemical variables, including the level of soluble vascular cell adhesion molecule 1 (VCAM-1), were assessed at the 1990 baseline visit and tested as predictors of joint replacement surgery.Results. Between 1990 and 2005, hip or knee joint replacement due to OA was performed in 60 subjects. VCAM-1 level emerged as a highly significant predictor of the risk of joint replacement surgery. Intervention rates were 1.9, 4.2, and 10.1 per 1,000 person-years in the first, second, and third tertiles, of the VCAM-1 level, respectively. In multivariable logistic regression analysis, the adjusted relative risk of joint replacement surgery in the highest versus the lowest tertile group of VCAM-1 level was 3.9 (95% confidence interval 1.7-8.7) (P < 0.001). Findings were robust in various sensitivity analyses and were consistent in subgroups. Addition of the VCAM-1 level to a risk model already including age, sex, and body mass index resulted in significant gains in model discrimination (C statistic) and calibration and in more accurate risk classification of individual participants.Conclusion. The level of soluble VCAM-1 emerged as a strong and independent predictor of the risk of hip and knee joint replacement due to severe OA. If our findings can be reproduced in other epidemiologic cohorts, they will assist in routine risk classification and will contribute to a better understanding of the etiology of OA.

Disabling Hip Osteoarthritis and Cardiovascular Pathology: Presence and Impact

“…In accord with other emerging data that vascular pathology may play a role in the pathogenesis of osteoarthritis [26], adults with hip osteoarthritis disability and one or more comorbid vascular health conditions studied here were more disabled than those without vascular pathology. In addition, many of these cases had higher body mass indices on average than those with no comorbid cardiovascular health condition.…”

“…Other research similarly emphasizes the importance of early detection and secondary prevention of all cardiovascular problems, to prevent future worsening of activity limitations [2], huge additional medical costs [17] and based on early studies, the risk for developing osteoarthritis [21][See Fig. 1 [30] Moreover, if the level of soluble vascular cell adhesion molecule (VCAM-1) is a possible predictor of severe hip osteoarthritis, and atherosclerosis and thrombosis as well as inflammation [26], sub groups with a high level of this factor might be selectively targeted. In the interim, it is recognized that the present cohort may not represent all cases with condition; not all data were available or complete; and the use of chart reviews to explore temporal trends and interactions and understand mediating or moderating factors influencing hip osteoarthritis disability may not be without limitations.…”

What Is the Utility of Biomarkers for Assessing the Pathophysiology of Hip Osteoarthritis? A Systematic Review

“…Eleven ''progression'' studies [7-9, 15, 17, 24, 29, 30, 35, 37, 39] investigated the association of 13 different biomarker levels with the progression of hip OA. Of the 11 studies, four looked at progression of known hip OA [9,15,37,39]; three studies investigated the progression to incident hip OA from unspecified prearthritic hip disease [8,17,29]; and four studies investigated both OA progression and incidence [7,24,30,35]. Duration of followup to evaluate OA progression ranged from 1 year to 15 years.…”

Role of Soluble Vascular Cell Adhesion Molecule-1 in Knee Osteoarthritis among Postmenopausal Women

“…[21] Other studies also reported the elevated level of soluble VCAM-1 in serum of patients with osteoarthritis. [22][23][24] In joints, VCAM-1 is expressed by microvascular endothelial cells, synovial fibroblasts, and chondrocytes. [25] It is not appreciably expressed on resting vascular endothelium but is rapidly induced in response to a number of inflammatory stimuli, such as TNF-a, IL-1β.…”