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Common valgus malalignment and high prevalence of lateral compartmental radiographic knee OA: The Wuchuan OA Study
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Abstracts / Osteoarthritis and Cartilage 24 (2016) S63eS534
(continued )
FEMALES e model 1 (Constant) Hypertension Dyslipidaemia Diabetes/IFG BMI (per unit increase) FEMALES e model 2 (Constant) No. metabolic factors FEMALES e model 3 (Constant) Metabolic syndrome
n
Unstandardised b
Unstandardised b 95% CI
P value
435
8.1 0.7 0.4 0.5 <0.1
3.1; 1.1; 2.4; 2.4; 0.2;
0.156 0.439 0.699 0.741 0.793
435
8.7 0.1
1.20; 18.5 0.7; 1.0
0.084 0.721
435
8.7 0.6
1.2; 18.5 1.8; 3.1
0.084 0.614
19.3 2.6 1.6 3.3 0.2
343 COMMON VALGUS MALALIGNMENT AND HIGH PREVALENCE OF LATERAL COMPARTMENTAL RADIOGRAPHIC KNEE OA: THE WUCHUAN OA STUDY B. Wang, Sr., Q. Liu, Y. Ke, Y. Xu, J. Lin. Peking Univ. People's Hosp., Beijing, China Purpose: Proportion of lateral compartment of knee OA to medial compartmental knee OA is higher in Chinese population than that in Whites in Framingham. Valgus alignment is strongly associated with lateral compartment of knee OA whereas varus is strongly associated with medial compartmental knee OA. We compared the relative prevalence of valgus malalignment in Chinese with that in Netherland where Whites are in the majority and evaluated relation of knee malalignment with medial and lateral compartmental knee OA. Methods: Wuchuan OA Study is a longitudinal study of risk factors for knee OA among participants >50 years in Wuchuan, China. At the baseline and follow-up visits participants had home interview, clinical examination and standard weight-bearing posteroanterior semi-flexed view of radiographs at tibiofemoral (TF) joints. One reader assessed radiographic knee OA using Framingham OA Study Atlas. (Kappa¼0.80). A knee was defined as having medial or lateral compartmental ROA, respectively, if it had a K/L grade 2 and joint space narrowing (1, 0e3) in medial or lateral compartments. Knee alignment was measured using anatomic axis (ICC¼0.92) as Rotterdam study mentioned and grouped into three categories: normal alignment (1820 and 1840), valgus (>1840), and varus (<1820). We examined the association of knee alignment categories and medial and lateral knee ROA separately using multiple logistic regression adjusting for age, gender, body mass index (BMI), education, annual income and levels of physical activity. Results: Of 1030 participants (2060 knees) included in this analysis, 55% (n¼566) were women, mean age was 59.4 (SD¼8.6) years, mean tibiofemoral angle was 184.40 (SD¼3.7) and mean BMI 23.2 kg/m2 (SD¼3.6). 282 (13.7%) knees had varus alignment, and 615(29.9%) knees had normal alignment. The relative proportion of valgus alignment in Wuchuan is 56.5% compared to 35.9% in Rotterdam. The prevalence of medial compartmental ROA was 18.4% in women and 13.1% in men, and the corresponding prevalence of lateral compartmental ROA was 6.0% and 2.5%, respectively. When compared with Framingham cohort age from 59e90 years, the prevalence of medial compartmental ROA in Wuchuan women and men was much higher to 29.3% and 17.3%, and the prevalence of lateral compartmental ROA was 7.0% and 2.4% respectively. Valgus alignment was associated with higher prevalence of lateral compartmental ROA (OR¼5.0, 95% CI: 2.4e10.6), while the association of valgus alignment with medial compartment of knee OA is low (OR¼0.3, 95% CI: 0.2e0.4) Conclusions: Prevalence of common valgus alignment of Wuchuan cohort was relatively high compared with Rotterdam where Whites are in the majority and was strongly associated with lateral compartment knee ROA which may explain why the lateral compartment of knee OA to medial compartmental knee OA is higher in Chinese population than that in Whites in Framingham.
344 MITOCHONDRIAL DNA(MTDNA)HAPLOGROUPS AND RADIOGRAPHIC OSTEOARTHRITIS PROGRESSION. A META-ANALYSIS ndez-Moreno, Sr. y, I. Rego-Perez, Sr. y, A. Soto-Hermida y, M. Ferna ndez-Mosquera, Jr. y, E. Corte s-Pereira, Jr. y, S. Relan ~ o y, M. Ferna rtega z, N. Oreiro-Villar y, C. Ferna ndez-Lo pez y, F.J. Blanco y. S. Pe y n Biom ~a Servicio de Reumatología, Inst. de Investigacio edica de A Corun ~ a (CHUAC), Sergas. (INIBIC), Complexo Hosp.ario Univ.rio de A Corun ~ a (UDC), A Corun ~ a, Spain; z Unidad de Epidemilogía Univ.e da Corun n Biom ~a Clínica y Bioestadística, Inst. de Investigacio edica de A Corun ~ a (CHUAC), Sergas. (INIBIC), Complexo Hosp.ario Univ.rio de A Corun ~ a (UDC), A Corun ~ a, Spain Univ.e da Corun Purpose: During the last years several studies suggested an active role of the mtDNA haplogroups not only in the prevalence of OA but also in the radiographic progression of this disease. We aimed to perform a meta-analysis to investigate the association between the mtDNA haplogroups and the risk of radiographic progression of the Osteoarthritis Methods: For this work we collected published and personal data involving the study of the mtDNA haplogroups in the radiographic progression of OA in terms of KL grade. We used the results from one Spanish cohort (PROCOAC), the CHECK cohort and the OAI cohort. Metaanalysis was carried out using the R software program (2.15.0) using the meta package. Combined effect was estimated using a random-effects model using hazard ratios (HR) with 95% confidence interval (CI) as the outcome variable. Results: A total of 3 studies involving 1603 OA patients (progressors and non-progressors) were taken into account. All the studies were based on the analysis of the mtDNA cluster TJ and the risk of radiographic progression. The results of this meta-analysis showed a significant association with a lower risk of radiographic OA progression for the mtDNA cluster TJ when compared with both the mtDNA cluster HV (HR¼1,3063; 95% CI¼1,0673e1,5989; p-value¼0.0096) and the mtDNA cluster KU (HR¼1,3359; 95% CI¼1,065e1,6757; p-value¼0.00123) considering the three cohorts combined (Figures 1 and 2). Conclusions: The mtDNA haplogroups of the cluster TJ correlate with a lower risk of radiographic disease progression in terms of KL grade. The mitochondrial polymorphisms of this mtDNA cluster could be considered as potential complementary genetic biomarkers to predict the risk of radiographic OA progression.
Figure 1. Forest plot showing the comparison between the mtDNA cluster HV and TJ on the risk of radiographic OA progression.
Abstracts / Osteoarthritis and Cartilage 24 (2016) S63eS534
(continued )
FEMALES e model 1 (Constant) Hypertension Dyslipidaemia Diabetes/IFG BMI (per unit increase) FEMALES e model 2 (Constant) No. metabolic factors FEMALES e model 3 (Constant) Metabolic syndrome
n
Unstandardised b
Unstandardised b 95% CI
P value
435
8.1 0.7 0.4 0.5 <0.1
3.1; 1.1; 2.4; 2.4; 0.2;
0.156 0.439 0.699 0.741 0.793
435
8.7 0.1
1.20; 18.5 0.7; 1.0
0.084 0.721
435
8.7 0.6
1.2; 18.5 1.8; 3.1
0.084 0.614
19.3 2.6 1.6 3.3 0.2
343 COMMON VALGUS MALALIGNMENT AND HIGH PREVALENCE OF LATERAL COMPARTMENTAL RADIOGRAPHIC KNEE OA: THE WUCHUAN OA STUDY B. Wang, Sr., Q. Liu, Y. Ke, Y. Xu, J. Lin. Peking Univ. People's Hosp., Beijing, China Purpose: Proportion of lateral compartment of knee OA to medial compartmental knee OA is higher in Chinese population than that in Whites in Framingham. Valgus alignment is strongly associated with lateral compartment of knee OA whereas varus is strongly associated with medial compartmental knee OA. We compared the relative prevalence of valgus malalignment in Chinese with that in Netherland where Whites are in the majority and evaluated relation of knee malalignment with medial and lateral compartmental knee OA. Methods: Wuchuan OA Study is a longitudinal study of risk factors for knee OA among participants >50 years in Wuchuan, China. At the baseline and follow-up visits participants had home interview, clinical examination and standard weight-bearing posteroanterior semi-flexed view of radiographs at tibiofemoral (TF) joints. One reader assessed radiographic knee OA using Framingham OA Study Atlas. (Kappa¼0.80). A knee was defined as having medial or lateral compartmental ROA, respectively, if it had a K/L grade 2 and joint space narrowing (1, 0e3) in medial or lateral compartments. Knee alignment was measured using anatomic axis (ICC¼0.92) as Rotterdam study mentioned and grouped into three categories: normal alignment (1820 and 1840), valgus (>1840), and varus (<1820). We examined the association of knee alignment categories and medial and lateral knee ROA separately using multiple logistic regression adjusting for age, gender, body mass index (BMI), education, annual income and levels of physical activity. Results: Of 1030 participants (2060 knees) included in this analysis, 55% (n¼566) were women, mean age was 59.4 (SD¼8.6) years, mean tibiofemoral angle was 184.40 (SD¼3.7) and mean BMI 23.2 kg/m2 (SD¼3.6). 282 (13.7%) knees had varus alignment, and 615(29.9%) knees had normal alignment. The relative proportion of valgus alignment in Wuchuan is 56.5% compared to 35.9% in Rotterdam. The prevalence of medial compartmental ROA was 18.4% in women and 13.1% in men, and the corresponding prevalence of lateral compartmental ROA was 6.0% and 2.5%, respectively. When compared with Framingham cohort age from 59e90 years, the prevalence of medial compartmental ROA in Wuchuan women and men was much higher to 29.3% and 17.3%, and the prevalence of lateral compartmental ROA was 7.0% and 2.4% respectively. Valgus alignment was associated with higher prevalence of lateral compartmental ROA (OR¼5.0, 95% CI: 2.4e10.6), while the association of valgus alignment with medial compartment of knee OA is low (OR¼0.3, 95% CI: 0.2e0.4) Conclusions: Prevalence of common valgus alignment of Wuchuan cohort was relatively high compared with Rotterdam where Whites are in the majority and was strongly associated with lateral compartment knee ROA which may explain why the lateral compartment of knee OA to medial compartmental knee OA is higher in Chinese population than that in Whites in Framingham.
344 MITOCHONDRIAL DNA(MTDNA)HAPLOGROUPS AND RADIOGRAPHIC OSTEOARTHRITIS PROGRESSION. A META-ANALYSIS ndez-Moreno, Sr. y, I. Rego-Perez, Sr. y, A. Soto-Hermida y, M. Ferna ndez-Mosquera, Jr. y, E. Corte s-Pereira, Jr. y, S. Relan ~ o y, M. Ferna rtega z, N. Oreiro-Villar y, C. Ferna ndez-Lo pez y, F.J. Blanco y. S. Pe y n Biom ~a Servicio de Reumatología, Inst. de Investigacio edica de A Corun ~ a (CHUAC), Sergas. (INIBIC), Complexo Hosp.ario Univ.rio de A Corun ~ a (UDC), A Corun ~ a, Spain; z Unidad de Epidemilogía Univ.e da Corun n Biom ~a Clínica y Bioestadística, Inst. de Investigacio edica de A Corun ~ a (CHUAC), Sergas. (INIBIC), Complexo Hosp.ario Univ.rio de A Corun ~ a (UDC), A Corun ~ a, Spain Univ.e da Corun Purpose: During the last years several studies suggested an active role of the mtDNA haplogroups not only in the prevalence of OA but also in the radiographic progression of this disease. We aimed to perform a meta-analysis to investigate the association between the mtDNA haplogroups and the risk of radiographic progression of the Osteoarthritis Methods: For this work we collected published and personal data involving the study of the mtDNA haplogroups in the radiographic progression of OA in terms of KL grade. We used the results from one Spanish cohort (PROCOAC), the CHECK cohort and the OAI cohort. Metaanalysis was carried out using the R software program (2.15.0) using the meta package. Combined effect was estimated using a random-effects model using hazard ratios (HR) with 95% confidence interval (CI) as the outcome variable. Results: A total of 3 studies involving 1603 OA patients (progressors and non-progressors) were taken into account. All the studies were based on the analysis of the mtDNA cluster TJ and the risk of radiographic progression. The results of this meta-analysis showed a significant association with a lower risk of radiographic OA progression for the mtDNA cluster TJ when compared with both the mtDNA cluster HV (HR¼1,3063; 95% CI¼1,0673e1,5989; p-value¼0.0096) and the mtDNA cluster KU (HR¼1,3359; 95% CI¼1,065e1,6757; p-value¼0.00123) considering the three cohorts combined (Figures 1 and 2). Conclusions: The mtDNA haplogroups of the cluster TJ correlate with a lower risk of radiographic disease progression in terms of KL grade. The mitochondrial polymorphisms of this mtDNA cluster could be considered as potential complementary genetic biomarkers to predict the risk of radiographic OA progression.
Figure 1. Forest plot showing the comparison between the mtDNA cluster HV and TJ on the risk of radiographic OA progression.