Abstract：
OBJECTIVE: This study aimed to investigate the effect of tibial plateau (TP) inclination and serum bone metabolic markers on bone marrow lesion (BML) in the general Japanese population with early knee osteoarthritis (EKOA).
METHODS: A total of 441 female volunteers who participated in the Iwaki Health Promotion Project in 2017 were enrolled. Participants without radiographic abnormalities were divided into normal and EKOA groups according to the Luyten\'s classification criteria for EKOA. The medial proximal tibial angle (MPTA), growth plate-TP angle, and growth plate-medial tibial plateau (MTP) angle were measured on standing anteroposterior radiographs of the knees. BML severity on T2-weighted fat-suppressed magnetic resonance imaging (MRI) was scored using the Whole-Organ MRI Score method. Serum levels of N-telopeptide of type I collagen, tartrate-resistant acid phosphatase-5b (TRACP-5b), bone-specific alkaline phosphatase, procollagen type I N-terminal propeptide, pentosidine, and homocysteine were assessed. Linear regression analysis was conducted to investigate the relationship between proximal tibial inclination, BML, and serum bone metabolic markers.
RESULTS: The growth plate was observed in 309 (70%) participants, and 48 (16%) participants had EKOA. The mean MPTA, growth plate-TP angle, and growth plate-MTP angle were 86.1 ± 5.9°, 3.6 ± 1.1°, and 9.9 ± 2.6°, respectively. The MPTA was negatively correlated with the growth plate-TP and growth plate-MTP angles (p = 0.006, p < 0.001). Participants with EKOA who had BML exhibited greater growth plate-MTP angle than those who did not (p = 0.018). Regression analysis revealed that BML severity was positively associated with MPTA (p = 0.036) and a bone formation marker (p = 0.045).
CONCLUSIONS: BML severity was positively associated with proximal tibial inclination and serum TRACP-5b level in participants with EKOA and normal knees, respectively. Assessment of proximal tibial inclination may provide insight into potential BML risk. Residual medial tibial inclination may potentially result in knee pain and symptoms in EKOA.
METHODS: III.
METHODS: A total of 441 female volunteers who participated in the Iwaki Health Promotion Project in 2017 were enrolled. Participants without radiographic abnormalities were divided into normal and EKOA groups according to the Luyten\'s classification criteria for EKOA. The medial proximal tibial angle (MPTA), growth plate-TP angle, and growth plate-medial tibial plateau (MTP) angle were measured on standing anteroposterior radiographs of the knees. BML severity on T2-weighted fat-suppressed magnetic resonance imaging (MRI) was scored using the Whole-Organ MRI Score method. Serum levels of N-telopeptide of type I collagen, tartrate-resistant acid phosphatase-5b (TRACP-5b), bone-specific alkaline phosphatase, procollagen type I N-terminal propeptide, pentosidine, and homocysteine were assessed. Linear regression analysis was conducted to investigate the relationship between proximal tibial inclination, BML, and serum bone metabolic markers.
RESULTS: The growth plate was observed in 309 (70%) participants, and 48 (16%) participants had EKOA. The mean MPTA, growth plate-TP angle, and growth plate-MTP angle were 86.1 ± 5.9°, 3.6 ± 1.1°, and 9.9 ± 2.6°, respectively. The MPTA was negatively correlated with the growth plate-TP and growth plate-MTP angles (p = 0.006, p < 0.001). Participants with EKOA who had BML exhibited greater growth plate-MTP angle than those who did not (p = 0.018). Regression analysis revealed that BML severity was positively associated with MPTA (p = 0.036) and a bone formation marker (p = 0.045).
CONCLUSIONS: BML severity was positively associated with proximal tibial inclination and serum TRACP-5b level in participants with EKOA and normal knees, respectively. Assessment of proximal tibial inclination may provide insight into potential BML risk. Residual medial tibial inclination may potentially result in knee pain and symptoms in EKOA.
METHODS: III.
摘要：
目的：本研究旨在探讨胫骨平台（TP）倾斜和血清骨代谢标志物对早期膝骨关节炎（EKOA）日本普通人群骨髓损伤（BML）的影响。
方法：纳入2017年参加Iwaki健康促进项目的441名女性志愿者。根据Luyten的EKOA分类标准，将无影像学异常的参与者分为正常组和EKOA组。胫骨近端内侧角(MPTA),生长板-TP角，在膝盖的前后位X光片上测量生长板-胫骨平台内侧（MTP）角度。使用全器官MRI评分方法对T2加权脂肪抑制磁共振成像（MRI）的BML严重程度进行评分。血清Ⅰ型胶原N端肽水平,抗酒石酸酸性磷酸酶5b（TRACP-5b），骨特异性碱性磷酸酶，Ⅰ型前胶原N端前肽,戊糖苷，和高半胱氨酸进行了评估。进行线性回归分析以研究胫骨近端倾斜度之间的关系。BML,和血清骨代谢标志物。
结果：在309名（70％）参与者中观察到生长板，48名(16%)参与者患有EKOA。平均MPTA，生长板-TP角，生长板-MTP角为86.1±5.9°，3.6±1.1°,和9.9±2.6°，分别。MPTA与生长板-TP和生长板-MTP角度呈负相关(p=0.006,p<0.001)。患有BML的EKOA参与者比未患有BML的参与者表现出更大的生长板-MTP角度（p=0.018）。回归分析显示，BML严重程度与MPTA（p=0.036）和骨形成标志物（p=0.045）呈正相关。
结论：在EKOA和正常膝关节的参与者中，BML严重程度与胫骨近端倾斜度和血清TRACP-5b水平呈正相关，分别。评估胫骨近端倾斜度可以深入了解潜在的BML风险。残余的胫骨内侧倾斜可能会导致膝关节疼痛和EKOA症状。
方法：III.
方法：纳入2017年参加Iwaki健康促进项目的441名女性志愿者。根据Luyten的EKOA分类标准，将无影像学异常的参与者分为正常组和EKOA组。胫骨近端内侧角(MPTA),生长板-TP角，在膝盖的前后位X光片上测量生长板-胫骨平台内侧（MTP）角度。使用全器官MRI评分方法对T2加权脂肪抑制磁共振成像（MRI）的BML严重程度进行评分。血清Ⅰ型胶原N端肽水平,抗酒石酸酸性磷酸酶5b（TRACP-5b），骨特异性碱性磷酸酶，Ⅰ型前胶原N端前肽,戊糖苷，和高半胱氨酸进行了评估。进行线性回归分析以研究胫骨近端倾斜度之间的关系。BML,和血清骨代谢标志物。
结果：在309名（70％）参与者中观察到生长板，48名(16%)参与者患有EKOA。平均MPTA，生长板-TP角，生长板-MTP角为86.1±5.9°，3.6±1.1°,和9.9±2.6°，分别。MPTA与生长板-TP和生长板-MTP角度呈负相关(p=0.006,p<0.001)。患有BML的EKOA参与者比未患有BML的参与者表现出更大的生长板-MTP角度（p=0.018）。回归分析显示，BML严重程度与MPTA（p=0.036）和骨形成标志物（p=0.045）呈正相关。
结论：在EKOA和正常膝关节的参与者中，BML严重程度与胫骨近端倾斜度和血清TRACP-5b水平呈正相关，分别。评估胫骨近端倾斜度可以深入了解潜在的BML风险。残余的胫骨内侧倾斜可能会导致膝关节疼痛和EKOA症状。
方法：III.
