■滑膜炎长期以来被认为是骨关节炎(OA)的常见和可改变的炎症特征,但目前的改善疾病的抗炎治疗在OA临床试验中似乎无效.阐明滑膜炎与OA之间的时间关系可以深入了解滑膜炎在OA中的作用。
■我们根据湘雅骨关节炎(XO)研究的基线和三年随访数据进行了一项前瞻性队列研究。我们使用广义估计方程评估了超声检测到的滑膜炎与X线照相和有症状的OA之间的双向关联。此外,我们利用XO人群的全基因组测序数据进行了双向孟德尔随机化(MR)分析,以检验这些假设.年龄,性别,身体质量指数,吸烟,酒精消费,教育水平,身体活动,和关节损伤病史被调整为这些分析。
■共有2211、2420、2280和2600名参与者参加了影像学膝关节OA(RKOA)的分析,症状性膝关节OA(SKOA),射线照相手OA(RHOA)和有症状的手OA(SHOA),分别。基线滑膜炎(即,滑膜炎vs.无滑膜炎)与RKOA相关(76/277vs.557/3674膝盖),SKOA(49/387vs.287/4213膝盖),RHOA(171/358vs.686/3664手)和SHOA(35/689vs.76/4327手),调整后的比值比(AORs)为2.2(95%CI1.7-3.1),2.0(1.3-2.9),3.4(2.7-4.4),和2.4(1.5-3.8),分别。基线RKOA(与OA相比无OA:409/1246vs.481/3758膝盖),SKOA(200/576vs.675/4356膝盖),RHOA(192/778vs.410/3723手),和SHOA(41/162vs.548/4285手)也与滑膜炎事件有关,aOR为3.4(95%CI2.9-4.1),2.7(2.1-3.4),2.3(1.8-2.9)和1.9(1.2-2.8),分别。与参考组相比,当滑膜炎更活跃时,这些双向关联更强(均P<0.05)。MR分析进一步支持双向关联,滑膜炎显著增加了两个部位OA的发生率,反之亦然(所有OR范围为1.2-1.7)。
■我们的基于人群的队列研究发现了滑膜炎和OA之间双向关联的新证据,通过MR分析进一步验证,提示双向关联可能是因果关系.我们的研究结果表明,滑膜炎既是OA的危险因素,也是OA的结果,而不仅仅是危险因素。
■国家重点研究发展计划,国家自然科学基金,湖南省重点研究发展计划,湖南省自然科学基金,中南大学创新驱动研究计划,和中南大学中央高校基础研究基金。
UNASSIGNED: Synovitis has long been considered a common and modifiable inflammatory feature of osteoarthritis (OA), but current disease-modifying anti-inflammatory treatments appear ineffective in OA clinical trials. Elucidating the temporal relationship between synovitis and OA could provide insight into the role of synovitis in OA.
UNASSIGNED: We conducted a prospective cohort
study based on the baseline and three-year follow-up data from the Xiangya Osteoarthritis (XO)
Study. We assessed bidirectional associations between ultrasound-detected synovitis and radiographic and symptomatic OA at knee and hand sites using generalized estimating equations. Additionally, we performed bidirectional Mendelian randomization (MR) analyses to test these hypotheses utilising whole-genome sequencing data in the XO population. Age, sex, body mass index, smoking, alcohol consumption, educational level, physical activity, and joint injury history were adjusted for these analyses.
UNASSIGNED: A total of 2211, 2420, 2280, and 2600 participants were enrolled for analyses of radiographic knee OA (RKOA), symptomatic knee OA (SKOA), radiographic hand OA (RHOA) and symptomatic hand OA (SHOA), respectively. The baseline synovitis (i.e., with synovitis vs. without synovitis) was associated with the incident RKOA (76/277 vs. 557/3674 knees), SKOA (49/387 vs. 287/4213 knees), RHOA (171/358 vs. 686/3664 hands) and SHOA (35/689 vs. 76/4327 hands), with adjusted odds ratio (aORs) of 2.2 (95% CI 1.7-3.1), 2.0 (1.3-2.9), 3.4 (2.7-4.4), and 2.4 (1.5-3.8), respectively. The baseline RKOA (with OA vs. without OA: 409/1246 vs. 481/3758 knees), SKOA (200/576 vs. 675/4356 knees), RHOA (192/778 vs. 410/3723 hands), and SHOA (41/162 vs. 548/4285 hands) were also associated with the incident synovitis, with aORs of 3.4 (95% CI 2.9-4.1), 2.7 (2.1-3.4), 2.3 (1.8-2.9) and 1.9 (1.2-2.8), respectively. These bidirectional associations were stronger when more active synovitis was compared with the reference group (all P < 0.05). MR analyses further supported bidirectional associations that synovitis significantly increased the odds of incident OA at both sites and vice versa (all ORs ranged from 1.2-1.7).
UNASSIGNED: Our population-based cohort
study found novel evidence of a bidirectional association between synovitis and OA, which was further validated through MR analysis and suggested that the bidirectional association is likely causal. Our findings indicated that synovitis is both a risk factor and a consequence of the OA rather than solely a risk factor.
UNASSIGNED: The National Key Research and Development Plan, the National Natural Science Foundation of China, the Key Research and Development Program of Hunan Province, the Natural Science Foundation of Hunan Province, the Central South University Innovation-Driven Research Programme, and the Fundamental Research Funds for the Central Universities of Central South University.