目的:描述年轻人中MRI标记与膝关节症状之间的关联。
方法:在儿童成人健康决定因素(CDAH)-膝关节研究(年:2008-10)和6-9年随访(CDAH-3;年:2014-2019)期间,使用WOMAC量表评估膝关节症状。膝关节核磁共振扫描,在基线时获得,评估形态学标志物(软骨体积,软骨厚度,软骨下骨区域)和结构异常(软骨缺损和骨髓病变(BMLs))。单变量和多变量(年龄,性别,BMI调整)零膨胀泊松(ZIP)回归模型用于分析。
结果:参与者的CDAH-膝盖和CDAH-3的平均年龄±SD分别为34.95±2.72和43.27±3.28岁,49%和48%的女性,分别。跨领域,股胫骨内侧区室(MFTC)之间存在微弱但显着的负相关[平均比率(RoM)=0.99971084;95CI:0.9995525-0.99986921;p<0.001],股胫骨外侧区室(LFTC)[RoM=0.99982602;95CI:0.99969915-0.9999529;p=0.007],和髌骨软骨体积[RoM=0.99981722;95CI:0.99965326-0.9999811;p=0.029]伴有膝关节症状。同样,髌骨软骨体积呈负相关(RoM=0.99975523;95CI:0.99961427-0.99989621;p=0.014),MFTC软骨厚度(RoM=0.72090775;95CI:0.59481806-0.87372596;p=0.001)和6-9年后评估的膝关节症状。在基线[RoM=0.9210485;95CI:0.8939677-0.9489496;p<0.001]和6-9年(RoM=0.9588811;95CI:0.9313379-0.9872388;p=0.005)时,总骨面积与膝关节症状呈负相关。在基线和6-9岁时,软骨缺损和BMLs与较高的膝关节症状相关。
结论:BMLs和软骨缺损与膝关节症状呈正相关,而MFTC的软骨体积和厚度以及总骨面积与膝关节症状呈弱负相关。这些结果表明,可以探索定量和半定量MRI标志物作为年轻人OA临床进展的标志物。
OBJECTIVE: To describe associations between MRI markers with knee symptoms in young adults.
METHODS: Knee symptoms were assessed using the WOMAC scale during the Childhood Determinants of Adult Health Knee Cartilage study (CDAH-knee; 2008-2010) and at the 6- to 9-year follow-up (CDAH-3; 2014-2019). Knee MRI scans obtained at baseline were assessed for morphological markers (cartilage volume, cartilage thickness, subchondral bone area) and structural abnormalities [cartilage defects and bone marrow lesions (BMLs)]. Univariable and multivariable (age, sex, BMI adjusted) zero-inflated Poisson (ZIP) regression models were used for analysis.
RESULTS: The participants\' mean age in CDAH-knee and CDAH-3 were 34.95 (s.d. 2.72) and 43.27 (s.d. 3.28) years, with 49% and 48% females, respectively. Cross-sectionally, there was a weak but significant negative association between medial femorotibial compartment (MFTC) [ratio of the mean (RoM) 0.99971084 (95% CI 0.9995525, 0.99986921), P < 0.001], lateral femorotibial compartment (LFTC) [RoM 0.99982602 (95% CI 0.99969915, 0.9999529), P = 0.007] and patellar cartilage volume [RoM 0.99981722 (95% CI 0.99965326, 0.9999811), P = 0.029] with knee symptoms. Similarly, there was a negative association between patellar cartilage volume [RoM 0.99975523 (95% CI 0.99961427, 0.99989621), P = 0.014], MFTC cartilage thickness [RoM 0.72090775 (95% CI 0.59481806, 0.87372596), P = 0.001] and knee symptoms assessed after 6-9 years. The total bone area was negatively associated with knee symptoms at baseline [RoM 0.9210485 (95% CI 0.8939677, 0.9489496), P < 0.001] and 6-9 years [RoM 0.9588811 (95% CI 0.9313379, 0.9872388), P = 0.005]. The cartilage defects and BMLs were associated with greater knee symptoms at baseline and 6-9 years.
CONCLUSIONS: BMLs and cartilage defects were positively associated with knee symptoms, whereas cartilage volume and thickness at MFTC and total bone area were weakly and negatively associated with knee symptoms. These results suggest that the quantitative and semiquantitative MRI markers can be explored as a marker of clinical progression of OA in young adults.