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Online Library: Osteoarthritis
The following pages provide an overview of the most recent research and clinical studies about the health benefits of micronutrients in fighting osteoarthritis. This collection of scientific facts proves that anyone who privately or publicly questions the health value of micronutrients does not serve YOUR health, or the health of the people, but rather the multi-billion dollar investment 'business with disease' based on patented pharmaceutical drugs.
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Antioxidants
Effect of Antioxidants on Knee Cartilage and Bone in Healthy, Middle-Aged Subjects: a Cross-Sectional Study
Source: Arthritis Research & Therapy 2007; 9(4): R66
Affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, VIC 3004, Australia
Abstract: The aim of the present study was to examine the effect of dietary antioxidants on knee structure in a cohort of healthy, middle-aged subjects with no clinical knee osteoarthritis. Two hundred and ninety-three healthy adults (mean age = 58.0 years, standard deviation = 5.5) without knee pain or knee injury were selected from an existing community-based cohort. The intake of antioxidant vitamins and food sources by these individuals was estimated from a food frequency questionnaire at baseline. The cartilage volume, bone area, cartilage defects and bone marrow lesions were assessed approximately 10 years later using magnetic resonance imaging. In multivariate analyses, higher vitamin C intake was associated with a reduced risk of bone marrow lesions (odds ratio = 0.50, 95% confidence interval (CI) = 0.29?0.87, P = 0.01) and with a reduction in the tibial plateau bone area (β = -35.5, 95% CI = -68.8 to -2.3, P = 0.04). Intake of vegetables and other carotenoids was not significantly associated with cartilage or bone measures. The present study suggests a beneficial effect of fruit consumption and vitamin C intake as they are associated with a reduction in bone size and the number of bone marrow lesions, both of which are important in the pathogenesis of knee osteoarthritis. While these findings need to be confirmed by longitudinal studies, they highlight the potential of the diet to modify the risk of osteoarthritis.
Chondroitin Sulfate
Chondroitin Sulfate for the Treatment of Hip and Knee Osteoarthritis: Current Status and Future Trends
Source: Life Sciences 2009; 85(13-14): 477-483
Affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.
Abstract: Chondroitin sulfate (CS), which has chondroprotective properties, is a promising candidate for the therapeutic treatment of osteoarthritis (OA). This study summarizes current knowledge as well as future trends of CS for the treatment of hip and knee OA. The study key findings confirm the safety and tolerability of CS. The study shows that CS is effective, at least in part, for the treatment of OA, and its therapeutic benefits occur through three main mechanisms: 1) stimulation of extracellular matrix production by chondrocytes; 2) suppression of inflammatory mediators; and 3) inhibition of cartilage degeneration. CS is a safe and tolerable therapeutic agent for the management of OA. Its effects include benefits that are not achieved by current medicines and include chondroprotection and the prevention of joint space narrowing. Such positive effects of CS represent a breakthrough in the treatment of hip and knee OA.
Long-Term Effects of Chondroitins 4 and 6 Sulfate on Knee Osteoarthritis: the Study on Osteoarthritis Progression Prevention, a Two-Year, Randomized, Double-Blind, Placebo-Controlled Trial
Source: Arthritis and Rheumatism 2009; 60(2): 524-533
Affiliation: University of Paris Descartes, and Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
Abstract: The objective of this study was to assess the long-term effects of chondroitins 4 and 6 sulfate (CS) on the radiographic progression and symptom changes associated with knee osteoarthritis (OA). It was an international, randomized, double-blind, placebo-controlled trial in which 622 patients with knee OA were randomly assigned to receive either 800 mg CS (n = 309 patients) or placebo (n = 313 patients) once daily for 2 years. Radiographs of the target knee, using the Lyon schuss view, were obtained at the time of enrollment and at 12, 18, and 24 months. The minimum joint space width (JSW) of the medial compartment of the tibiofemoral joint was assessed by digital image analysis. The primary outcome was the loss in minimum JSW over 2 years. RESULTS: The intent-to-treat analysis demonstrated a significant reduction (P < 0.0001) in minimum JSW loss in the CS group (mean +/- SEM -0.07 +/- 0.03 mm) as compared with the placebo group (-0.31 +/- 0.04 mm). Pain improved significantly faster in the CS group than in the placebo group (P < 0.01). There were no differences in safety between groups. The study concludes that the long-term combined structure-modifying and symptom-modifying effects of CS suggest that it could be a disease-modifying agent in patients with knee OA.
Effect of Glucosamine or Chondroitin Sulfate on the Osteoarthritis Progression: a Meta-Analysis
Source: Rheumatology International 2009 June 21. [Epub ahead of print]
Affiliation: Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1 ga, Anam-dong, Seongbuk-gu, Seoul, 136-705, Korea.
Abstract: The aim of this study was to assess the structural efficacies of daily glucosamine sulfate and chondroitin sulfate in patients with knee osteoarthritis (OA). The authors surveyed randomized controlled studies that examined the effects of long-term daily glucosamine sulfate and chondroitin sulfate on joint space narrowing (JSN) in knee OA patients using the Medline and the Cochrane Controlled Trials Register, and by performing manual searches. Six studies involving 1,502 cases were included in this meta-analysis, which consisted of two studies on glucosamine sulfate and four studies on chondroitin sulfate. This meta-analysis of available data shows that glucosamine and chondroitin sulfate may delay radiological progression of OA of the knee after daily administration for over 2 or 3 years.
Potential Effects of Chondroitin Sulfate on Joint Swelling: a GAIT Report
Source: Osteoarthritis and Cartilage 2008; 16 Suppl 3: S22-S24
Affiliation: University of Maryland School of Medicine, MSTF 8-34, Baltimore, MD 21201, United States.
Abstract: The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) was a randomized double-blind placebo and active comparator (celecoxib) controlled trial of 1583 persons with symptomatic osteoarthritis (OA) of the knee. Patients randomized to celecoxib had significant improvement in knee pain compared to those randomized to placebo. No statistically significant improvement in knee pain compared to placebo was seen among patients randomized to the dietary supplements, although a subset of patients with moderate-to-severe knee pain at entry who were assigned to the combination of glucosamine and chondroitin sulfate did seem to experience some improvement. Additionally, patients taking chondroitin sulfate were noted to have a statistically significant improvement in knee joint swelling. An exploratory post hoc analysis of GAIT patients suggested the effect of chondroitin sulfate on joint swelling occurred more often in patients with milder pain and lower Kellgren-Lawrence Grade at entry.
Clinical Review of Chondroitin Sulfate in Osteoarthritis
Source: Osteoarthritis and Cartilage 2008; 16 Suppl 3: S19-S21
Affiliation: Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Switzerland.
Abstract: Symptomatic slow-acting drugs for the treatment of osteoarthritis (SYSADOA; OA) are compounds which are prescribed as drugs in European countries since many years, whereas they are sold as nutraceuticals in USA. In Europe, the publication of the EULAR Recommendations for the Treatment of Knee OA in 2003 has listed oral chondroitin sulfate (CS) as evidence 1A and strength of recommendation A which represents the highest level for a therapeutic strategy. The main rationale behind the use of the SYSADOA therapeutic class is the reduction of NSAIDs in the overall drug management of OA disease and therefore consequently to limit the very significant risks of upper Gastro-intestinal (GI) tract erosions, ulcers with bleeding and/or deleterious renal effects in elderly patients. The evidence for clinical efficacy of oral CS as a drug able to significantly improve the algo-functional symptoms of OA disease does come from a set of randomized clinical studies published a couple of years ago. Indeed, it was demonstrated that the drug was effective in knee and finger OA, whereas previous data suggested that hip OA patients could also benefit from it. In addition, oral CS supported the comparison with NSAIDs such as diclofenac sodium in a medium/long-term clinical study in patients with knee OA. A couple of other compounds such as hyaluronan, diacerein, avocado and soya unsaponifiables, doxycycline have also been tested with respect to their potential disease-modifying effects.
Symptom and Structure Modifying Properties of Chondroitin Sulfate in Osteoarthritis
Source: Mini Reviews in Medicinal Chemistry 2007; 7(10): 1051-1061
Affiliation: Department of Public Health Economics, University of Liège, Liège, Belgium.
Abstract: Chondroitin sulfate (CS) is a complex carbohydrate polymer with variable sulfation which impacts function. CS exhibits a wide range of biological activities. Many experimental and clinical data are available, affirming that CS represents an effective and safe symptomatic treatment of osteoarthritis (OA) with delayed and sustained effects.
Glucosamine
Effect of Glucosamine or Chondroitin Sulfate on the Osteoarthritis Progression: a Meta-Analysis
Source: Rheumatology International 2009 June 21. [Epub ahead of print]
Affiliation: Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1 ga, Anam-dong, Seongbuk-gu, Seoul, 136-705, Korea
Abstract: The aim of this study was to assess the structural efficacies of daily glucosamine sulfate and chondroitin sulfate in patients with knee osteoarthritis (OA). The authors surveyed randomized controlled studies that examined the effects of long-term daily glucosamine sulfate and chondroitin sulfate on joint space narrowing (JSN) in knee OA patients using the Medline and the Cochrane Controlled Trials Register, and by performing manual searches. Meta-analysis was performed using a fixed effect model because no between-study heterogeneity was evident. Six studies involving 1,502 cases were included in this meta-analysis, which consisted of two studies on glucosamine sulfate and four studies on chondroitin sulfate. Glucosamine sulfate did not show a significant effect versus controls on minimum JSN over the first year of treatment (SMD 0.078, 95% CI -0.116 to -0.273, P = 0.429). However, after 3 years of treatment, glucosamine sulfate revealed a small to moderate protective effect on minimum JSN (SMD 0.432, 95% CI 0.235-0.628, P < 0.001). The same was observed for chondroitin sulfate, which had a small but significant protective effect on minimum JSN after 2 years (SMD 0.261, 95% CI 0.131-0.392, P < 0.001). This meta-analysis of available data shows that glucosamine and chondroitin sulfate may delay radiological progression of OA of the knee after daily administration for over 2 or 3 years.
A Review of Evidence-Based Medicine for Glucosamine and Chondroitin Sulfate Use in Knee Osteoarthritis
Source: Arthroscopy 2009; 25(1): 86-94.
Affiliation: Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
Abstract: The investigation of disease-modifying treatment options for osteoarthritis (OA) has become an important aspect of orthopedic care. The purpose of this review is to critically evaluate the evidence for the use of glucosamine and chondroitin sulfate for knee OA with the goal of elucidating their indications for clinical use. The published clinical studies of glucosamine and chondroitin sulfate on OA are reviewed within the context of evidence-based medicine. Almost every included trial has found the safety of these compounds to be equal to placebo. Many studies confirmed OA pain relief with glucosamine and chondroitin sulfate use. The excellent safety profile of glucosamine and chondroitin sulfate therapy should be discussed with patients, and these supplements may serve a role as an initial treatment modality for many OA patients.
Effects of an Oral Administration of glucosamine-Chondroitin-Quercetin Glucoside on the Synovial Fluid Properties in Patients with Osteoarthritis and Rheumatoid Arthritis
Source: Bioscience, Biotechnology, and Biochemistry 2009; 73(2): 288-292
Affiliation: Matsuno Clinic for Rheumatic Diseases, Toyama, Japan
Abstract: The effects of an orally administered combination of a glucosamine-chondroitin-quercetin glucoside (GCQG) supplement on the synovial fluid properties of patients with osteoarthritis (OA) and rheumatoid arthritis (RA) were investigated from the clinical nutrition view point. In this study, forty-six OA and twenty-two RA patients were administered with the GCQG supplement orally for 3 months. Several parameters of the knee joints were monitored before and after supplementation. The OA patients showed a significant improvement in pain symptoms, daily activities (walking and climbing up and down stairs), and visual analogue scale, and changes in the synovial fluid properties with respect to the protein concentration, molecular size of hyaluronic acid, and chondroitin 6-sulphate concentration were also observed. However, no such effects were observed in the RA patients. These results suggest that the GCQG supplement exerted a special effect on improving the synovial fluid properties in OA patients.
Glucosamine/Chondroitin/Primorine Combination Therapy for Osteoarthritis
Source: Drugs of Today 2009;45(1): 21-31
Affiliation: East Tennessee State University, Family Physicians of Kingsport, Tennessee 37660, USA
Abstract: Glucosamine sulfate and chondroitin sulfate have been evaluated in many studies as agents to relieve pain, improve functional activity, and slow disease progression in osteoarthritis (OA) especially of the hip and knee. Primorine is a combination of products thought to alter these biochemical oxidative byproducts. Based on current evidence, the use of a combination product of glucosamine sulfate and chondroitin sulfate seems to have the greatest potential as a therapeutic intervention for patients at increased risk from the adverse events of accepted current oral therapies. The use of primorine and its combination of products as an intervention in OA has theoretical advantages but its benefits are unproven. A new product, relamine, is a combination of these three formulations. While no studies have evaluated glucosamine sulfate, chondroitin sulfate and primorine in a single product, it may be an option for those who wish to try an alternate therapy for OA, as there appears to be a low risk for serious adverse events.
Combined Glucosamine and Chondroitin Sulfate Provides Functional and Structural Benefit in the Anterior Cruciate Ligament Transection Model
Source: Clinical Rheumatology 2009; 28(2): 109-117
Affiliation: Department of Rheumatology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Abstract: Evidence that combined glucosamine sulfate and chondroitin sulfate (Gluchon) or isolated glucosamine (Glu) modifies joint damage in osteoarthritis (OA) is still lacking. This study examined joint pain and cartilage damage using the anterior cruciate ligament transection (ACLT) model. Wistar rats were subjected to ACLT of the right knee (OA) or sham operation. Groups received either Glu (500 mg/kg), Gluchon (500 mg/kg glucosamine +400 mg/kg chondroitin) or vehicle (non-treated--NT) per os starting 7 days prior to ACLT until sacrifice at 70 days. Joint pain was evaluated daily using the rat-knee joint articular incapacitation test. Gluchon administration significantly reversed both the increases in CS content (54.4 +/- 12.1 microg/mg) and Mw (4:18 +/- 0.2 x 10(4) g/mol) as compared to NT. Isolated Glu decreased CS content though not reaching statistical significance. Cartilage histology alterations were also significantly prevented by Gluchon administration. Gluchon provides clinical (analgesia) and structural benefits in the ACLT model. This is the first demonstration that biochemical alterations occurring in parallel to histological damage in OA are prevented by Gluchon administration.
Glucosamine and Chondroitin for Osteoarthritis
Source: The Journal of International Medical Research 2008; 36(6): 1161-1179
Affiliation: King Edward VII Hospital, London, UK
Abstract: Osteoarthritis (OA) is a common, chronic disease that most frequently affects the knees and is a major cause of disability in the elderly. It is characterized by progressive cartilage loss, accompanied by secondary changes such as osteophyte formation and calcium deposition. Inflammatory processes are also involved, leading to stiffness and pain, for which patients seek treatment. Conventional treatment includes analgesics or non-steroidal anti-inflammatory drugs, however life-style changes should also be recommended, such as weight reduction and specific exercises. Glucosamine and chondroitin, classed as over-the-counter supplements or nutraceuticals, are regularly self-administered by patients with OA. Both agents are produced endogenously in the human body and are essential components of cartilage. This review discusses the evidence that supports the use of these agents either alone or in combination for pain relief and as disease-modifying agents in OA.
The Effect of Glucosamine and/or Chondroitin Sulfate on the Progression of Knee Osteoarthritis: a Report from the Glucosamine/Chondroitin Arthritis Intervention Trial
Source: Arthritis and Rheumatism 2008; 58(10): 3183-3191
Affiliation: University of Utah School of Medicine, Salt Lake City, UT 84132, USA
Abstract: This study was undertaken to evaluate the effect of glucosamine and chondroitin sulfate (CS), alone or in combination, as well as celecoxib and placebo on progressive loss of joint space width (JSW) in patients with knee OA. A 24-month, double-blind, placebo-controlled study, conducted at 9 sites in the United States as part of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), enrolled 572 patients with knee OA who satisfied radiographic criteria (Kellgren/Lawrence [K/L] grade 2 or grade 3 changes and JSW of at least 2 mm at baseline). Patients with primarily lateral compartment narrowing at any time point were excluded. Patients who had been randomized to 1 of the 5 groups in the GAIT continued to receive glucosamine 500 mg 3 times daily, CS 400 mg 3 times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The minimum medial tibiofemoral JSW was measured at baseline, 12 months, and 24 months. The primary outcome measure was the mean change in JSW from baseline. The study concludes that at 2 years, no treatment achieved a predefined threshold of clinically important difference in JSW loss as compared with placebo. However, knees with K/L grade 2 radiographic OA appeared to have the greatest potential for modification by these treatments.
Proline
Regulation of Type II Collagen Synthesis During Osteoarthritis by Prolyl-4-Hydroxylases: Possible Influence of Low Oxygen Levels
Source: The American Journal of Pathology 2006; 169(2): 491-502
Affiliation: Division of Orthopedic Rheumatology, Department of Orthopedic Surgery im Waldkrankenhaus St. Marien, University of Erlangen-Nuremberg, Rathsbergerstrasse 57, D-91054 Erlangen, Germany
Abstract: Osteoarthritic (OA) chondrocytes are metabolically active, displaying increased synthesis of type II collagen. This study shows by immunohistochemistry and polymerase chain reaction that in comparison with healthy cartilage, OA articular chondrocytes exhibit increased in vivo synthesis of collagen prolyl-4-hydroxylase type II, a pivotal enzyme in collagen triple helix formation. Exposure of primary human articular chondrocytes to 1% oxygen enhanced accumulation of native type II collagen and stabilized hypoxia-inducible factor-1alpha (HIF-1alpha). This effect was abolished by addition of the HIF-1 inhibitor 2-methoxyestradiol. Treatment of hypoxic chondrocytes with 2-methoxyestradiol reduced transcriptional activity of HIF-1 and synthesis of alpha(II), and to a lesser extent alpha(I), subunits of collagen prolyl-4-hydroxylases. From these results and in vivo data, this study inferred that besides increased Col2A1 mRNA expression by OA chondrocytes, accelerated posttranslational modification processes might contribute to the increased synthesis and accumulation of type II collagen during OA and experimental hypoxia.
Vitamin C
Status of Lipid Peroxidation, Glutathione, Ascorbic Acid, Vitamin E and Antioxidant Enzymes in Patients with Osteoarthritis
Source: Indian Journal of Medical Sciences 2007; 61(1): 9-14
Affiliation: Department of Biochemistry, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinoutpally, Gannavaram, AP, India
Abstract: The exact pro-oxidant and antioxidant status in osteoarthritis patients is still not clear. To add a new insight to the question, changes in the erythrocyte lipid peroxidation products (MDA), levels of glutathione (GSH), ascorbic acid and plasma vitamin E (nonenzymatic antioxidant parameters); and activities of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase in erythrocytes and plasma glutathione - S - transferase (GST) were measured in patients with osteoarthritis. This study was undertaken to assess oxidative stress and antioxidant status in patients with osteoarthritis. The study was conducted in 20 patients and compared to controls. Levels of erythrocyte MDA, GSH, ascorbic acid, plasma vitamin E; and activities of antioxidant enzymes were measured in patients with osteoarthritis. It was observed that there was a significant increase in erythrocyte MDA levels; SOD, GPX and plasma GST activities; and a significant decrease in erythrocyte GSH, ascorbic acid, plasma vitamin E levels and catalase activity in patients with osteoarthritis when compared to controls. The results of this study suggest higher oxygen-free radical production, evidenced by increased MDA and decreased GSH, ascorbic acid, vitamin E and catalase activity, support to the oxidative stress in osteoarthritis. The increased activities of antioxidant enzymes may be a compensatory regulation in response to increased oxidative stress.
Effect of Antioxidants [Including Vitamin C] on Knee Cartilage and Bone in Healthy, Middle-Aged Subjects: a Cross-Sectional Study
Source: Arthritis Research and Therapy 2007; 9(4): R66
Affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, VIC 3004, Australia
Abstract: The aim of the present study is to examine the effect of dietary antioxidants on knee structure in a cohort of healthy, middle-aged subjects with no clinical knee osteoarthritis. Two hundred and ninety-three healthy adults (mean age = 58.0 years, standard deviation = 5.5) without knee pain or knee injury were selected from an existing community-based cohort. The intake of antioxidant vitamins and food sources by these individuals was estimated from a food frequency questionnaire at baseline. The cartilage volume, bone area, cartilage defects and bone marrow lesions were assessed approximately 10 years later using magnetic resonance imaging. In multivariate analyses, higher vitamin C intake was associated with a reduced risk of bone marrow lesions (odds ratio = 0.50, 95% confidence interval (CI) = 0.29-0.87, P = 0.01) and with a reduction in the tibial plateau bone area (beta = -35.5, 95% CI = -68.8 to -2.3, P = 0.04). Lutein and zeaxanthin intake was associated with a decreased risk of cartilage defects (odds ratio = 0.71, 95% CI = 0.51-0.99, P = 0.04), and vitamin E intake tended to be positively associated with the tibial plateau bone area (beta = 33.7, 95% CI = -3.1 to 70.4, P = 0.07) only after adjusting for vitamin C intake. Intake of vegetables and other carotenoids was not significantly associated with cartilage or bone measures. The present study suggests a beneficial effect of fruit consumption and vitamin C intake as they are associated with a reduction in bone size and the number of bone marrow lesions, both of which are important in the pathogenesis of knee osteoarthritis. While our findings need to be confirmed by longitudinal studies, they highlight the potential of the diet to modify the risk of osteoarthritis.
Vitamin D
Vitamin D Status, Bone Mineral Density, and the Development of Radiographic Osteoarthritis of the Knee: The Rotterdam Study
Source: Journal of Clinical Rheumatology 2009; 15(5): 230-237
Affiliation: Departments of Internal Medicine, Erasmus Medical Center, Rotterdam 3000 DR, The Netherlands
Abstract: The objective of this study was to examine the association between baseline vitamin D status, bone mineral density (BMD), and the development of radiographic osteoarthritis (ROA) of the knee in a large population-based cohort of men and women. A sample of 1248 subjects (728 women and 520 men) was drawn from the Rotterdam Study, a prospective population-based cohort study of the elderly. At baseline, vitamin D dietary intake was determined, and BMD and 25-hydroxy vitamin D (25(OH)D) serum levels were measured. After a mean follow-up time of 6.5 years incidence and progression of knee ROA of was assessed. The study concludes that low dietary vitamin D intake increases the risk of progression of knee ROA. Particularly in subjects with low baseline BMD, vitamin D status seems to influence the incidence and progression of knee ROA. Thus, improving the vitamin D status in the elderly could protect against the development and worsening of knee OA, especially in those with low BMD.
Serum Levels of Vitamin D, Sunlight Exposure, and Knee Cartilage Loss in Older Adults: the Tasmanian Older Adult Cohort Study
Source: Arthritis and Rheumatism 2009; 60(5): 1381-1389
Affiliation: Menzies Research Institute, University of Tasmania, Hobart, Tasmania
Abstract: The objective of this study was to determine the associations between serum levels of vitamin D, sunlight exposure, and knee cartilage loss cross-sectionally and longitudinally in older adults. A total of 880 randomly selected subjects (mean age 61 years [range 51-79 years], 50% women) were studied at baseline, and 353 of these subjects were studied 2.9 years later. Serum levels of 25-hydroxyvitamin D (25[OH]D) were assessed by radioimmunoassay, and sunlight exposure was assessed by questionnaire. T1-weighted fat-suppressed magnetic resonance imaging (MRI) of the right knee was performed to determine knee cartilage volume and defects. Knee radiographic osteoarthritis (OA) and knee pain were also assessed. The study concludes that sunlight exposure and serum 25(OH)D levels are both associated with decreased knee cartilage loss (assessed by radiograph or MRI). This is best observed using the whole range of 25(OH)D levels rather than predefined cut points and implies that achieving vitamin D sufficiency may prevent and/or retard cartilage loss in knee OA.
Bone Mineral Density and Vitamin D Status in Female and Male Patients with Osteoarthritis of the Knee or Hip
Source: European Surgical Research 2009; 42(1): 1-10
Affiliation: Department of Orthopaedic Surgery, Johannes Gutenberg University Hospital of Mainz, Mainz, Germany
Abstract: This study investigated the association between bone mineral density (BMD), vitamin D and OA in patients undergoing total hip or knee replacements. In total, 82 women and 35 men with mean ages of 70 and 68 years, respectively, were recruited for the study. The BMD of the lumbar spine and the proximal femur were measured by dual-energy X-ray absorptiometry. The vitamin D status was assessed by 25(OH)D levels, with a cut-off of
Low Levels of Vitamin D and Worsening of Knee Osteoarthritis: Results of Two Longitudinal Studies
Source: Arthritis and Rheumatism 2007;56(1): 129-136
Affiliation: Boston University School of Medicine, Boston, Massachusetts 02118, USA
Abstract: The objective of this study was to confirm reports that 25-hydroxyvitamin D (25[OH]D) deficiency is associated with an increased risk of joint space narrowing or cartilage loss in osteoarthritis (OA). The study measured 25(OH)D levels in subjects from 2 longitudinal cohort studies, the Framingham Osteoarthritis Study and the Boston Osteoarthritis of the Knee Study (BOKS). In the first, weight-bearing anteroposterior (AP) and lateral knee radiographs were obtained on subjects in 1993-1994 and again in 2002-2005 (mean interval 9 years); blood was drawn for measurement of vitamin D status in 1996-2000. In the second, subjects with symptomatic knee OA participating in a natural history study had fluoroscopically positioned semiflexed posteroanterior (PA) and lateral radiography of both knees and magnetic resonance imaging (MRI) of the more symptomatic knee performed at baseline and at 15 and 30 months. In both studies, 25(OH)D levels were measured by radioimmunoassay. Analyses focused on whether vitamin D levels, defined in tertiles or as deficient (25[OH]D <20 ng/ml) versus nondeficient, predicted worsening of OA. Logistic regression analysis adjusted for age, body mass index, sex, and baseline OA level was used. The findings indicate that vitamin D status is unrelated to the risk of joint space or cartilage loss in knee OA.