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Biochemical markers of bone and cartilage remodeling are poorly correlated with clinical and radiological severity of knee osteoarthritis.

Jean-Yves Reginster: 1,2, Julien Collette: 1, Lucio Rovati: 3, Rita Deroisy: 1, Aline Honore: 1,2, Olivier Bruyere: 1,2, Laurence Seidel: 2, Yves Henrotin: 1

1.Bone and Cartilage Metabolism, University of Liège, Liège, Belgium.

2.WHO Collaborating Center for Public Health Aspects of Osteoarticular Disorders – Dept.of Epidemiology and Public Health, University of Liège, Liège, Belgium.

3.Rotta Research Laboratories, Monza, Italy.

We investigated the relationship between biochemical markers of bone [serum osteocalcin (BGP), urine Pyridinoline/Creatinine ratio (Pyr), urine Deoxypyridinoline/Creatinine ratio (DPyr)], and cartilage [serum hyaluronic acid (HA), serum keratan sulfate (KS), and serum cartilage oligomeric matrix protein (COMP)] remodeling and clinical (WOMAC) or structural [mean joint space width (JSW), joint space narrowest point (JN), Altman radiologic global score (AGS)] indices of the severity of osteoarthritis in 212 patients, from both genders, suffering from mild to moderate knee osteoarthritis.

These examinations were performed at baseline of a prospective, double-blind, placebo-controlled trial aiming at the assessment of glucosamine sulfate as treatment of knee osteoarthritis. Total mean joint space width (JSW) of the medial compartment of the tibio-femoral joint was assessed by digital image analysis by a validated computerized algorithm. The narrowest point of the medial joint space was measured using a magnification lens. No significant correlations were observed between JWS, JN, WOMAC (total score or pain, function and stiffness dimensions separately) and any of the biochemical markers. The Altman radiological score correlated significantly with HA (r=0.41; p<0.0001), Pyr (r=0.16; p =0.017) and COMP (r=0.24 ; p <0.0001).

However,when performing a stepwise analysis,HA remained the only marker to be significantly correlated to AGS (p <0.0001).The percentage of variability of AGS explained by HA is 17%as compared to 21%when including all markers in the model. We conclude that biochemical markers of bone and join remodeling are poorly correlated with clinical and radiographic features of knee osteoarthritis.