Diagnostic and prognostic value of some biochemical markers in early knee osteoarthritis

摘要

Background Osteoarthritis (OA); the most common joint disease, is not only characterized by cartilage destruction; but also by alteration of bone and synovial tissue metabolism, though their relative importance in the initiation and progression of OA is still debated. To identify patients with a high risk for destructive OA, more sensitive techniques than plain X-rays are needed. Aim of the work To study the diagnostic and prognostic value of some biochemical markers serum hyaluronic acid (HA) and serum cartilage oligomeric matrix protein (COMP), high sensitive C-reactive protein (hs-CRP) in the included patients had early OA knees and their relation to disease progression. Patients and methods Sixty patients had early knee OA and 20 control subjects were included. WOMAC index, laboratory investigations (COMP, HA, hs-CRP) and radiological evaluation (Kellgren and Lawrence grading scale and Thomas compartmental score) were performed for each patient at baseline and after one year. Results HA was significantly higher in patients than controls ( p 0.001) with the highest specificity and positive predictive value. It was significantly correlated with COMP at baseline and after one year ( p = 0.01). The levels of HA at baseline correlated with its levels after one year ( p 0.001). It also correlated with K–L grading score ( p = 0.02). COMP was significantly higher in patients than controls ( p 0.001). It was significantly correlated with Thomas score after one year ( p = 0.007). Baseline levels of COMP correlated significantly with its levels after one year ( p = 0.005). The differences of the serum levels of hs-CRP at the baseline evaluation and after one year between patients and controls were not statistically significant ( p = 0.4, 0.5, respectively). Conclusions The measurements of HA and COMP may be of diagnostic and prognostic value in differentiating patients with early joint destruction and in determining disease progression. A single biochemical marker has definitive diagnostic value and the combination with other biochemical markers as well as with clinical and radiographic data would most likely help to improve the clinical assessment of patients. Serum hs-CRP is not a good predictor of individual patient progression and has a poor sensitivity and specificity.