Associations between endogenous sex hormones and MRI structural changes in patients with symptomatic knee osteoarthritis

Jin, Xingzhong; Wang, B.H.; Wang, X.; Antony, Benny; Zhu, Zhaohua; Han, Weiyu; Cicuttini, Flavia Maria; Wluka, Anita E.; Winzenberg, Tania; Blizzard, Leigh; Jones, Graeme; Ding, Changhai

doi:10.1016/j.joca.2017.01.015

Cited by 47 publications

(29 citation statements)

References 38 publications

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“…Along with oestrogen and testosterone, especially the sex‐hormone‐binding globulin SHBG (or sex steroid‐binding globulin) affects cartilage and bones . .…”

Section: Introductionmentioning

confidence: 99%

Sex hormones in association with general joint laxity and hypermobility in the temporomandibular joint in adolescents—results of the epidemiologic LIFE child study

Graf

Schierz

Steinke

et al. 2019

J of Oral Rehabilitation

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Objectives:The aim of this cross-sectional study was to investigate whether sex hormones (testosterone, oestradiol, sex-hormone-binding globulin = SHBG) are associated with general joint laxity (GJL) and hypermobility or derangements of the temporomandibular joint (TMJ) in adolescents. Methods:Within the LIFE Child study, 970 adolescents (10-18 years) were included.GJL was assessed using the Beighton test. Maximum mouth opening (MMO) and clinical clicking sounds as signs of disc displacement (DD) in the TMJ were assessed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).Serum levels of sex hormones were assessed using standardised laboratory analyses.Results: Hypermobile joints were found in 54.9% (N = 532) of the sample; females were more affected than males (61.4% vs. 51.8%, P < 0.001). Using logistic regression analyses, the odds ratio (OR) for having >1 hypermobile joints increased to 1.15 (95% confidence interval [CI]: 1.04-1.27) in males and 1.09 (95% CI: 1.02-1.17) in females per 10 units of the SHBG serum level, compared to those without hypermobile joints-after controlling for the effect of age, adjusted BMI, pubertal development (Tanner scale), testosterone as well as oestradiol levels. Female subjects with >1 hypermobile joints showed a higher OR (1.89; 95% CI: 1.05-3.43) for having clinical clicking sounds in the TMJ and a 3.28 times higher OR (95% CI: 1.44-7.44) for MMO ≥ 55 mm. Conclusions:We observed age-and gender-independent associations of higher SHBG serum levels with GJL in adolescents. Moreover, hypermobile female adolescents show a more frequent hypermobility of the TMJ and clinical signs of DD. K E Y W O R D Sadolescents, general joint laxity, hypermobility, sex hormones, temporomandibular disorders

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“…Along with oestrogen and testosterone, especially the sex‐hormone‐binding globulin SHBG (or sex steroid‐binding globulin) affects cartilage and bones . .…”

Section: Introductionmentioning

confidence: 99%

Sex hormones in association with general joint laxity and hypermobility in the temporomandibular joint in adolescents—results of the epidemiologic LIFE child study

Graf

Schierz

Steinke

et al. 2019

J of Oral Rehabilitation

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“…24,26 Ageing is associated with loss of sex hormones in both men and women rendering a joint environment that is more susceptible to damage and degradation. 9,27 Progesterone is the precursor for all steroid hormones and its receptors have been localized in the chondrocytes of knee cartilage. 27 Some studies even show that this hormone stimulates proteoglycan changes in cartilage, either directly or indirectly through cytokines and, identification of estrogen receptors ERa and ERb on human articular chondrocytes confirm that cartilage is sensitive to estrogen.…”

Section: Hormonesmentioning

confidence: 99%

“…9,27 Progesterone is the precursor for all steroid hormones and its receptors have been localized in the chondrocytes of knee cartilage. 27 Some studies even show that this hormone stimulates proteoglycan changes in cartilage, either directly or indirectly through cytokines and, identification of estrogen receptors ERa and ERb on human articular chondrocytes confirm that cartilage is sensitive to estrogen. 25 Scarcity of this steroid hormone leads to increased osteoclast recruitment and, therefore, enhanced bone resorption as well as impaired mechanosensitivity and mechanotransduction, compromising the optimal level of osteoblast activity in bone deposition.…”

Section: Hormonesmentioning

confidence: 99%

“…24 A study by Jin et al, found that progesterone was positively associated with cartilage volume for females, however, it is important to note that the participants in the study were vitamin D insufficient. 27 As KOA is more common in postmenopausal females, limited investigations were performed to study the effect of male hormones on the development of KOA in male. 27 Cicuttini et al, studied the effect of serum testosterone in 45 males, and proposed a contribution of the serum testosterone to the tibial cartilage volume.…”

Section: Hormonesmentioning

confidence: 99%

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Nutritional, metabolic and genetic considerations to optimise regenerative medicine outcome for knee osteoarthritis

Hafsi

McKay

et al. 2019

Journal of Clinical Orthopaedics and Trauma

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Knee osteoarthritis (KOA) is a multifactorial degenerative disorder of joints, affecting the world's population over the age of 65 and with a higher prevalence in females. KOA is responsible for many age associated joint problems such as stiffness and pain. Conventional methods for managing KOA such as nonsteroidal anti-inflammatory drugs (NSAID) may not improve pain or alter the disease progression and may have adverse side effects. Non-pharmacological management of OA is fundamental to management of functional limitations and provides effective symptom relief but has not shown that disease progression can be altered. Regenerative medicine is a relatively new approach which aims to induce cellular regeneration and promote self-healing through minimally invasive methods. The use of regenerative medicine slowed the progression of KOA and revealed significant improvements, yet further investigations are required to optimize the outcomes. Nutritional and metabolic aspects such as supplementations, vitamins and minerals were proven to have an impact on the progression of KOA. Genetic variations are rapidly inspected to identify any potential influence of these variations in the predisposition and diagnosis of KOA. Further supporting evidence suggests the potential influence of metabolic, nutritional and genetic aspects in optimizing the outcomes of regenerative medicine in the management of KOA.

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“…[ 4 , 5 ] Differences in endogenous sex hormones, body composition, knee structure and biomechanics, and psychosocial characteristics may play a role in the increased risk of knee OA in women. [ 6 – 8 ] Patients with knee OA experience pain, swelling, muscular atrophy, and restricted movement; these problems may negatively affect physical activity, causing difficulties in activities of daily living and reducing quality of life. [ 9 ]…”

Section: Introductionmentioning

confidence: 99%

Clinical effects of lateral wedge arch support insoles in knee osteoarthritis

Hsieh

Lee

2016

Medicine

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We compared the short-term efficacy of rigid versus soft lateral wedge arch support (LWAS) insoles for patients with knee osteoarthritis (OA), as assessed using the International Classification of Functioning, Disability and Health (ICF) system, through a prospective, double-blind, randomized controlled trial.Participants who fulfilled the combined radiographic and clinical criteria for knee OA, as defined by the American College of Rheumatology, were randomly prescribed 1 pair of rigid or soft LWAS insoles. Body functions and structures were evaluated according to Kellgren–Lawrence scores, the Foot Posture Index, Hospital Anxiety and Depression Scale scores, the pain–pressure threshold, postural stability, dynamic balance, and fall risk; activities and participation were assessed according to 10-m fast speed walking, stair climbing and chair rising times, and Chronic Pain Grade questionnaire responses; and knee OA-related health status was evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Hospital Anxiety and Depression Scale scores, the pain–pressure threshold, physical activity, balance, Chronic Pain Grade questionnaire responses, and the KOOS were recorded before treatment and at 1-, 2-, and 3-month follow-ups.We enrolled 90 participants, 70 women and 20 men, with mean ages of 60.6 ± 10.8 and 63.1 ± 10.8 years in the rigid and soft LWAS insole groups, respectively. Repeated-measures analysis of covariance revealed significant time × group effect improvements in pain (P = 0.008 for the KOOS), stair ascent time (P = 0.003), daily living function (P = 0.003 for the KOOS), sports and recreation function (P = 0.012 for the KOOS), and quality of life (P = 0.021 for the KOOS) in the soft LWAS insole group.Patients with knee OA who used soft LWAS insoles for a short term showed more significant improvement than did those who used rigid LWAS insoles in pain, physical activity, daily living function, sports and recreation function, and quality of life, which belong to the body functions and structures and the activities and participation components in the ICF scheme.

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Associations between endogenous sex hormones and MRI structural changes in patients with symptomatic knee osteoarthritis

Abstract: In women but not men, low serum levels of endogenous estradiol, progesterone and testosterone are associated with increased knee effusion-synovitis and possibly other OA-related structural changes. This may contribute to observed sex differences in knee OA.

Cited by 47 publications

References 38 publications

Sex hormones in association with general joint laxity and hypermobility in the temporomandibular joint in adolescents—results of the epidemiologic LIFE child study

Sex hormones in association with general joint laxity and hypermobility in the temporomandibular joint in adolescents—results of the epidemiologic LIFE child study

Nutritional, metabolic and genetic considerations to optimise regenerative medicine outcome for knee osteoarthritis

Clinical effects of lateral wedge arch support insoles in knee osteoarthritis

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