Effects of dietary weight loss with and without exercise on interstitial matrix turnover and tissue inflammation biomarkers in adults with knee osteoarthritis: the Intensive Diet and Exercise for Arthritis trial (IDEA)

Abstract

Summary Objective To examine the effects of dietary weight loss, with and without exercise, on selected soluble biomarkers in overweight and obese older adults with symptomatic knee OA. Design Blood samples were analyzed from 429 participants in the IDEA trial randomized to either an 18 month exericse control group (E), weight loss diet (D), or D+E. C1M, C2M, C3M and CRPM biomarkers and IL-6 were quantitated using ELISAs. Radiographic progression was defined as a decrease in joint space width of ≥ 0.7mm. Statistical modeling of group means and associations used mixed models adjusted for visit, baseline BMI, gender, and baseline values of the outcome. Results Compared to the E control group, C1M was significantly lower in the D and D+E groups at both 6 and 18 months while C3M was significantly lower in D and D+E at 6 months and in D+E at 18 months. C2M did not change in any group. Using data from all groups, change in C1M (p<0.0001), C3M (p<0.0001), as well as CRPM (p=0.0004) from baseline to 18 months was positively associated with change in weight. No marker was associated with change in WOMAC pain or radiographic progression. C3M (p=0.008) and CRPM (p=0.028) were positively associated with change in WOMAC function. Change in IL-6 was positively associated with change in C1M, C3M, and CRPM. Conclusion Overweight and obese adults with knee OA who lost weight from diet and diet plus exercise reduced serum markers of interstitial matrix turnover and inflammation but not type II collagen degradation.

Impact of Exercise Therapy on Molecular Biomarkers Related to Cartilage and Inflammation in Individuals at Risk of, or With Established, Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

“…Ultimately, we included 12 articles involving 57 study comparisons (Figure ). One study was reported in 2 different articles . We included both articles and counted them as 1 study with 2 study comparisons, as suggested in the Cochrane guidelines.…”

“…Biomarker samples were obtained at 4 to 24 weeks following the exercise therapy intervention in all the studies. Additionally, 3 studies reported in 4 articles included 1 additional follow‐up assessment at 18 months ; see Supplementary Table , available on the Arthritis Care & Research web site at http://onlinelibrary.wiley.com/doi/10.1002/acr.23786/abstract for a narrative synthesis of these results. However, we included the first available follow‐up time point in our analyses to allow for a more homogeneous time to follow‐up, ranging from 1 to 6 months across the included studies.…”

The acute and long‐term impact of physical activity on biochemical markers and MRI measures in osteoarthritis—Perspectives for clinical osteoarthritis research

“…Furthermore, one large study found decreased serum levels of CRPM, C1M, and C3M, suggesting beneficial effects of regular exercise on inflammation, bone, and cartilage health. 24 The current literature indicates that COMP is a dynamic BM, which may be suitable when assessing acute PA impact on joint tissue. However, COMP is not specific to cartilage, as COMP is present in tendinous tissue, 25 which is also largely stimulated during PA. Other dynamic and more specific BM, such as ARGS neoepitope of aggrecan (ARGS), 26 which may be useful for assessment of acute and long-term impact of PA still need evaluation.…”

Nonsurgical Management of Cartilage Defects of the Knee: Who, When, Why, and How?

“…However, these systemic biomarker changes were not associated with improvements in WOMAC pain or function despite signs of structural enhancement in the joint on MRI. 32…”