Health related quality of life among patients with erosive hand osteoarthritis in The United States

Abstract

The study was designed to investigate the influence of type 2 diabetes mellitus (T2DM) on articular syndrome and parameters of cytokines in patients with osteoarthritis (OA). Methods: The study involved 49 patients (10 males), aged 56.37±1.17 with OA and T2DM in Regional Hospital of Kharkov. All patients were divided into 2 groups: group 1 (n¼21)-with OA, group 2 (n¼28)-with combined course of OA and T2DM (BMI<30 kg/m2). Baseline characteristics of patients included history of OA (1st group-8.52±0.53 years; 2nd group-7.39±0.52 years), T2DM (9.85±0.97 years). The survey plan included anthropometric data, global knee pain [visual analog scale (VAS)], the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), indices of carbohydrate exchange (insulin, glucose, HbA1C, HOMA-IR). The level of HbA1C was <7.5% in all patients. The level of C-reactive protein (CRP) was determined by using of a latex test. The level of TNF-a and IL-1b was determined by ELISA. The X-ray examination of knees was performed for all patients. Results: A statistically significant relations between the degree of diagnosis complexity and radiological changes by Kellgren were found (M-L X^2¼15.58 p¼0.0036<0.05). The indices of WOMAC Pain score and WOMAC stiffness were similar in both groups, but the indices of WOMAC physical function subscore were significantly higher in the 2nd group (M-W U¼88, Z¼À4.167, p¼0.00003). The levels of TNF-a, IL-1b and CRP were higher in group with OA and T2DM, however the difference was not significant. We found significant correlation between TNF-a and IL-1b in both groups (1st-r¼0.66; р<0.05; 2nd-r¼0.70; р<0.05). The significant correlation between TNF-б and CRP was determined in group of patients with OA (r¼0.46; р<0.05) as well as in the group with combined course of OA and T2DM (r¼0.82; р<0.05). Also the correlation between IL-1b and CRP was determined in 1st group(r¼0.48; р<0.05) and in the 2nd group as well (r¼0.52; р<0.05). The level of indices of WOMAC Pain score correlated with TNF-a (r¼0.63; р<0.05), IL-1b (r¼0.45; р<0.05) and CRP (r¼0.66; р<0.05) among the patients of the 1st group. We determined significant correlation between WOMAC Pain score and TNF-a (r¼0.44; р<0.05), IL-1b (r¼0.47; р<0.05); between WOMAC stiffness and TNF-a (r¼0.39; р<0.05), also between WOMAC physical function score and CRP (r¼0.29; р<0.05) in the 2nd group with comorbid pathology. Conclusions: The study demonstrates that T2DM was associated with more pronounced radiographic changes and more severe changes of physical function in patients with comorbid OA. Significant correlation between TNF-a, IL-1b and CRP in patients with combined course of OA and T2DM suggests that T2DM can be an important factor that contributes to derangements of immune and metabolic processes and progression of OA.

Deep learning‐based fully automatic segmentation of wrist cartilage in MR images

“…The early diagnosis of a cartilage degeneration is essential for a proper choice of treatment modality and leads to a better prognosis of the treatment outcome. Quality of life of patients with OA is usually not very high due to factors such as physical limitations and pain 29,30 . Despite the fact that fewer and fewer people in the modern world are involved in manual labor, the majority of people work with computers, and disability of wrists may have a crucial impact on their working ability.…”