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Changes in serum osteocalcin but not other serum and urinary markers of bone and cartilage metabolism,measured after 12 months,are significantly correlated to long-term (36 months) structural changes in knee osteoarthritis (OA).


Jean-Yves Reginster:1,2, Julien Collette:1, Lucio Rovati: 3, Rita Deroisy:1, Olivier Bruyere: 1,2, YvesHenrotin: 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.

In a population of 212 patients,suffering from knee osteoarthritis (OA) and followed for three years in a double-blind, placebo controlled prospective study, evaluating the effects of glucosamine sulfate on OA symptoms and joint structure, we measured, at baseline and after one year of follow-up, 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).

We investigated whether the changes observed after one year in these biochemical markers were related to the changes observed after three years in structural indices (mean joint space width (JSW) and joint space narrowest point (JN) of the progression of OA, after correction for treatment (glucosamine or placebo) effect. 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. The only biochemical parameter for which a correlation was observed, independently of treatment effect, with structural progression of the disease was serum osteocalcin.

After adjusting for treatment effect, a decrease in serum osteocalcin observed during the first year of the treatment was significantly associated with a lesser deterioration of joint space after three years of follow-up, assessed both by the mean joint space width (p =0.025) or the narrowest point of the joint space (p =0.008). No significant correlations were observed between changes in HA, KS, Pyr, Dpyr, or COMP after one year and structural changes observed in knee joint after three years. We conclude that early changes in serum osteocalcin, a marker of bone turnover, could be predictive of long-term structural changes in knee OA.