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The cartilage degradation marker, urinary CTX-II, is associated with the risk of incident total joint replacement in postmenopausal women. A 18 year evaluation of the OFELY prospective cohort.
Osteoarthritis Cartilage. 2020 04; 28(4):468-474.OC

Abstract

OBJECTIVE

Identifying objective risk-indicators for total joint replacement (TJR) is useful to enrich population at high risk in OA clinical trials. We investigate the association of urinary CTX-II, a biochemical marker of cartilage breakdown, with the risk of TJR.

METHOD

478 postmenopausal women (mean age 65.5 ± 7.5 yr) from the OFELY cohort were studied. CTX-II, serum CTX-I (bone resorption) and PINP (bone formation), were measured at baseline. Association between CTX-II and incidence of TJR was assessed by Cox Hazard Regression.

RESULTS

During a median (95%CI) 17.8 (15.0-18.1) years follow-up, 38 women sustained a TJR, including hip (n = 29) or knee (n = 9) replacement. CTX-II -but not CTX-I or PINP- was higher in patients with TJR (+34%, P = 0.001 vs women with no TJR). Increased baseline CTX-II levels were associated with a higher risk of TJR with a Hazard Ratio (HR) (95 CI) of 1.45 (1.13-1.85) per 1 SD increase after adjustment for age, BMI and total hip BMD. CTX-II remained significantly associated with the risk of TJR after further adjustment for total WOMAC, prevalent knee OA (KL ≥ 2) and self-reported hip OA [HR (95 CI): 1.31 (1.01-1.71), P = 0,04]. When women were categorized as low and high CTX-II (lower and above the 95 percentile of healthy premenopausal women, respectively), subjects with high levels had an age-BMI-hip BMD adjusted HR (95 CI) of 3.00 (1.54-5.85) compared to women with low levels which remained significant after further adjustment for WOMAC, knee and/or hip OA [HR (95 CI): 2.45 (1.25-4.89), P = 0.01].

CONCLUSION

CTX-II is an independent risk indicator of TJR in postmenopausal women suggesting that it may be useful to identify subjects at high risk of TJR.

Authors+Show Affiliations

INSERM research unit 1033-Lyos, Lyon, France. Electronic address: patrick.garnero@inserm.fr.INSERM research unit 1033-Lyos, Lyon, France.INSERM research unit 1033-Lyos, Lyon, France.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31982562

Citation

Garnero, P, et al. "The Cartilage Degradation Marker, Urinary CTX-II, Is Associated With the Risk of Incident Total Joint Replacement in Postmenopausal Women. a 18 Year Evaluation of the OFELY Prospective Cohort." Osteoarthritis and Cartilage, vol. 28, no. 4, 2020, pp. 468-474.
Garnero P, Sornay-Rendu E, Chapurlat R. The cartilage degradation marker, urinary CTX-II, is associated with the risk of incident total joint replacement in postmenopausal women. A 18 year evaluation of the OFELY prospective cohort. Osteoarthritis Cartilage. 2020;28(4):468-474.
Garnero, P., Sornay-Rendu, E., & Chapurlat, R. (2020). The cartilage degradation marker, urinary CTX-II, is associated with the risk of incident total joint replacement in postmenopausal women. A 18 year evaluation of the OFELY prospective cohort. Osteoarthritis and Cartilage, 28(4), 468-474. https://doi.org/10.1016/j.joca.2019.12.012
Garnero P, Sornay-Rendu E, Chapurlat R. The Cartilage Degradation Marker, Urinary CTX-II, Is Associated With the Risk of Incident Total Joint Replacement in Postmenopausal Women. a 18 Year Evaluation of the OFELY Prospective Cohort. Osteoarthritis Cartilage. 2020;28(4):468-474. PubMed PMID: 31982562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The cartilage degradation marker, urinary CTX-II, is associated with the risk of incident total joint replacement in postmenopausal women. A 18 year evaluation of the OFELY prospective cohort. AU - Garnero,P, AU - Sornay-Rendu,E, AU - Chapurlat,R, Y1 - 2020/01/23/ PY - 2019/09/13/received PY - 2019/12/06/revised PY - 2019/12/31/accepted PY - 2020/1/27/pubmed PY - 2021/4/30/medline PY - 2020/1/27/entrez KW - Biomarker KW - CTX-II KW - Osteoarthritis KW - Total joint replacement SP - 468 EP - 474 JF - Osteoarthritis and cartilage JO - Osteoarthritis Cartilage VL - 28 IS - 4 N2 - OBJECTIVE: Identifying objective risk-indicators for total joint replacement (TJR) is useful to enrich population at high risk in OA clinical trials. We investigate the association of urinary CTX-II, a biochemical marker of cartilage breakdown, with the risk of TJR. METHOD: 478 postmenopausal women (mean age 65.5 ± 7.5 yr) from the OFELY cohort were studied. CTX-II, serum CTX-I (bone resorption) and PINP (bone formation), were measured at baseline. Association between CTX-II and incidence of TJR was assessed by Cox Hazard Regression. RESULTS: During a median (95%CI) 17.8 (15.0-18.1) years follow-up, 38 women sustained a TJR, including hip (n = 29) or knee (n = 9) replacement. CTX-II -but not CTX-I or PINP- was higher in patients with TJR (+34%, P = 0.001 vs women with no TJR). Increased baseline CTX-II levels were associated with a higher risk of TJR with a Hazard Ratio (HR) (95 CI) of 1.45 (1.13-1.85) per 1 SD increase after adjustment for age, BMI and total hip BMD. CTX-II remained significantly associated with the risk of TJR after further adjustment for total WOMAC, prevalent knee OA (KL ≥ 2) and self-reported hip OA [HR (95 CI): 1.31 (1.01-1.71), P = 0,04]. When women were categorized as low and high CTX-II (lower and above the 95 percentile of healthy premenopausal women, respectively), subjects with high levels had an age-BMI-hip BMD adjusted HR (95 CI) of 3.00 (1.54-5.85) compared to women with low levels which remained significant after further adjustment for WOMAC, knee and/or hip OA [HR (95 CI): 2.45 (1.25-4.89), P = 0.01]. CONCLUSION: CTX-II is an independent risk indicator of TJR in postmenopausal women suggesting that it may be useful to identify subjects at high risk of TJR. SN - 1522-9653 UR - https://www.unboundmedicine.com/medline/citation/31982562/The_cartilage_degradation_marker_urinary_CTX_II_is_associated_with_the_risk_of_incident_total_joint_replacement_in_postmenopausal_women__A_18_year_evaluation_of_the_OFELY_prospective_cohort_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1063-4584(20)30029-7 DB - PRIME DP - Unbound Medicine ER -