Gonartrotik Kıkırdak Dejenerasyonunun Metabolik Sendrom ve İnflamatuar İndikatörler İle İlişkisi: Yeni Bir Bakış

Amaç: Yüksek vücut kitle indeksi (BMI), merkezi obezite, yüksek yoğunluklu lipoprotein (HDL) seviyesi düşüklüğü, yüksek trigliserid, yüksek tansiyon ve hiperglisemi gibi bir dizi metabolik anormalliğin kombinasyonu metabolik sendrom (MetS) olarak tanımlanır. Bu çalışma metabolik sendrom bileşenlerinin eklem dejenerasyonuna etkisini ve sistemik iltihabi cevapla son evre osteoartritin klinik gidişatı arasındaki ilişkiyi araştırmayı amaçlamaktadır. Material ve Metod: Primer diz osteoartriti sebebiyle total diz artroplastisi uygulanan elliyedi hasta, metabolik sendrom tanı kriterlerine göre sınıflandırıldı ve Uluslarasarası Osteoartrit Araştırma Grubu (Osteoarthritis Research Society International - OARSI) skorlama sistemine göre medial ve lateral tibial plato örnekleri histopatolojik olarak evrelendi. Bulgular: 33 hastaya sağ (% 57.9), 24 hastaya sol (% 42.1) total diz artroplastisi uygulandı. Ortalama yaş 68.46 ± 6.88 idi (57-85). Ortalama BMI değeri 30.31 ± 5.26 idi (20.2 - 48). Uluslarası Diabet Kuruluşu’nun (International Diabetes Foundation - IDF) 2005 metabolik sendrom tanı kriterlerine göre; % 31.5 (n = 18) hastada metabolik sendrom yokken, % 68.4 (n = 39) hastada vardı. Tibial plato OARSI skorlarıyla metabolik sendrom tanı kriterleri arasında istatistiksel anlamlı bir ilişki bulunamadı (p> 0.05). Ayrıca OARSI skorlarıyla opere taraf, hipertansiyon ve BMI arasında da istatistiksel anlamlı bir ilişki yoktu (p> 0.05). Sonuç: Metabolik sendrom bileşenleri adipokinler yoluyla osteoartrit gelişimini başlatıcı etkiye sahip olabilse de, tibia plato kıkırdağı dejenerasyonu ile proinflamatuar mediatörler arasında artritik sürecin son evresine kadar devam eden bir ilişki tespit edemedik.

The Relationship of Inflammatory Indicators and Metabolic Syndrome with Gonarthrotic Cartilage Degeneration: A Novel Glance

Objective: The combination of a number of metabolic abnormalities such as highbody mass index (BMI), central obesity, low high-density lipoprotein (HDL), hightriglycerides, high blood pressure, and hyperglycemia is defined as metabolicsyndrome (MetS). This study aimed to clarify the effect of metabolic syndromecomponents on joint degeneration and investigate the relationship between systemicinflammatory response and end-stage osteoarthritis clinical course.Material and Methods: Fifty-seven patients, who underwent total knee arthroplastydue to primary knee osteoarthritis, were classified according to metabolic syndromediagnosis criteria. Their medial and lateral tibial plateau specimens were gradedhistopathologically according to Osteoarthritis Research Society International scoringsystem (OARSI).Results: 33 patients were performed right total arthroplasty (57.9%), 24 wereperformed left (42.1%). The mean age was 68.46 ± 6.88 (range 57 to 85). Themean BMI value was 30.31 ± 5.26 (range 20.2 to 48). According to the InternationalDiabetes Foundation (IDF) 2005 metabolic syndrome (MetS) diagnostic criteria;31.5% (n = 18) of the patients did not have MetS, while 68.4% (n = 39) had. Therewas no statistically significant relationship between tibial plateau OARSI scores andmetabolic syndrome (p> 0.05). Besides, these OARSI scores and the operation side,hypertension, and BMI had no statistically significant relationship (p> 0.05).Conclusions: Metabolic syndrome components may play a role in initiating theosteoarthritic process via adipokines, but we could not identify certain effects ofpro-inflammatory mediator components on tibial plateau cartilage degeneration withhistopathological scores till end-stage arthritic progress.

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