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Associations between endogenous sex hormones and MRI structural changes in patients with symptomatic knee osteoarthritis


Jin, X and Wang, BH and Wang, X and Antony, B and Zhu, Z and Han, W and Cicuttini, F and Wluka, AE and Winzenberg, T and Blizzard, L and Jones, G and Ding, C, Associations between endogenous sex hormones and MRI structural changes in patients with symptomatic knee osteoarthritis, Osteoarthritis and Cartilage, 25, (7) pp. 1100-1106. ISSN 1063-4584 (2017) [Refereed Article]

Copyright Statement

© 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI: doi:10.1016/j.joca.2017.01.015


Objective: To investigate the longitudinal association between endogenous sex hormones and knee osteoarthritis (OA) structures and pain.

Method: We examined 200 participants (mean age 63.0 ± 7.3 years) from a clinical trial of vitamin D supplement for symptomatic knee OA. Serum levels of estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG) were analyzed at baseline and 24 months later. Magnetic resonance imaging (MRI) scans of selected knee were obtained at both baseline and follow-up for the measurement of cartilage volume, cartilage defects, bone marrow lesions (BMLs) and effusion-synovitis volume. Knee pain was assessed using a 100 mm visual analogue scale (VAS). Longitudinal data were analyzed using linear mixed-effects model.

Results: One hundred and seven males and 93 females were included in this study. For females, after adjustment for age, body mass index (BMI), and vitamin D level, progesterone was positively associated with cartilage volume (β = 0.12 mm3 per quartile, P < 0.01). Estradiol levels were associated with lower grades of BMLs (β = -0.46 per quartile, P = 0.03), while estradiol (β = -1.28 per quartile, P = 0.04), progesterone (β = -1.56 per quartile, P < 0.01) and testosterone (β = -1.51 per quartile, P = 0.01) were inversely associated with effusion-synovitis volume. Testosterone was inversely associated with knee pain. No consistent associations were observed for males.

Conclusion: In women but not men, low serum levels of endogenous estradiol, progesterone and testosterone are associated with increased knee effusion-synovitis and possibly other OA-related structural changes. This may contribute to observed sex differences in knee OA.

Item Details

Item Type:Refereed Article
Keywords:bone marrow lesion, cartilage, effusion synovitis, osteoarthritis, sex hormone
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Jin, X (Mr Xingzhong Jin)
UTAS Author:Wang, X (Ms Xia Wang)
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
UTAS Author:Zhu, Z (Mr Zhaohua Zhu)
UTAS Author:Han, W (Dr Weiyu Han)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
ID Code:121406
Year Published:2017
Web of Science® Times Cited:26
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-09-27
Last Modified:2022-08-29

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