EXTENDED REPORT

Urinary type II collagen C-telopeptide levels are increased in patients with rapidly destructive hip osteoarthritis

P Garnero^1,2, T Conrozier³, S Christgau⁴, P Mathieu³, P D Delmas¹, E Vignon³

¹ INSERM Research Unit 403, Lyon France
² Synarc, Lyon, France
³ Hôpital Sud, Lyon, France
⁴ NordicBiosciences, Herlev, Denmark

Correspondence to:
Correspondence to:
Dr P Garnero, INSERM Unit 403, Hôpital E Herriot, Pavillon F, 69437 Lyon Cedex 03, France;
patrick.garnero{at}synarc.com

Objective: To compare type II collagen degradation using a new urinary specific marker in patients with rapidly destructive and those with slowly progressive hip OA.

Methods: Twelve patients with rapidly destructive and 28 patients with slowly progressive hip OA were included in a prospective, cross sectional case-control study. Urinary levels of C-terminal crosslinking telopeptide of collagen type II (CTX-II) as a marker of cartilage degradation were measured by an ELISA, and urinary free deoxypyridinoline (free DPD), a marker of bone resorption, was measured by high performance liquid chromatography. One x ray evaluation of the hips and urine samples was made in all patients when the diagnosis of OA was established.

Results: Patients with hip OA had higher mean (SD) urinary CTX-II levels than 65 healthy age matched controls (492 (232) v 342 (141), p<0.001), but no significant difference was seen for urinary free DPD (p=0.30). Increased urinary CTX-II, but not urinary free DPD, correlated significantly with decreased minimum joint space width assessed by radiograph of the hip. Mean urinary CTX-II levels were significantly higher in patients with rapidly progressive OA than in the slowly progressive group (612 (218) v 441 (221), p=0.015), whereas no significant difference of urinary free DPD was seen between the two groups (p=0.55).

Conclusion: Patients with hip OA have increased CTX-II degradation as assessed by a new urinary marker. Increased urinary CTX-II levels are associated with rapidly destructive disease, suggesting that this marker might be useful in identifying patients with hip OA at high risk for rapid progression of joint damage.

Keywords: hip; osteoarthritis; cartilage; pyridinoline; type II collagen

Abbreviations: BMI, body mass index; CTX-II, C-terminal crosslinking telopeptide of type II collagen; DPD, deoxypyridinoline; JSW, joint space width; OA, osteoarthritis

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