Urinary CTX-II levels are associated with radiographic subtypes of osteoarthritis (OA) in hip, knee, hand and facet joints in subject with familial OA at multiple sites. The GARP study

Ingrid Meulenbelt ^1*, Margreet Kloppenburg ¹, Herman M. Kroon ¹, Jeanine J. Houwing-Duistermaat ¹, Patrick Garnero ², Marie-Pierre Hellio Le Graverand ³, Jeroen DeGroot ⁴ and Eline P. Slagboom ¹

¹ LUMC, Netherlands
² Synarc, France
³ Pfizer, United States
⁴ TNO, Netherlands

^* To whom correspondence should be addressed. E-mail: i.meulenbelt{at}lumc.nl.

Accepted 25 July 2005

Abstract

Objective: To assess the relationship between the urinary levels of type II collagen C-telopeptide (UCTX-II) and radiographic signs of osteoarthritis (ROA) in the GARP (Genetics Osteoarthritis and Progression) study.

Methods: UCTX-II levels were measured in the GARP study consisting of sibling pairs predominantly with symptomatic OA at multiple sites. ROA was assessed in the knees, hips, hands, vertebral facet joints and spinal disc degeneration (DD) by the Kellgren and Lawrence score. A proportionate score was made for each joint location based on the number of joints with ROA. Summed, the total ROA score represents a measure of cartilage abnormalities within each patient. By using linear mixed models the total ROA score and the joint- site specific ROA scores were associated to the UCTX-II level.

Results: In 302 subjects the mean (sd) and median (range) level of UCTX-II was 265 (168) and 219 (1346) ng/mmol creatine, respectively. We found significant association between the total ROA score and UCTX-II levels. Subsequent multivariate analysis showed that the joint site-specific ROA score of all joint sites, except for spinal DD, independently of each other contributed to this association.

Conclusion: The total ROA score of GARP patients representing cartilage abnormalities at the most prevalent ROA joint locations showed a remarkable sensitive association with UCTX-II levels. Furthermore, it is shown that the specific ROA score of the hip, hand, facet and knee joints additively and independently explain this association. Even within patients with OA at multiple sites, UCTX-II may be a sensitive quantitative marker of ROA.

Keywords: Biochemical, GARP-study, UCTX-II, marker, osteoarthritis

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