Urinary CTX-II and Glucosyl-galactosyl-pyridinoline are associated with presence and severity of radiographic knee osteoarthritis in men

Kelsey M Jordan ¹, Holly E Syddall ¹, Patrick Garnero ², Evelyne Gineyts ², Elaine Dennison ¹, Avan Aihie Sayer ¹, Pierre D Delmas ³, Cyrus Cooper ¹ and Nigel K Arden ^4*

¹ MRC Environmental Resource Centre, United Kingdom
² INSERM U 403, France
³ University Lyon, France
⁴ Southampton General Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: nka{at}mrc.soton.ac.uk.

Accepted 9 November 2005

Abstract

Objective: To investigate the association between biochemical markers of bone, cartilage and synovial turnover with the presence and severity of knee osteoarthritis in men

Methods: 176 men aged 59-70 years from the MRC Hertfordshire Cohort were studied. Weight bearing AP and lateral semi-flexed radiographs were taken of both knees. A lifestyle questionnaire including basic demographic details and a questionnaire detailing knee pain was completed. This stratified random sample based on Kellgren Lawrence (K/L) score had analysis of the following biochemical markers: serum osteocalcin, serum C-terminal crosslinked telopeptide of type I collagen (CTX-I), urinary C-terminal crosslinked telopeptide of type II collagen (CTX-II) and urinary glucosyl- galactosyl-pyridinoline (Glc-Gal-Pyd).

Results: Age, BMI, social class, smoking and alcohol consumption were similar across K/L grades. There was only one subject with grade 4 K/L score, who was amalgamated with grade 3 subjects. There was a strong statistically significant association between presence of knee osteoarthritis and urinary CTX-II and urinary Glc-Gal-Pyd (p=0.0001 and p=0.009), which persisted after adjustment for age and BMI. There was also a significantly positive association between urinary CTX-II and urinary Glc-Gal-Pyd and the severity of K/L grade, joint space narrowing and osteophytes scores which also persisted after adjustment for age and BMI. No associations between presence and severity of knee osteoarthritis were found for serum CTX-I or serum osteocalcin.

Conclusions: Urinary CTX-II and Glc-Gal-Pyd, but not systemic markers of bone turnover, are strongly associated with disease severity and presence of osteoarthritis at the tibio-femoral and patello-femoral joints in men.

Keywords: Urinary CTX-II, biochemical markers, knee osteoarthritis, radiographic osteoarthritis, urinary Glc-gal-pyd

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