Background Osteoarthritis of the hands is one of the most prevalent musculoskeletal diseases.Epidemiological studies have shown an intriguing correlation between hand OA and obesity. Since mechanical stress cannot explain such a correlation, metabolic factors have been suggested to play a significant role. Adipocytes secrete adipokines such as leptin, adiponectin, resistin and visfatin, which exert regulatory activities on target tissues and cells involved in rheumatic diseases including OA.
Objectives Determine the association between serum adipokines levels and the severity of hand osteoarthritis.
Methods Fifty patients with primary HOA; diagnosed according to the American College of Rheumatology (ACR) classification criteria for HOA were enrolled in this study.
Local Hand musculoskeletal examination was performed where distal interphalangeal (DIP), proximal interphalangeal (PIP), interphalangeal (IP), metacarpopharangeal (MCP)and trapeziometacarpal joints were examined for tenderness, soft tissue swelling, hard tissue enlargement, and deformity.
Body mass index (BMI) was calculated for each patient, pain was assessed by VAS. Grip strength was measured with a dynamometer, and pinch strength was measured with a pinchmeter.
Pain, stiffness and physical function were assessed using AUSCAN-index
Serum level of leptin, adiponectin and resistin were detected by ELISA technique.
The Kellgren and Lawrence (KL) scale was used for assessing severity of OA radiologically.
High resolution ultrasound examination of the hands was done using linear multifrequency transducer for assessment of joint abnormalities.
Results Following the assessment of one hundred osteoarthritic hands, the results of the study were as follows: there was a significant positive correlation between serum levels of leptin and the age, disease duration and BMI of studied patients. The number of osteophytes detected sonographically in the PIPs, MCPs and IPs correlated positively with serum leptin levels. Also, there was a significant negative correlation between serum leptin and grip and pinch strength. Whereas there was no significant correlation between serum leptin levels and clinical findings, KL scale and AUSCAN scale. There was a significant positive correlation between serum levels of adiponectin and both effusion and the number of osteophytes detected sonographically in the IP joints.Whereas there was no significant correlation between serum adiponectin levels and clinical findings, KL scale, AUSCAN scale and grip and pinch strength. A significant positive correlation was found between serum resistin levels and hard swelling detected clinically in the DIPs and the PIPs as well as osteophytes detected sonographically. No significant correlation was found between resistin and BMI, AUSCAN scale and grip and pinch strength.
Conclusions Leptin, adiponectin and resistin could be an important factor in the development of HOA and its severity in obese patients.
Disclosure of Interest None declared