Background The influence of different interleukins on development and progression of osteoarthritis (OA) has been proved. However, there is lack of data on relationship between mental health and immunological features in OA patient with type 2 diabetes mellitus (T2DM).
Objectives To estimate the relationship between mental health and the proinflammatory serum cytokine levels in patients with knee OA and T2DM depending on glycemic control.
Methods A study was performed on 45 persons who had bilateral knee OA according to the ACR criteria and T2DM. Then patients were divided into two groups according to the compensation degree T2DM taking into account parameters of glycated hemoglobin concentrations (HbA1c) which were assessed using liquid chromatography. Group 1 (n=26) had controlled T2DM. Group 2 (n=19) had uncontrolled T2DM. All patients were comparable by age, sex and duration of OA. Serum cytokine levels (IL-1b, IL-6, IL-10, IL-18), NO, and adypokines (adiponectin, leptin) using ELISA were measured. Blood glucose level was also estimated. The parameters of QoL, mental health, depression degree and coping strategies to overcome pain were measured by short form 36 (SF-36), Knee injury and Osteoarthritis Outcome Score – (KOOS) and with patient health questionnaire-9 (PHQ-9), Coping Strategy Questionnaire (CSQ). We used U-Mann-Whitney tests to detect differences between selected groups. Correlation was assessed using Spearman correlation coefficient (rs).
Results Patients with OA and uncontrolled T2DM had significant low values of role limitations due to emotional problems (SF-RE) (median (Me) 38; interquartile range (IQR) 25–52.3; p=0.02). Serum cytokines levels were not different between studied groups. Correlation analysis identified the relationships between parameters of mental health and serum cytokine levels in OA patients with uncontrolled T2DM. Certain data are presented (Table).
Conclusions It follows from these results mental and immunology parameters of OA patients with uncontrolled T2DM can be linked. Such interleukins as IL-6 and IL-10 may play a role of potential biomarkers of mental impairment in this category of patients. These data should be verified by larger studies and may allow in future to develop programs of treatment and rehabilitation of OA patients with uncontrolled T2DM within personalized medicine.
Kapoor, M. Role of proinflammatory cytokines in the pathophysiology of osteoarthritis/M. Kapoor, J. Martel-Pelletier, D. Lajeunesse et al. Nat. Rev. Rheumatol. 2011;7(1):33–42.
Stannus, O. Circulating levels of IL-6 and TNF-alpha are associated with knee radiographic osteoarthritis and knee cartilage loss in older adults/O. Stannus, G. Jones, F. Cicuttini et al. Osteoarthr. Cartil. 2010:18(11):1441–1447.
Louati K. et al. Association between diabetes mellitus and osteoarthritis: systematic literature review and meta-analysis. RMD open. 2015;1(1).
Disclosure of Interest None declared