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Do synovial leptin levels correlate with pain in end stage arthritis?

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Abstract

Purpose

We evaluated whether synovial fluid (SF) leptin concentrations correlate with pain severity in patients with hip or knee endstage osteoarthritis (OA) and whether they mediate the association between increased joint pain and (1) female gender and (2) obesity.

Methods

We conducted a cross-sectional study including patients with primary hip and knee OA undergoing joint replacement between January and December 2010. SF leptin concentrations obtained on the day of surgery were assessed. Main outcome was pain severity measured pre-operatively using WOMAC and VAS pain scales.

Results

A total of 219 patients were included, 123 hip and 96 knee arthroplasties. Mean age was 72 years, 59 % were women. Mean SF leptin levels were 22.9 (±25.6) ng/ml in women and 5.4 (±5.9) ng/ml in men. Levels >19.6 ng/ml (highest quartile) were significantly associated with increased pain on both WOMAC (mean difference −9.6, 95 % CI −15.1 to −4.0) and VAS scale (mean difference 0.8, 95 % CI 0.2–1.3). Associations remained unchanged after adjusting for age, co-morbidities, contra-lateral arthritic joint, OA site, and disability. The associations observed between increased pain and female gender or obesity were substantially reduced after adjusting for SF leptin.

Conclusion

Joint pain is associated with SF leptin concentrations. Increased pre-operative pain observed in women and obese may be related to high intra-articular leptin levels.

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Acknowledgment

The authors would like to express their deep appreciation to all the orthopaedic surgeons, the personnel of the operating room and especially to Mme Carole Bandi and Mme Madeleine Vuillet for their efforts in data collection.

Funding

Internal institutional funding was received for this study.

Prof. Pierre Hoffmeyer received institutional financial support from Medacta, Johnson & Johnson, and Zimmer. The funding sources had no role in the collection, analysis, or interpretation of the data, in the preparation of the manuscript, or its submission for publication.

Conflicts of interest

None declared.

Ethics committee approval

The study was approved by the institutional review board of the Geneva University Hospitals and the patients’ informed consent was obtained (N° 09-215; NAC 09-072).

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Authors and Affiliations

  1. Division of Orthopaedics and Trauma Surgery, University of Geneva and Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Genève, Switzerland

    Anne Lübbeke, Gabor J. Puskas, Domizio Suva, Alexandre Lädermann, Daniel Fritschy & Pierre Hoffmeyer

  2. Division of Rheumatology, University of Geneva and Geneva University Hospitals, Geneva, Switzerland

    Axel Finckh & Cem Gabay

  3. Department of Medical Specialties and Department of Genetics and Laboratory Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland

    Sylvette Bas

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  1. Anne Lübbeke
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  2. Axel Finckh
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  9. Pierre Hoffmeyer
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Correspondence to Anne Lübbeke.

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Lübbeke, A., Finckh, A., Puskas, G.J. et al. Do synovial leptin levels correlate with pain in end stage arthritis?. International Orthopaedics (SICOT) 37, 2071–2079 (2013). https://doi.org/10.1007/s00264-013-1982-6

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  • DOI: https://doi.org/10.1007/s00264-013-1982-6

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