الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Decreased bone mass and joint degeneration are both common conditions in senior population. It would be anticipated that OP and OA frequently coexist due to their high prevalence in elderly. But the association between these conditions is still controversial even after years of research. Osteoporosis is commonly accepted as a bone disorder while OA is generally considered as a joint disorder. Causes which are included in the pathophysiology of OP can also be included in the pathophysiology of OA of the subchondral bone. Also If OA has been present for some time the resulting immobility is likely to affect bone mass. The identification of a subset of OA patients with osteoporotic or osteopenic BMD suggested that OA and OP can coexist in some cases, with no evident protective role of one disease on the other one.
Leptin, the protein product of obesity gene, is a hormone produced in adipose tissue and has several physiological functions such as energy homeostasis, neuroendocrine communication, reproduction, angiogenesis and bone formation. Leptin regulate osteoblast synthesis by both the central nervous system pathway and the peripheral way. Also leptin receptors are expressed within the cartilage and mediate many inflammatory and destructive responses in the joint tissues.
The aim of this work was to assess the relationship between knee OA and OP.
Twenty five primary knee OA patients according to ACR criteria were included in this study. Exclusion criteria were as follows: previous history of knee trauma, other rheumatologic and metabolic diseases. Full history of knee OA was taken and all patients subjected to complete knee clinical examination. Western Ontario and Mcmaster University Osteoarthritis Index (WOMAC) was used to assess severity of self-reported physical function limitation, pain, and stiffness. And disease severity was assessed by radiological KL grading system.
Laboratory parameters included ESR, CRP, serum uric acid, serum calcium, phosphorus, alkaline phosphatase and serum leptin were done for all subjects participating in this study. And BMD of femur neck, spine (L1-L4) and Lt radius were assessed by DEXA scan.
The current study showed a significant negative correlation between age of patients and BMD with the postmenopausal group had a significant lower BMD than the premenopausal group.
As regard functional questionnaire, there was statistically significant negative correlation between total WOMAC score of knee and BMD of Lt femur neck. While no significant correlation was observed with BMD of Lt radius and spine.
Serum leptin level, KL radiographic grading and BMI show non-significant correlation with BMD. While there was a significant positive correlation between WOMAC score and K-L radiographic grading of knee OA. Also a significant positive correlation was found between serum leptin level and BMI.
In conclusion, BMD decreases significantly with aging and worsening of functional state of knee OA patients, but it is not affected by severity of K-L radiographic grading and serum leptin level.