الفهرس 
Aetiology of OsteoarthritisOnly 14 pages are availabe for public view
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Abstract
Background:
Osteoarthritis (OA) which is characterized by articular cartilage loss, subchondral bone remodeling, soft tissue damage and low grade synovitis, is the most common form of arthritis and a major cause of disability in the adult population (Goldring and Goldring, 2010 & Karvonen-Gutierrez et al., 2013). Knee OA is among the most common burden diseases in developed and developing countries and its prevalence is set to continue to increase in the near future, likely due to aging of the population (Salihu et al., 2009).
Most treatment options of OA, including physiotherapy, lifestyle modifications and pharmacotherapy, aim to provide symptomatic relief rather than targeting the disease process itself ending in progressive cartilage damage necessitating surgical intervention (Felson, 2006 & Sawitzke et al., 2010).
In recent years, biomarkers offer a potential alternative mean for earlier diagnosis of OA and show a promising factor in determination of the disease severity (Blanco, 2014). Resistin is a macrophage / monocyte derived adipokine and its production can be induced by proinflammatory cytokines as IL-1, IL-6 and TNF (Steppan and Lazar, 2002 & Kaser et al., 2003). Resistin can induce inflammatory cytokines and PGE2 synthesis. These proinflammatory cytokines can lead to the degeneration of cartilage and damage of other structures involved in OA (Lee et al., 2009).
Aim:
To measure serum resistin level in patients with primary knee OA in order to find out its possible relation to disease severity.
Patients and Methods:
This study was conducted on 30 patients with primary knee OA fulfilling ACR criteria for the classification of knee OA (Altman et al., 1986) and ten healthy subjects serving as a control group. The two groups were matching in age, sex and BMI.
All subjects were subjected to full medical history, clinical examination, laboratory investigations including (CBC, ESR, serum uric acid, serum creatinine, liver function tests, fasting and 2 hours post prandial blood glucose, lipid profile, RF, ANA and serum resistin level) and also severity of primary knee OA was assessed using K-L grading of knee radiographs and WOMAC score.
Results:
• There was no statistically significant difference between the cases and the controls regarding age, sex and BMI.
• There was a highly significant difference between patients and controls regarding serum resistin level.
• There was a highly significant positive correlation of serum resistin level with age and disease duration.
• There was a highly significant positive correlation between disease duration and K-L grading.
• There was a highly significant positive correlation of serum resistin level with K-L grading, WOMAC score (total and subscales).
• There was a non significant correlation of serum resistin level with BMI and ESR.
• Comparison between females & males in patients group and between patients who took & who did not take the following drugs: NSAIDs or glucosamine as regard serum resistin levels revealed no statistically significant difference.
• There was a significant difference between serum resistin levels in patients who had ligament laxity and highly significant difference in patients who had bilateral joint affection, effusion and morning stiffness compared with other patients.
• There was a high statistically significant difference of serum resistin on comparing its levels in patients with knee OA classified according to K-L grading.
• There was a significant difference as regard serum resistin level between grades (2&3) and a highly significant difference between grades (2&4) and (3&4).
• ROC curve (receiver operating characteristic) showed that serum resistin level can be used for diagnosis of cases at a cut off level of 2.6ng/ml with 100% sensitivity and 90% specificity.
Conclusion:
Resistin measurement may not only serve as a biochemical marker for disease severity but also has the potential to contribute to the fundamental processes underlying the pathogenesis of primary knee OA.