الفهرس 
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Abstract
Osteoarthritis (OA) is a chronic degenerative condition of mobile joints, primarily a non-inflammatory disorder characterized by an imbalance between the synthesis and degradation of articular cartilage leading to classic pathological change of wearing away and destruction of cartilage (Brandet et al, 2009).
Adrenomedullin (ADM), a recently identified myokine, has an anti-inflammatory effect, ADM may be involved in the pathogenesis of OA through the anti-inflammatory effect. The aim of the present study was to assess the correlation of serum adrenomedullin concentrations with the presence and grade of severity of the knee osteoarthritis (OA)
The present study was a case-control study conducted on 70 individuals divided into two groups; fifty (50) patients with OA of the knee diagnosed according to American college of Rheumatology (ACR) Revised Criteria for Early Diagnosis of Knee Osteoarthritis and; twenty (20) healthy volunteers with no clinical features of OA matched in age and sex with the OA patients. The Kellgren and Lawrence classification was used to evaluate the disease severity of knee OA. All patients were subjected to full clinical and laboratory investigations. Disease activity in osteoarthritis patients was assessed by The Western Ontario and Mcmaster Universities Arthritis Index (WOMAC). Blood samples had been collected from patients with OA and healthy controls and were kept to assess adrenomedullin in patients’ sera by ELISA technique using commercially available kits according to the manufacturer’s instructions.
There were a significant increased serum adrenomedullin concentrations in the case group compared to the control group (10.64 ±19.2 vs. 1.39 ±1.6) in cases and controls respectively; (p-value = 0.036). Spearman correlation analysis showed a positive significant correlation of serum adrenomedullin concentrations with KL grades (r=0.608, p-value <0.001; and r=0.438, p-value <0.001) in the studied Rt. And Lt knees respectively. No detected significant correlation between Body Mass Index (BMI) and Serum adrenomedullin concentrations. There were significantly increased serum adrenomedullin concentrations in the OA case group had VAS Score >6 as compared to the OA case group had VAS Score <6
This study concluded that serum adrenomedullin (ADM) level probably plays a part in the regulation of the inflammatory process of OA, and its plasma levels could be used as an index of the degree of OA disease; our data suggest that plasma ADM levels increase with the activity of OA.