The presence of MEFV gene mutations in patients with primary osteoarthritis who require surgery

( Sedat Yilmaz ),( Hakan Erdem ),( Servet Tunay ),( Deniz Torun ),( Halil Genc ),( Yusuf Tunca ),( Omer Karadag ),( Ismail Simsek ),( Muhterem Bahce ),( Salih Pay ),( Ayhan Dinc ) 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.5

Background/Aims: Chronic arthritis of familial Mediterranean fever (FMF) involves weight-bearing joints and can occur in patients without a history of acute attack. Our aim was to investigate a possible causal relationship between FMF and osteoarthritis in a population in which FMF is quite common. Methods: Patients with late stage primary osteoarthritis were enrolled, and five MEFV gene mutations were investigated. The frequency of MEFV gene mutations was compared among patients with osteoarthritis and a previous healthy group from our center. Results: One hundred patients with primary osteoarthritis and 100 healthy controls were studied. The frequency of MEFV gene mutations was significantly lower in the osteoarthritis group (9% vs. 19%). M694V was the most frequent mutation (5%) in the osteoarthritis group, whereas in the control group, E148Q was the most common (16%). In subgroup analyses, the mutation frequency of patients with hip osteoarthritis was not different from that of patients with knee osteoarthritis and controls (7.1%, 9.7%, and 19%, respectively). There were no differences among the three groups with respect to MEFV gene mutations other than E148Q (8.1% vs. 3.6%). E148Q was significantly lower in the osteoarthritis group than in the controls (16% vs. 1%), although the mutations did not differ between patients with knee osteoarthritis and controls. Conclusions: In a population with a high prevalence of MEFV gene mutations, we did not find an increased mutation rate in patients with primary osteoarthritis. Furthermore, we found that some mutations were significantly less frequent in patients with osteoarthritis. Although the number of patients studied was insufficient to claim that E148Q gene mutation protects against osteoarthritis, the potential of this gene merits further investigation.

Prevalence of Knee Osteoarthritis and Health-Related Quality of Life in Stroke Patients over 60 Years Old: A Cross-Sectional Study Using Korean National Health and Nutrition Examination Survey V

Kil Yong Jeong,Hyun Jung Lee 대한노인병학회 2021 Annals of geriatric medicine and research Vol.25 No.3

Background: This study investigated the prevalence of knee osteoarthritis among stroke survivors aged over 60 years and analyzed the association between knee osteoarthritis and health-related quality of life (HRQOL) in stroke survivors. Methods: We analyzed data of 287 participants who had experienced a stroke (stroke group) from the 2010–2012 Korean National Health and Nutrition Examination Survey. Among the participants, 65 stroke survivors also had knee osteoarthritis. We used the European Quality of Life-5 Dimensions (EQ-5D) questionnaire to compare the differences in HRQOL according to the presence or absence of knee osteoarthritis in the stroke group. Multiple regression analysis was performed to determine associated factors affecting HRQOL in the stroke group. Results: The prevalence of knee osteoarthritis was 21% in the stroke group. The EQ-5D index score was significantly lower in patients in the stroke group with knee osteoarthritis than in those without knee osteoarthritis (adjusted mean ±standard error [SE], 0.680±0.011 for stroke with knee osteoarthritis and 0.817±0.003 stroke without knee osteoarthritis; p<0.0001). Knee osteoarthritis, age, income level, education level, smoking, diabetes, and cardiovascular disease significantly influenced HRQOL in the stroke group. Conclusion: The study results confirmed that the prevalence of knee osteoarthritis was 21% in the stroke group and that HRQOL was significantly lower among patients in the stroke group with knee osteoarthritis. These findings suggest the importance of active management of knee osteoarthritis in stroke survivors for HRQOL.

经筋针刺联合理筋疗法对膝骨性关节炎的临床应用研究

김효철 인문사회 21 2023 인문사회 21 Vol.14 No.2

The aim of this paper is to provide a summary of the clinical application of meridian acupuncture combined with tendon therapy for knee osteoarthritis, guided by the principles of meridian tendon theory. Additionally, this paper seeks to elucidate the clinical efficacy of this combined approach in treating knee osteoarthritis and to establish a foundation for the clinical application of meridian theory in the treatment of knee osteoarthritis. To achieve these goals, the author conducted a thorough review of relevant literature on the treatment of knee osteoarthritis with acupuncture based on meridian theory, using online data knowledge service platforms such as ‘China Knowledge Network’ and ‘Wanfang’. Keywords such as “meridian”, “acupuncture”, and “meridian tui na” were used to organize and study the relevant literature and compile the current research and relevant results on the treatment of knee osteoarthritis using acupuncture and meridian theory. Furthermore, the current status of research and relevant research results on the treatment of osteoarthritis of the knee based on the theory of meridian tendon were compiled. I found that the pathogenesis of knee osteoarthritis, a common clinical tendon disease, is closely related to the injury of the tendons in the acupuncture system of Chinese medicine. I concluded that knee osteoarthritis can be effectively treated by acupuncture at the focal points of the tendons, based on the effectiveness of acupuncture and tui-na therapy on osteoarthritis of the knee under the guidance of meridian tendon theory. I proposed the optimal treatment plan of “tendon first and then acupuncture”, as combining the two therapies can further improve the therapeutic effect of meridian tendon therapy on osteoarthritis of the knee. The preliminary results of the study showed that the core of knee osteoarthritis is the damage to the meridian tendons. Therefore, the treatment should focus on the release of the local damaged meridian tendon tissue pathological pressure through the meridian tendon massage and tendon manipulation, followed by the use of meridian tendon acupuncture to regulate the meridian tendons. The synergistic effect of the two therapies can restore the structural function of the knee joint, thus providing an optimal clinical treatment plan for the clinical treatment of knee osteoarthritis from the meridian tendon theory.

골관절염 노인의 건강수준, 건강행위와 삶의 질

양숙자 ( Sook Ja Yang ),안지숙 ( Ji Sook An ) 이화여자대학교 간호과학연구소 2011 Health & Nursing Vol.23 No.2

Purpose: The present study was to identify health status, health behavior and quality of life(QOL) in the elderly aged over 65 years with osteoarthritis compared with those of the healthy elderly. Methods: We analysed data from 326 elderly drawn from the Forth Korea National Health and Nutrition Examination Survey 2009 performed by Ministry of Health and Welfare and Korea Centers for Disease Control and Prevention: 244 elderly with osteoarthritis and 82 healthy elderly without chronic diseases. Results: The elderly with osteoarthritis were more likely to be female, no spouse, low educational level, low subjective health status and low functional health status. The elderly with osteoarthritis were found to have lower smoking, lower alcohol consumption and more obesity than those of the healthy elderly. Walking physical activity was not different between the elderly with osteoarthritis and the healthy elderly. Finally, the elderly with osteoarthritis were found to have lower mobility, lower usual activities, more pain/discomfort, and more anxiety/depression among EQ-5D(Euro Quality of Life-5 Dimension) health profiles, lower EQ-5D index and lower EuroQoL-VAS mean. Conclusions: The elderly with osteoarthritis were at high risk for poor QOL. It is necessary to supply a comprehensive management program to improve QOL for the elderly with osteoarthritis.

Natural Products as Sources of Novel Drug Candidates for the Pharmacological Management of Osteoarthritis: A Narrative Review

( Young-hoon Kang ),( Hyun Jae Lee ),( Choong Jae Lee ),( Jin-sung Park ) 한국응용약물학회 2019 Biomolecules & Therapeutics(구 응용약물학회지) Vol.27 No.6

Osteoarthritis is a chronic degenerative articular disorder. Formation of bone spurs, synovial inflammation, loss of cartilage, and underlying bone restructuring have been reported to be the main pathologic characteristics of osteoarthritis symptoms. The onset and progression of osteoarthritis are attributed to various inflammatory cytokines in joint tissues and fluids that are produced by chondrocytes and/or interact with chondrocytes, as well as to low-grade inflammation in intra-articular tissues. Disruption of the equilibrium between the synthesis and degradation of the cartilage of the joint is the major cause of osteoarthritis. Hence, developing a promising pharmacological tool to restore the equilibrium between the synthesis and degradation of osteoarthritic joint cartilage can be a useful strategy for effectively managing osteoarthritis. In this review, we provide an overview of the research results pertaining to the search for a novel candidate agent for osteoarthritis management via restoration of the equilibrium between cartilage synthesis and degradation. We especially focused on investigations of medicinal plants and natural products derived from them to shed light on the potential pharmacotherapy of osteoarthritis.

우리나라 골관절염 환자의 의료이용과 관련된 요인: 2005년 국민건강영양조사 자료를 이용하여

김민영,박종구,고상백,김춘배,Kim, Min-Young,Park, Jong-Ku,Koh, Sang-Baek,Kim, Chun-Bae 대한예방의학회 2010 예방의학회지 Vol.43 No.6

Objectives: The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. Methods: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. Results: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant association with medical utilization in men. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant association with medical utilization in women. Conclusions: The patients who tend to receive less care are those who suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.

Risk Factors for Osteoarthritis and Contributing Factors to Current Arthritic Pain in South Korean Older Adults

이경민,정진엽,성기혁,이승열,원성훈,김태균,최영,권순선,김연호,박문석 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.1

Purpose: Although previous studies have focused on risk factors for osteoarthritis, there is some debate on this issue. Furthermore, associated factors with arthritic symptom (arthralgia) have not been sufficiently investigated, despite its clinical importance in the management of osteoarthritis. This study was performed to examinethe risk factors for osteoarthritis and the contributing factors to current arthriticpain in older adults. Materials and Methods: The Fourth Korean National Health and Nutrition Examination Surveys was conducted in 2009. Therein, 720 males and 1008 females aged 65 years and older were included. Comprehensive data on habitual, socioeconomic, medical, nutritional, and psychological factors were collected along with the presence of osteoarthritis and arthritic pain. After univariate analysis, binary logistic regression analysis was performed to identify risk factors for osteoarthritis and contributing factors to current arthritic pain. Results:Age (p=0.005), female gender (p<0.001), higher body mass index (BMI) (p<0.001), and osteoporosis (p<0.001) were significant risk factors for osteoarthritis,while higher education level (p=0.025) was a protective factor for osteoarthritis. Higher BMI (p=0.047), lack of weekly moderate intensity activity (p<0.001), and unfavorable subjective health status (p<0.001) were significant factors contributingto current arthritic pain among subjects with osteoarthritis. Both osteoarthritisand current arthritic pain adversely affected health related quality of life. Conclusion:Higher BMI, lack of weekly moderate intensity activity, and unfavorable subjective health status were significant factors contributing to current arthritic pain. More attention needs to be paid to psychiatric effects on osteoarthritis and joint related pain.

The Association between Health-related Quality of Life and Depression on Activity Restriction in Osteoarthritis: A Cross-sectional Study

( Do-youn Lee ),( Seong-gil Kim ) 대한물리치료학회 2020 대한물리치료학회지 Vol.32 No.6

Purpose: The purpose of this study is to provide basic evidence on the need to approach osteoarthritis patients through a psychological factors-considering rehabilitation program by understanding how activity restrictions in osteoarthritis affect health-related quality of life and depression. Methods: This study assessed 3,761 osteoarthritis patients from the Korea National Health and Nutrition Examination Survey. The subjects were divided into two categories: with and without activity restriction. Results: The prevalence of osteoarthritis in women was higher than that of men (men: 19.7%; women: 80.3%), and high BMI increased the prevalence of osteoarthritis. The EQ-5D index of subjects with activity restriction was 0.84±0.18 (points), while in those without activity restriction was 0.93±0.12, and the diagnosis of depression was 15.8%, 8.2%. There was a statistically significant difference in the odds ratio for each item in the EQ-5D. Moreover, the odds ratio for depression with activity restriction was 2.098 compared with no activity restriction. Conclusion: Activity restriction of osteoarthritis patients significantly decreases the health-related quality of life and increase the probability of depression. Therefore, early diagnosis of depression symptoms to prevent deterioration of symptoms in patients with osteoarthritis and to increase compliance with rehabilitation treatment, and to provide arbitration, including treatment that can alleviate depression.

한국인 골관절염 환자에 대한 Celecoxib와 서방형 Diclofenac의 유효성 및 안전성 비교: 다기관 임상연구

안홍준 ( Hong Joon Ahn ),이찬희 ( Chan Hee Lee ),정성모 ( Sung Mo Chung ),이상헌 ( Sang Heon Lee ),이충기 ( Choong Ki Lee ),배성권 ( Sung Kwon Bae ),송정수 ( Jung Soo Song ),박원 ( Won Park ),배상철 ( Sang Cheol Bae ),유대현 ( Da 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.4

Objective: Long-term use of the analgesic acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis is limited due to the lack of effectiveness and presence of side effects. Celecoxib is a selective inhibitor of cyclo-oxygenase (COX)-2 and expected to help NSAIDs in expressing the effective anti-inflammatory effect by not inhibiting COX-1. Thus, 200 mg of celecoxib and 100 mg of slow releasing diclofenac were compared for their effectiveness and safety in Korean patients with knee osteoarthritis. Methods: We administered 200 mg of celecoxib or 100 mg of slow releasing diclofenac in 223 randomly selected patients with knee osteoarthritis for 4 weeks. The effectiveness of these drugs on osteoarthritis was assessed by evaluating pain in each patient, making overall evaluation on osteoarthritis by the patient and his/her attending physician, and measuring the severity indices on osteoarthritis before treatment, and 2 weeks and 4 weeks after treatment. Moreover, safety and drug resistance were evaluated by assessing the rate of adverse effects, rate of withdrawal, laboratory tests, and vital signs. Results: The clinical symptoms of osteoarthritis were improved significantly by 4 weeks after treatment with celecoxib and diclofenac. According to the results of overall evaluation made by attending physicians 2 weeks after treatment, the rate of improvement was 49.5% in celecoxib group and 35.7% in diclofenac group, showing a statistically significant difference (p=0.023). Other than this difference, no other significant difference was present between the two groups with other variables used for the evaluation of effectiveness. The rate of adverse effects was significantly lower in celecoxib group compared with diclofenac group. According to laboratory findings, no abnormal figure was found in both groups but total bilirubin, SGOT, and SGPT were consistently higher in patients in diclofenac group. Thirteen patients dropped out of the study due to side effects (10 patients) and treatment failure (3 patients). Conclusion: Our findings from the clinical comparison of celecoxib and diclofenac in Korean patients with knee osteoarthritis were similar to those results found in previous studies. Although celecoxib showed similar effectiveness as diclofenac on knee osteoarthritis in the treatment of symptoms, it showed a lower rate of adverse effects; thus, we concluded that celecoxib is safer compared with diclofenac.

우리나라 65세 이상 노인의 골관절염 유병률과 관련요인: 제5기 국민건강영양조사자료 분석, 2010∼2012

이혜상 ( Hye Sang Lee ) 대한영양사협회 2014 대한영양사협회 학술지 Vol.20 No.2

본 연구는 2010∼2012년도 국민건강영양조사의 65세 이상 노인자료를 사용하여 골관절염 유병률과 건강관련 생활습관, 신체특성 및 생화학적 지표, 영양소 섭취상태와 골관절염 발생과의 관련성을 복합표본분석방법을 활용하여 분석하였다. 본 연구의 결과를 요약하면 다음과 같다. 1. 골관절염군은 남자 152명, 여자 669명, 정상군은 남자 1,508명, 여자 1,420명이었으며, 골관절염 유병률은 남자 9.3%, 여자 32.5%로 성별과 골관절염 유무와는 유의한 관계를 나타냈다. 거주지역, 교육수준, 소득수준, 고혈압약 복용여부는 골관절염 유무와 유의한 관계를 나타냈다. 골관절염군의 평균 연령이 정상군보다 유의하게 높았다. 2. 골관절염 유무와 관련성을 나타낸 거주지역, 교육수준, 소득수준, 나이, 고혈압약 복용여부로 보정한 후 평균값은 남녀 모두 골관절염군의 BMI, 허리둘레가 정상군에 비해 유의하게 높았다. 또한 건강 관련 삶의 질은 남녀 모두 골관절염군에서 정상군에 비해 유의하게 낮게 나타났다. 3. 흡연, 알코올 섭취, 격렬한 신체활동 실천율, 중등도 신체활동 실천율, 걷기 실천율은 골관절염 유병률과 관련이 없었다. 4. BMI에 의한 비만, 복부비만은 정상에 비해 골관절염 유병률이 각각 1.96배, 1.82배 높게 나타났다. 5. 비타민 A와 리보플라빈의 경우에는 EAR 미만 섭취하는 집단이 EAR 이상 섭취하는 집단에 비해 골관절염 유병률이 각각 1.26배, 1.34배로 나타났으며, 그 외에 다른 영양소는 섭취 부족 여부가 골관절염 발생에 미치는 위험도에 있어서 통계적인 유의성을 나타내지 않았지만 영양소 부족 집단에서 골관절염 유병률이 높았다. 2010∼2012년도 국민건강영양조사 자료를 사용하여 65세 이상 노인을 대상으로 신체특성 및 생화학적 지표, 건강관련 생활습관 및 영양소 섭취상태와 골관절염 발생과의 관련성을 복합표본분석방법을 활용하여 분석한 이상의 결과를 살펴볼 때, 대부분의 건강행태, 혈액의 생화학적 지표에 의한 질병은 골관절염 유병률과 유의한 관련성을 나타내지 않았고, 비만과 비타민 A/리보플라빈 섭취부족은 골관절염 유병률을 높이는 것으로 나타났다. 이 연구의 제한점은 단면 연구라서 골관절염과의 관련성 여부만을 제시할 수 있다는 점과 1일 24시간 회상법에 의한 자료를 사용하여 대상자의 일상적인 평균섭취량을 반영하지 못한 점이라 할 수 있다. 하지만 이 연구는 우리나라 노인의 건강 관련 삶의 질에 영향을 주는 골관절염에 대해 최근 진단의 객관성을 보완한 방사선 자료를 사용하여 골관절염 유병률을 측정하였고, 건강관련 생활습관, 만성질환, 영양소 섭취상태와 골관절염 발생과의 관련성을 다면적으로 분석하였다는 점에서 가치가 있다. The purpose of this study was to estimate the prevalence of osteoarthritis as well as assess the risk factors associated with osteoarthritis in Koreans over 65 years using data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010∼2012. Of the participants from KNHANES V, a total of 3,479 subjects were analyzed using SPSS statistics complex samples (Windows ver. 21.0). Osteoarthritis was more frequently found in female (32.5%) or rural (26.8%) groups than male (9.3%) or urban (20.3%) groups. Mean age of the osteoarthritis group was significantly higher than that of the normal group. Mean values of BMI and waist circumference were significantly higher in the osteoarthritis group than in the normal group, whereas height, fasting blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, hemoglobin, and hematocrit levels were not. Health-related quality of life (EQ-5D) was significantly higher in the normal group than in the osteoarthritis group. The results of multiple logistic regression showed that obesity and vitamin A/riboflavin intakes were significantly related to the prevalence of osteoarthritis, whereas smoking, alcohol intake, physical activity, hypertension, hypercholesterolemia, hypertriglyceridemia, anemia, and diabetes were not. This study suggests that obesity and nutrient intakes were associated with osteoarthritis, whereas chronic diseases such as hyper-lipidemia, anemia, and diabetes as well as health habits were not. Prospective research of long-term control is needed to establish the effects of those factors on the osteoarthritis.