Elevated High-Sensitivity C-Reactive Protein And Interleukin-6 Plasma As Risk Factors For Symptomatic Lumbar Osteoarthritis In Postmenopausal Women
Keywords:low back pain, hs-CRP, ESR, IL-6
AIM: To determine whether elevated high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR), as risk factors of symptomatic lumbar osteoarthritis (OA) in estrogen deficiency postmenopausal women.
METHODS: A case-control study was conducted between January and June 2017. The inclusion criteria include post-menopausal women with estrogen deficiency with low back pain. Exclusion criteria were: patients with a history of undergoing bilateral oophorectomy, taking hormonal replacement therapy or corticosteroid, malignancies, and lumbosacral spine trauma. The blood examinations were taken to measure IL-6 level by ELISA, hs-CRP level by spectrophotometry and ESR by modified Westergren method.
RESULTS: A group of 44 pairs of subjects were divided equally into case and control groups showed that in estrogen deficiency postmenopausal women, an increased level of hs-CRP increased the risk for symptomatic lumbar OA (OR = 2.83, CI95% = 1.065-8.776, p = 0.034). Also, a high level of IL-6 increased the risk of symptomatic lumbar OA (OR = 2.7, CI95% = 0.991-8.320, p = 0.033). No such significant findings were found for an increased ESR level.
CONCLUSION: Elevated level of plasma hs-CRP and IL-6 were concluded as risk factors for symptomatic lumbar OA in post-menopausal women.
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Richette P, Corvol M, Bardin T. Estrogen, cartilage, and osteoarthritis. Joint Bone Spine. 2003; 70(4):257-62. https://doi.org/10.1016/S1297-319X(03)00067-8
Suyasa IK, Kawiyana IKS, Bakta IM, Widiana IGR. Interleukin-6 and ratio of plasma interleukin-6/interleukin-10 as risk factors of symptomatic lumbar osteoarthritis. World Journal of Orthopedics. 2017; 8(2):149-155. https://doi.org/10.5312/wjo.v8.i2.149 PMid:28251065 PMCid:PMC5314144
Fujiwara A, Lim T-H, An HS, et al. The Effect of Disc Degeneration and Facet Joint Osteoarthritis on the Segmental Flexibility of the Lumbar Spine. Spine. 2000; 25(23):3036-3044. https://doi.org/10.1097/00007632-200012010-00011 PMid:11145815
Sniekers YH, Weinans H, van Osch GJ, van Leeuwen JP. Oestrogen is important for maintenance of cartilage and subchondral bone in a murine model of knee osteoarthritis. Arthritis Research & Therapy. 2010; 12(5): R182. https://doi.org/10.1186/ar3148 PMid:20923566 PMCid:PMC2991014
Wluka AE, Cicuttini FM, Spector TD. Menopause, estrogen, and arthritis. Maturitas. 2000; 30:183-99. https://doi.org/10.1016/S0378-5122(00)00118-3
Park CH, Lee SH. Investigation of High-Sensitivity C-reactive Protein and Erythrocyte Sedimentation Rate in Low Back Pain Patients. The Korean Journal of Pain. 2010; 23(2):147. https://doi.org/10.3344/kjp.2010.23.2.147 PMid:20556218 PMCid:PMC2886244
Macphail K. C-Reactive Protein, Chronic low back pain, diet, and lifestyle. Journal of Pain & Relief. 2014; 03(05). https://doi.org/10.4172/2167-0846.1000160
Zhang Y, Guo TM, Guo X, Wu S. Clinical diagnosis for discogenic low back pain. Int JBiol Sci. 2009; 5(7):647-58. https://doi.org/10.7150/ijbs.5.647
Xiao Y, Haynes WL, Michalek JE, Russell IJ. Elevated serum high-sensitivity C-reactive protein levels in fibromyalgia syndrome patients correlate with body mass index, interleukin-6, interleukin-8, erythrocyte sedimentation rate. Rheumatology International. 2012; 33(5):1259-1264. https://doi.org/10.1007/s00296-012-2538-6 PMid:23124693
Livshits G, Zhai G, Hart DJ, et al. Interleukin-6 is a significant predictor of radiographic knee osteoarthritis. Arthritis Rheum. 2009; 60(7):2037-45. https://doi.org/10.1002/art.24598 PMid:19565477 PMCid:PMC2841820
Suyasa I, Setiawan I. The role of ageing, body mass index and estrogen on symptomatic lumbar osteoarthritis in post-menopausal women. International Journal of Research in Medical Sciences. 2016:1325-1328.
Conrozier T, Saxne T, Fan CSS, et al. Serum concentrations of cartilage oligomeric matrix protein and bone sialoprotein in hip osteoarthritis: A one-year prospective study. Annals of the Rheumatic Diseases. 1998; 57(9):527-532. https://doi.org/10.1136/ard.57.9.527 PMid:9849311 PMCid:PMC1752738
Stannus OP, Jones G, Quinn SJ, Cicuttini FM, Dore D, Ding C. The association between leptin, interleukin-6, and hip radiographic osteoarthritis in older people: a cross-sectional study. Arthritis Research & Therapy. 2010; 12(3). https://doi.org/10.1186/ar3022 PMid:20482813 PMCid:PMC2911879
Sharma P, Rahman A, Mahmood T, Singh N. Role of tumour necrosis factor alpha (TNF-Î±) and interleukin-6 (il-6) in postmenopausal osteoarthritic female patients. Journal of Evidence-Based Medicine and Healthcare. 2016; 3(27):1242-1244. https://doi.org/10.18410/jebmh/2016/285
Wojdasiewicz P, Poniatowski ÅA, Szukiewicz D. The Role of Inflammatory and Anti-Inflammatory Cytokines in the Pathogenesis of Osteoarthritis. Mediators of Inflammation. 2014; 2014:1-19. https://doi.org/10.1155/2014/561459 PMid:24876674 PMCid:PMC4021678
Lotz M, Guerne PA. Interleukin-6 induces the synthesis of tissue inhibitor of metalloproteinases-1/erythroid potentiating activity (TIMP-1/EPA). J Biol Chem. 1991; 266(4):2017-20. PMid:1846608
Giuliani N, Sansoni P, Girasole G, et al. Serum interleukin-6, soluble interleukin-6 receptor and soluble gp130 exhibit different patterns of age- and menopause-related changes. Experimental Gerontology. 2001; 36(3):547-557. https://doi.org/10.1016/S0531-5565(00)00220-5
Holm S, Mackiewicz Z, Holm AK, et al. Pro-inflammatory, Pleiotropic, and Anti-inflammatory TNF-Î±, IL-6, and IL-10 in Experimental Porcine Intervertebral Disk Degeneration. Veterinary Pathology. 2009; 46(6):1292-1300. https://doi.org/10.1354/vp.07-VP-0179-K-FL PMid:19605905
Keller ET. Molecular and cellular biology of interleukin-6 and its receptor. Frontiers in Bioscience. 1996; 1(4):d340-357. https://doi.org/10.2741/A136 PMid:9159238
Svensson CI. Interleukin-6: a local pain trigger? Arthritis Research & Therapy. 2010; 12(5):145. https://doi.org/10.1186/ar3138 PMid:21067533 PMCid:PMC2991005
Rannou F, Ouanes W, Boutron I, et al. High-sensitivity C-reactive protein in chronic low back pain with vertebral end-platemodec signal changes. Arthritis & Rheumatism. 2007; 57(7):1311-1315. https://doi.org/10.1002/art.22985 PMid:17907216
Sugimori K, Kawaguchi Y, Morita M, Kitajima I, Kimura T. High-sensitivity analysis of serum C-reactive protein in young patients with lumbar disc herniation. The Journal of Bone and Joint Surgery British volume. 2003; 85-B(8):1151-1154. https://doi.org/10.1302/0301-620X.85B8.14538
Shimura Y, Kurosawa H, Sugawara Y, et al. The factors associated with pain severity in patients with knee osteoarthritis vary according to the radiographic disease severity: a cross-sectional study. Osteoarthritis and Cartilage. 2013; 21(9):1179-1184. https://doi.org/10.1016/j.joca.2013.05.014 PMid:23973128
Gebhardt K, Brenner H, StÃ¼rmer T, et al. The course of high-sensitive C-reactive protein in correlation with pain and clinical function in patients with acute lumbosciatic pain and chronic low back pain-Asix6 months prospective longitudinal study. European Journal of Pain. 2006; 10(8):711-711. https://doi.org/10.1016/j.ejpain.2005.11.005 PMid:16403662
Pearle A, Scanzello C, George S, et al. Elevated high-sensitivity C-reactive protein levels are associated with local inflammatory findings in patients with osteoarthritis. Osteoarthritis and Cartilage. 2007; 15(5):516-523. https://doi.org/10.1016/j.joca.2006.10.010 PMid:17157039
Sturmer T. Pain and high sensitivity C reactive protein in patients with chronic low back pain and acute sciatic pain. Annals of the Rheumatic Diseases. 2005; 64(6):921-925. https://doi.org/10.1136/ard.2004.027045 PMid:15897311 PMCid:PMC1755532
Kim OY, Chae JS, Paik JK, et al. Effects of aging and menopause on serum interleukin-6 levels and peripheral blood mononuclear cell cytokine production in healthy nonobese women. Age. 2011; 34(2):415-425. https://doi.org/10.1007/s11357-011-9244-2 PMid:21487705 PMCid:PMC3312621
Jin X, Beguerie JR, Zhang W, Blizzard L, Otahal P, Jones G, Ding C. Circulating C reactive protein in osteoarthritis: a systematic review and meta-analysis. Annals of the rheumatic diseases. 2015; 74(4):703-10. https://doi.org/10.1136/annrheumdis-2013-204494 PMid:24363360
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