title: Association between urinary C-telopeptide fragments of type II collagen and knee structure in middle-aged women without clinical knee disease.
abstract: OBJECTIVE
  There is evidence for an association between levels of urinary C-telopeptide fragments of type II collagen (uCTX-II) and risk of knee osteoarthritis (OA). The aim of this cohort study was to examine the association between uCTX-II levels and knee cartilage and bone changes in middle-aged women without clinical knee disease.
  
  
  METHODS
  140 women, aged 40-67 years, with no significant knee pain, knee injury or any forms of arthritis, underwent knee magnetic resonance imaging (MRI) at baseline and 2 years later. Cartilage volume, cartilage defects, tibial plateau bone area and bone marrow lesions (BMLs) were measured using validated methods. Baseline uCTX-II was measured using enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  For every one unit (natural logarithm transformed) increase in baseline uCTX-II level, there was an increase in the prevalence of medial tibiofemoral cartilage defects (Odds ratio (OR) 4.36, 95% confidence interval (CI) 1.58-12.04), medial (80.2 mm(2), 95% CI 9.3-151.1) and lateral (86.0 mm(2), 95% CI 33.3-138.7) tibial plateau bone area, and the prevalence of lateral tibiofemoral BMLs (OR 10.62, 95% CI 1.82-61.85). Baseline uCTX-II levels were not significantly associated with baseline tibial cartilage volume or changes in knee cartilage volume or defects or bone area over 2 years, although there was a trend for the deterioration of medial tibiofemoral BMLs (P = 0.06).
  
  
  CONCLUSIONS
  In middle-aged women without clinical knee disease, higher uCTX-II levels were associated with early detrimental structural changes at the knee (cartilage defects, tibial bone expansion and BMLs) at baseline but not over 2 years. Further work will be needed to determine its sensitivity to change and whether it predicts disease progression over longer time periods.
authors: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia. Electronic address: bing.wang@monash.edu.
authors: B
authors: B
authors: Wang
authors: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia. Electronic address: hans.kurniawan91@gmail.com.
authors: H K
authors: HK
authors: Pramono
authors: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia. Electronic address: flavia.cicuttini@monash.edu.
authors: F M
authors: FM
authors: Cicuttini
authors: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia; School of Rural Health, Monash University, Melbourne, VIC 3800, Australia. Electronic address: fahad.hanna@monash.edu.
authors: F
authors: F
authors: Hanna
authors: Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia. Electronic address: susan.davis@monash.edu.
authors: S R
authors: SR
authors: Davis
authors: Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia. Electronic address: robin.bell@monash.edu.
authors: R J
authors: RJ
authors: Bell
authors: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia. Electronic address: yuanyuan.wang@monash.edu.
authors: Y
authors: Y
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D001853:Bone Marrow / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D024043:Collagen Type II / Q000652:urine*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000652:urine*; D010446:Peptide Fragments / Q000652:urine*
chemical_list: D024043:Collagen Type II; D010446:Peptide Fragments; C543437:collagen II C-telopeptide
keywords: Bone marrow lesions; Cartilage defects; Knee; Osteoarthritis; Subchondral bone; Urinary CTX-II