Osteoarthritis

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Vascular cell adhesion molecule 1 as a predictor of severe osteoarthritis of the hip and knee joints

  1. Georg Schett1,†,*,
  2. Stefan Kiechl2,†,
  3. Enzo Bonora3,
  4. Jochen Zwerina1,
  5. Agnes Mayr4,
  6. Roland Axmann1,
  7. Siegfried Weger4,
  8. Friedrich Oberhollenzer4,
  9. Rolando Lorenzini4,
  10. Johann Willeit1

Article first published online: 30 JUL 2009

DOI: 10.1002/art.24757

Issue

Arthritis & Rheumatism

Arthritis & Rheumatism

Volume 60, Issue 8, pages 2381–2389, August 2009

Additional Information

How to Cite

Schett, G., Kiechl, S., Bonora, E., Zwerina, J., Mayr, A., Axmann, R., Weger, S., Oberhollenzer, F., Lorenzini, R. and Willeit, J. (2009), Vascular cell adhesion molecule 1 as a predictor of severe osteoarthritis of the hip and knee joints. Arthritis & Rheumatism, 60: 2381–2389. doi: 10.1002/art.24757

Author Information

  1. 1

    University of Erlangen–Nuremberg, Erlangen, Germany

  2. 2

    Medical University Innsbruck, Innsbruck, Austria

  3. 3

    University of Verona Medical School, Verona, Italy

  4. 4

    Bruneck Hospital, Bruneck, Italy

  1. †

    Drs. Schett and Kiechl contributed equally to this work.

*Department of Internal Medicine III and Institute for Clinical Immunology, University of Erlangen–Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany

Publication History

  1. Issue published online: 30 JUL 2009
  2. Article first published online: 30 JUL 2009
  3. Manuscript Accepted: 17 MAY 2009
  4. Manuscript Received: 29 JAN 2009

Funded by

  • Interdisciplinary Center of Clinical Research Erlangen (IZKF Project C5)
  • Gesundheitsbezirk Bruneck
  • Assessorat für Gesundheit und Sozialwesen
  • START prize of the Austrian Ministry of Sciences
  • European Union projects Masterswitch, Kinacept, and Adipoa
  • Pustertaler Verein zur Prävention von Herz- und Hirngefässerkrankungen

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Abstract

Objective

Osteoarthritis (OA) is a leading cause of pain and physical disability in middle-aged and older individuals. We undertook this study to determine predictors of the development of severe OA, apart from age and overweight.

Methods

Joint replacement surgery due to severe hip or knee OA was recorded over a 15-year period in the prospective Bruneck cohort study. Demographic characteristics and lifestyle and biochemical variables, including the level of soluble vascular cell adhesion molecule 1 (VCAM-1), were assessed at the 1990 baseline visit and tested as predictors of joint replacement surgery.

Results

Between 1990 and 2005, hip or knee joint replacement due to OA was performed in 60 subjects. VCAM-1 level emerged as a highly significant predictor of the risk of joint replacement surgery. Intervention rates were 1.9, 4.2, and 10.1 per 1,000 person-years in the first, second, and third tertiles, of the VCAM-1 level, respectively. In multivariable logistic regression analysis, the adjusted relative risk of joint replacement surgery in the highest versus the lowest tertile group of VCAM-1 level was 3.9 (95% confidence interval 1.7–8.7) (P < 0.001). Findings were robust in various sensitivity analyses and were consistent in subgroups. Addition of the VCAM-1 level to a risk model already including age, sex, and body mass index resulted in significant gains in model discrimination (C statistic) and calibration and in more accurate risk classification of individual participants.

Conclusion

The level of soluble VCAM-1 emerged as a strong and independent predictor of the risk of hip and knee joint replacement due to severe OA. If our findings can be reproduced in other epidemiologic cohorts, they will assist in routine risk classification and will contribute to a better understanding of the etiology of OA.

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