ABSTRACT
To investigate the effect of 25-hydroxyvitamin D [25[OH]D] in Kuwaiti patients with primary knee osteoarthritis [OA] and to assess its relation with radiological grading and functional status. In this cross-sectional study, 25[OH]D was measured using radioimmunoassay in 99 patients [90 women and 9 men; mean age 56.5 +/- 9.1 years [range: 36-80]] with clinical and radiological findings of primary knee OA. X-ray grading using the Kellgren-Lawrence grading scale and the Osteoarthritis Research Society International [OARSI] Atlas grading scale and functional assessments using Lequesne's indices were evaluated in relation to the 25[OH]D level. Other variables studied were age at onset of symptoms, body mass index and duration of disease. The age of the patients at the onset and the duration of disease were 51.58 +/- 7.14 and 3.88 +/- 2.51 years, respectively. Mean scoring for functional assessment was 10.31 +/- 4.35 and mean Kellgren-Lawrence radiological grading was 2.43 +/- 0.85. Radiological finding according to the OARSI Atlas revealed joint space narrowing of grades 2-3 in 87 [87.9%] patients and the presence of osteophytes in 55 [55.6%] patients. The mean value of 25[OH]D level was 11.4 +/- 6.07 ng/ml. Of the 99 patients, 92 [92.9%] were vitamin D deficient. Comparison of 25[OH]D levels to radiological findings and different functional classes showed no significant association. Most of our patients had vitamin D deficiency, but the level of 25[OH]D was not related to the severity of the knee X-ray grading or to the functional assessment in our patients with primary knee OA
ABSTRACT
Peroxisome proliferator-activated receptors [PPARs] play an important role in a number of cellular and metabolic functions. This study was carried out to determine the prevalence of a missense mutation [Pro12Ala] in the PPARG2 gene in Kuwaiti Arab patients with primary knee osteoarthritis [OA] and healthy controls with the aim of identifying a possible association. A prospective cross-sectional study carried out at three major teaching hospitals [referral centers] in the country over a one-year period. The prevalence of PPARG2 gene Pro12Ala missense mutation was determined in 104 Kuwaiti Arab patients with primary knee OA and 111 ethnically matched healthy controls. The prevalence of this Pro12Ala missense mutation was also determined in clinical subgroups of OA patients divided on the basis of age at onset, function and radiologic grading. The Pro-Pro genotype of the PPARG2 gene Pro12Ala missense mutation was detected in 95/104 [91.3%] cases compared to 111/111 [100%] in the control subjects. The heterozygous Pro-Ala genotype was detected in 9/104 [8.7%] of the OA patients, while it was not detected in any of the controls. The Ala-Ala genotype was not detected in any of the OA patients or the controls. No significant differences were detected in the PPARG2 gene Pro12Ala genotypes in the subgroups of patients classified on the basis of age at onset, functional assessment using Lequesne's functional index, and radiological grading using Kellgren-Lawrence [K-L] grading. This study found no significant association between the PPARG2 gene Pro12Ala missense mutation and knee OA. However, the presence of the Pro-Pro genotype of the PPARG2 gene mutation has a protective effect against development of OA