Knee osteoarthritis in type 2 diabetes mellitus: does insulin therapy retard osteophyte formation?

Objective: The aim of this study was to investigate whether or not radiographic changes observed in knee osteoarthritis [OA] in type 2 diabetes mellitus [T2DM] patients on insulin therapy differed from those not on insulin

Material and Methods: A cross-sectional study was performed in 311 subjects: 211 T2DM patients and 100 without diabetes [controls] in Mubarak Hospital, Kuwait. Patients were categorized into 3 groups: T2DM patients not on insulin [G1, n = 99], T2DM patients on insulin [G2, n = 112] and a nondiabetic control group [G3, n = 100]. Plain X-ray of both knees was used to assess the changes of knee OA and graded using the Kellegren-Lawrence scale [0-4] and the Osteoarthritis Research Society International Atlas grading scale [0-3]. A total of 622 knee X-rays were evaluated. SPSS version 21.0 was used for data analysis

Results: A highly significant association [p < 0.0001] was observed for joint space narrowing [JSN] as well as for osteophyte formation between the three groups. Comparing G2 and G3, a highly significant association [p < 0.0001] was retained for JSN [201 [89.7%] vs. 199 [99.5%]] and for osteophyte formation [26 [11.7%] vs. 72 [36.0%]]. Comparing G1 and G2, significantly less osteophyte formation was noted in G2 patients compared to G1 patients [26 [11.7%] vs. 39 [19.7%], p = 0.02]. Multivariate logistic regression analysis showed that the G2 group had less chance of osteophyte formation than either the G1 group or G3 control group [OR = 0.294, p = 0.008 and OR = 0.098, p < 0.001, respectively]

Conclusion: Our findings show that T2DM patients with OA knees on insulin therapy have less radiographic osteophytes compared to T2DM patients not on insulin

Disease activity and cytokine production in mitogen-stimulated peripheral blood mononuclear cells from patients with rheumatoid arthritis

To test whether there are differences in the levels and ratios of 6 pro- and 3 anti-inflammatory cytokines produced by mitogen-stimulated peripheral blood mononuclear cells [PBMCs] in rheumatoid arthritis [RA] subjects compared to controls. 79 participants [42 seropositive RA patients and 37 healthy controls] were enrolled in this study. The production levels in mitogen-stimulated PBMCs of the 6 proinflammatory cytokines [IFN-gamma, TNF-alpha, TNF-beta, lL-8, IL-17, IL-18] and 3 anti-inflammatory cytokines [IL-4, IL-10, IL13] were assayed by ELISA using kits obtained from Immunotech SA. The ratios of pro- to anti-inflammatory cytokines were calculated for all participants. There were significantly elevated levels of IL-8 and IL-10, and reduced levels of IFN-gamma, IL4, and IL-17 in mitogen-stimulated PBMC culture supernatants of RA subjects compared to controls. Of the 18 pro-/anti-inflammatory cytokine ratios, 3 ratios [TNF-alpha/lL13, IL-8/lL-4 and IL-8/lL-13] were significantly higher in RA patients compared to controls; and 6 were higher in controls [IFN-gamma/IL-4; IFN-gamma/IL-10; IFN-gamma/lL-13; TNF-beta/IL10; IL-17/IL-10; IL-18/IL-10]. Activated PBMCs of RA patients, regardless of disease activity, showed higher-level production of IL-8 and IL-10 compared to controls; lower-level production of IFN-gamma, IL-4, and lL-17; and elevated ratios of TNF-alpha/lL-13, IL-8/1L-4 and IL-8/lL-13