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Folate deficiency is associated with increased radiographic severity of osteoarthritis in knee joints but not in hand joints


1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea, and Department of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China.
  2. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
  3. Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
  4. Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
  5. Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
  6. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, and Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
  7. Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Republic of Korea.
  8. Gwangju-Jeonnam Regional Cardio-cerebrovascular Center, Chonnam National University Hospital, Gwangju, Republic of Korea.
  9. Department of Neurosurgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
  10. Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea. shinseok@chonnam.ac.kr

CER16029
2023 Vol.41, N°5
PI 1149, PF 1154
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PMID: 36226605 [PubMed]

Received: 09/07/2022
Accepted : 27/09/2022
In Press: 12/10/2022
Published: 03/05/2023

Abstract

OBJECTIVES:
No previous studies have explored the effect of folate deficiency on the severity of osteoarthritis (OA). Therefore, we investigated the relationship between folate level and features on knee and hand radiographs in a large, population-based OA cohort.
METHODS:
Among 9,260 subjects enrolled in the Dong-gu study, 2,489 who had knee and hand joint radiographs were included. Of these, subjects with a history of amputation or total knee replacement were excluded. Serum folate levels were measured using blood samples collected at the time of enrolment and stored. A semi-quantitative system was used to grade the severity of hand and knee x-ray changes. Linear regression was performed to assess relationships between serum folate levels and knee and hand radiographic scores after adjusting for age, sex, body mass index, smoking, alcohol consumption, education, physical activity, occupation, vitamin D, and ferritin.
RESULTS:
A total of 2,322 subjects were recruited. After adjusting for confounders, participants with folate deficiency (<4 ng/mL) had higher total (p<0.001), osteophyte (p<0.001), joint space narrowing (p=0.002), tibial attrition (p<0.001), and sclerosis (p=0.005) scores for knee joint radiographs compared to participants with a normal folate level. After adjusting for confounders, the radiographic scores for hand joints did not differ between the groups.
CONCLUSIONS:
Folate deficiency is associated with increased radiographic severity of OA in knee joints, but not in hand joints. Further studies are needed to explore the differential effects of folate on the severity of knee and hand OA.

DOI: https://doi.org/10.55563/clinexprheumatol/69k9xr

Rheumatology Article