A new study, led by Georg Schett of the University of Erlangen-Nuremberg in Erlangen, Germany, reports that vascular cell adhesion molecule 1 (VCAM-1) is a significant predictor of knee and hip joint replacement as a result of severe osteoarthritis (OA). VCAM-1 is a combination sugar and protein that is found on cells in cartilage and connective tissues.
The study included data from 912 healthy people in Bruneck, Italy. Of the study group, 60 underwent knee or hip replacement as a result of severe OA during a 15 year follow up period. The study participants were given a baseline exam in 1990 and five year follow-up exams until 1995. Among other analyses, the participant’s blood samples were analyzed for VCAM-1.
The results of the study showed that VCAM-1 levels were significantly elevated in the 60 people who underwent joint replacement. The highest baseline exam levels were found in those who underwent multiple joint replacements.
“The level of VCAM-1 emerged as a significant predictor of the risk of joint replacement due to severe OA, equaling or even surpassing the effects of age.”
They also note that inclusion of VCAM-1 levels in risk prediction models resulted in a more accurate classification of individuals.
Establishing laboratory biomarkers for severe osteoarthritis is important for several reasons. The standard risk factors of weight and age are not adequate for accurate risk prediction. In addition, OA is a highly widespread disease and it would be helpful to accurately recognize those who are at greater risk of developing rapid progression or severe disease.
Early diagnosis would also be advantageous because the disease is present before clinical symptoms are present.
Ultimately, a better predictive tool for severe osteoarthritis would help identify patients for treatments such as aerobic exercise, strength training and weight loss. the first to establish a laboratory marker for the risk of severe OA,
“Further clarification of the mechanism underlying the association between VCAM-1 level and OA may well contribute to a better understanding of disease etiology,” the authors conclude.
They added that application of their findings in routine clinical practice would require further studies to duplicate the results.
The study was published in the August issue of Arthritis & Rheumatism.
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Originally posted 2009-08-13 13:01:31. Republished by Blog Post Promoter
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