1. Inflammatory and bone turnover markers in a cross-sectional and prospective study of acute Charcot osteoarthropathy.
- Author
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Petrova NL, Dew TK, Musto RL, Sherwood RA, Bates M, Moniz CF, and Edmonds ME
- Subjects
- Adult, Aged, Arthropathy, Neurogenic blood, Arthropathy, Neurogenic complications, Arthropathy, Neurogenic physiopathology, Biomarkers blood, Bone Resorption etiology, Cohort Studies, Cross-Sectional Studies, Humans, Immobilization, Inflammation Mediators blood, Longitudinal Studies, Middle Aged, Prospective Studies, Remission Induction, Up-Regulation, Arthropathy, Neurogenic therapy, Bone Resorption prevention & control, Collagen Type I blood, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 2 complications, Down-Regulation, Interleukin-6 blood, Peptides blood
- Abstract
Aims: To assess markers of inflammation and bone turnover at presentation and at resolution of Charcot osteoarthropathy., Methods: We measured serum inflammatory and bone turnover markers in a cross-sectional study of 35 people with Charcot osteoarthropathy, together with 34 people with diabetes and 12 people without diabetes. In addition, a prospective study of the subjects with Charcot osteoarthropathy was conducted until clinical resolution., Results: At presentation, C-reactive protein (P = 0.007), tumour necrosis factor-α (P = 0.010) and interleukin-6 (P = 0.002), but not interleukin-1β, (P = 0.254) were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes. Serum C-terminal telopeptide (P = 0.004), bone alkaline phosphatase (P = 0.006) and osteoprotegerin (P < 0.001), but not tartrate-resistant acid phosphatase (P = 0.126) and soluble receptor activator of nuclear factor-κβ ligand (P = 0.915), were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes. At follow-up it was found that tumour necrosis factor-α (P = 0.012) and interleukin-6 (P = 0.003), but not C-reactive protein (P = 0.101), interleukin-1β (P = 0.457), C-terminal telopeptide (P = 0.743), bone alkaline phosphatase (P = 0.193), tartrate-resistant acid phosphatase (P = 0.856), osteoprotegerin (P = 0.372) or soluble receptor activator of nuclear factor-kβ ligand (P = 0.889), had significantly decreased between presentation and the 3 months of casting therapy time point, and all analytes remained unchanged from 3 months of casting therapy until resolution. In people with Charcot osteoarthropathy, there was a positive correlation between interleukin-6 and C-terminal telopeptide (P = 0.028) and tumour necrosis factor-α and C-terminal telopeptide (P = 0.013) only at presentation., Conclusions: At the onset of acute Charcot foot, serum concentrations of tumour necrosis factor-α and interleukin-6 were elevated; however, there was a significant reduction in these markers at resolution and these markers may be useful in the assessment of disease activity., (© 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.)
- Published
- 2015
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