Serum Hyaluronan Levels May Reflect Osteoarthritis Disease Burden

January 17, 2005

Laurie Barclay, MD

Jan. 12, 2005 ‹ Serum hyaluronan (HA) levels may be a useful biomarker for

evaluating osteoarthritis (OA) disease burden, according to the results of a

population study published in the January issue of Arthritis & Rheumatism.

The investigators note that sex and ethnicity need to be considered for this

biomarker.

" [serum HA] is a constituent of synovium and cartilage and is thought to

contribute to the lubricating mechanisms of synovial fluid, " write Alan L.

Elliott, MD, MPH, from the Thurston Arthritis Research Center at the

University of North Carolina in Chapel Hill. " Local increased production of

HA has been demonstrated in inflamed synovium from patients with rheumatoid

arthritis, OA, ankylosing spondylitis, and reactive arthritis. "

The investigators selected 753 participants from the ston County

Osteoarthritis Project, an ethnically diverse, population-based sample,

using stratified simple random sampling to achieve balance in radiographic

knee OA status, ethnicity, sex, and age. Radiographic OA variables included

knee OA, knee OA laterality, knee OA severity, concomitant knee and hip OA,

and total number of knee and hip joints affected by OA.

Levels of log-transformed (ln) serum HA, measured by enzyme-linked

immunosorbent assay, were positively correlated with all definitions of

radiographic OA (P < .0001) and were moderately correlated with age (r =

..35; P < .0001). White patients (P = .0094) and male patients (P = .0038)

had higher levels of ln serum HA. The associations with radiographic OA,

ethnicity, sex, and age remained significant after adjustment (P < .0045),

and there were no interactions between ethnicity and the other covariates.

Study limitations include lack of objective data on liver and kidney

function, both of which may affect serum HA levels, and on medication use.

" These cross-sectional data support a role for serum HA as a biomarker of

radiographic OA, " the authors write. " The variations in levels of serum HA

attributable to ethnicity, sex, and age were not explained by radiographic

OA, [body mass index], or comorbidities. The lack of strong confounding

between serum HA and comorbidities further supports a role for serum HA as a

potential biomarker. "

The Centers for Disease Control, the National Institutes of Health, and the

Arthritis Foundation supported this study.

Arthritis Rheum. 2005;52:105-111

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