Inflammatory and bone turnover markers in a cross‐sectional and prospective study of acute Charcot osteoarthropathy. Issue 2 (17th October 2014)

• Record Type: Journal Article
• Authors: Petrova, N. L.; Dew, T. K.; Musto, R. L.; Sherwood, R. A.; Bates, M.; Moniz, C. F.; Edmonds, M. E.
• Is Part Of: Diabetic medicine. Volume 32:Issue 2(2015:Feb.)
• Page Start: 267
• Page End: 273
• Publication Date: 2014-10-17
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12590
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12590-abs-0001"> <title>Abstract</title> <sec id="dme12590-sec-0001" sec-type="section"> <title>Aims</title> <p>To assess markers of inflammation and bone turnover at presentation and at resolution of Charcot osteoarthropathy.</p> </sec> <sec id="dme12590-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="dme12590-sec-0003" sec-type="section"> <title>Results</title> <p>At presentation, C‐reactive protein (<italic>P </italic>=<italic> </italic>0.007), tumour necrosis factor‐α (<italic>P </italic>=<italic> </italic>0.010) and interleukin‐6 (<italic>P </italic>=<italic> </italic>0.002), but not interleukin‐1β, (<italic>P </italic>=<italic> </italic>0.254) were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes. Serum C‐terminal telopeptide (<italic>P </italic>=<italic> </italic>0.004), bone alkaline phosphatase (<italic>P </italic>=<italic> </italic>0.006) and osteoprotegerin (<italic>P </italic><<italic> </italic>0.001), but not tartrate‐resistant acid phosphatase (<italic>P </italic>=<italic> </italic>0.126) and soluble receptor activator of nuclear factor‐κβ ligand (<italic>P </italic>=<italic> </italic>0.915), were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes.</p> <p>At follow‐up it was found that tumour necrosis factor‐α (<italic>P </italic>=<italic> </italic>0.012) and interleukin‐6 (<italic>P </italic>=<italic> </italic>0.003), but not C‐reactive protein (<italic>P </italic>=<italic> </italic>0.101), interleukin‐1β (<italic>P </italic>=<italic> </italic>0.457), C‐terminal telopeptide (<italic>P </italic>=<italic> </italic>0.743), bone alkaline phosphatase (<italic>P </italic>=<italic> </italic>0.193), tartrate‐resistant acid phosphatase (<italic>P </italic>=<italic> </italic>0.856), osteoprotegerin (<italic>P </italic>=<italic> </italic>0.372) or soluble receptor activator of nuclear factor‐kβ ligand (<italic>P </italic>=<italic> </italic>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 (<italic>P </italic>=<italic> </italic>0.028) and tumour necrosis factor‐α and C‐terminal telopeptide (<italic>P </italic>=<italic> </italic>0.013) only at presentation.</p> </sec> <sec id="dme12590-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>