Biomarker clusters differentiate phenotypes of lumbar spine degeneration and low back pain: The Johnston County Osteoarthritis Project

Adam P. Goode; David Hu; Steven Z. George; Todd A. Schwartz; Virginia B. Kraus; Janet L. Huebner; Rebecca J. Cleveland; Kenneth A. Taylor; Joanne M. Jordan; Yvonne M. Golightly

Osteoarthritis and Cartilage Open (Sep 2022)

Biomarker clusters differentiate phenotypes of lumbar spine degeneration and low back pain: The Johnston County Osteoarthritis Project

Adam P. Goode,
David Hu,
Steven Z. George,
Todd A. Schwartz,
Virginia B. Kraus,
Janet L. Huebner,
Rebecca J. Cleveland,
Kenneth A. Taylor,
Joanne M. Jordan,
Yvonne M. Golightly

Affiliations

Adam P. Goode: Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Corresponding author. Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA.
David Hu: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
Steven Z. George: Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
Todd A. Schwartz: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
Virginia B. Kraus: Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, NC, USA
Janet L. Huebner: Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
Rebecca J. Cleveland: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
Kenneth A. Taylor: Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
Joanne M. Jordan: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA; Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
Yvonne M. Golightly: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA; Division of Physical Therapy, University of North Carolina, Chapel Hill, NC, USA

Journal volume & issue: Vol. 4, no. 3
p. 100270

Abstract

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Objective: Describe the association between biomarkers and lumbar spine degeneration (vertebral osteophytes [OST], facet joint osteoarthritis [FOA], and disc space narrowing [DSN]), for persons with and without low back pain (LBP) and determine whether clusters based on biomarkers differentiate lumbar spine structure with and without LBP. Methods: Using data from the Johnston County Osteoarthritis Project (2006–2010), we measured serum N-cadherin, Keratin-19, Lumican, CXCL6, RANTES, HA, IL-6, BDNF, OPG, and NPY, and urinary CTX-II. Biomarkers were used to group participants using k-means cluster analysis. Logistic regression models were used to compare biomarker clusters. Results: The sample consisted of 731 participants with biospecimens and lumbar spine radiographic data. Three biomarker subgroups were identified: one characterized by structural degenerative changes; another characterized by structural degenerative changes and inflammation, with pain; and a referent cluster with lower levels of biomarkers, pain, and structural degenerative changes. Compared to the referent subgroup, the structural change subgroup was associated with DSN (OR = 1.94, 95% CI 1.30–2.90) and FOA (OR = 1.72, 95% CI 1.12–2.62), and the subgroup with structural degenerative change, inflammation, and pain was associated with OST with LBP (OR = 1.60, 95% CI 1.04–2.46), FOA with LBP (OR = 1.59, 95% CI 1.04–2.45), and LBP (OR = 1.63, 95% CI 1.11–2.41). The subgroup with structural degenerative changes was more likely to have OST (OR = 1.82, 95% CI 1.06–3.13) and less likely to have FOA with LBP (OR = 0.62, 95% CI 0.40–0.96) compared to the group with inflammation and pain. Conclusion: Clustering by biomarkers may assist in differentiating patients for specific clinical interventions aimed at decreasing LBP.

Published in Osteoarthritis and Cartilage Open

ISSN: 2665-9131 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/osteoarthritis-and-cartilage-open/

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