Evaluation of urinary C-terminal cross-linked telopeptides of type II collagen CTX-II as a biomarker for early diagnosis of osteoarthritis in comparison to routine diagnostic methods

Abstract

Background: Work-related musculoskeletal disorders (WRMSDs) are serious occupational health problems among workers worldwide. Aim of the study: evaluate urinary C-terminal telopeptide of collagen type II (CTX-II) as a biomarker for early diagnosis of osteoarthritis and compare results with those obtained by the routinely used methods. Subjects and methods: One hundred and eighty workers from the outpatient clinics of rehabilitation center in Cairo performing physically demanding and office jobs. One hundred and twenty three workers diagnosed with knee OA (Group I) and 57 workers were healthy (Group II). Clinical examination, X-rays and questionnaire were done. Erythrocyte sedimentation rate, high sensitive C reactive protein and human CTX-II were measured. Results: No statistical significant difference between CTX-II in osteoarthritis workers and age, residence, smoking status and sport practice. Marked increase of urinary CTX-II level was found in osteoarthritis workers compared to healthy group. A high significance difference between CTX-II level and Western Ontario and Mcmaster Universities Arthritis Index (WOMAC) index scores in osteoarthritis workers, in addition high levels were found among grade 4 osteoarthritis. Mean urinary level of CTX-II in osteoarthritis workers increased with increased work duration and total working hours. Conclusion: Urinary CTX-II can predict clinical diagnostic criteria and x-ray progression in osteoarthritis, so it can be used as a tool for diagnosis of knee OA.