Association between Circulating Adiponectin Levels and Osteoarthritis: A Meta-analysis

Young Ho Lee; Gwan Gyu Song

doi:10.4078/jrd.2018.25.4.231

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Lee and Song: Association between Circulating Adiponectin Levels and Osteoarthritis: A Meta-analysis

Original Article

J Rheum Dis 2018;25(4):231-238.

Published online: 31 October 2018

DOI: https://doi.org/10.4078/jrd.2018.25.4.231

Association between Circulating Adiponectin Levels and Osteoarthritis: A Meta-analysis

Young Ho Lee, Gwan Gyu Song

Department of Rheumatology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea

Corresponding to: Young Ho Lee http://orcid.org/0000-0003-4213-1909 Department of Rheumatology, Korea University Anam Hospital, Korea University College of Medicine 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea. E-mail: lyhcgh@korea.ac.kr

Received 3 January 201826 January 2018 Accepted 15 March 2018

This is a Open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

The aim of this study was to analyze the relationship between the circulating adiponectin levels and osteoarthritis (OA).

Methods

Meta-analysis was conducted on the serum/plasma adiponectin levels in patients with OA and controls, and subgroup analysis was performed based on ethnicity, sex, OA site, and adjustment for age, sex, and/or body mass index (BMI).

Results

Seven studies with eleven comparisons including 538 patients with OA and 366 controls were selected, which showed that the adiponectin levels were significantly higher in the OA group than in controls (standardized mean difference [SMD]=0.745, 95% confidence interval [CI]=0.316∼1.174, p=0.001). Stratification according to ethnicity showed significantly elevated adiponectin levels in Caucasian individuals with OA (SMD=0.769, 95% CI=0.218∼1.319, p=0.006). Stratification according to sex revealed significantly higher adiponectin levels in women with OA, but not in men (SMD=0.861, 95% CI=0.099∼1.623, p=0.027; SMD=1.177, 95% CI=−0.911∼3.316, p=0.281). Stratification by an adjustment for age, sex, or BMI showed significantly higher adiponectin levels in the OA group (SMD=0.837, 95% CI=0.326∼1.349, p=0.001). Stratification according to the OA site showed significantly higher adiponectin levels in patients with knee OA (SMD=0.938, 95% CI=0.456∼1.419, p＜0.001).

Conclusion

The significantly higher levels of circulating adiponectin in patients with OA than in healthy controls indicates that adiponectin likely plays a role in the pathogenesis of OA.

Keywords: Osteoarthritis, Adiponectin

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Figure 2.

Meta-analysis of the relationship between adiponectin levels and osteoarthritis (OA). Std diff: standard difference, CI: confidence interval.

Figure 1.

Flow diagram of the study selection process. OA: osteoarthritis.

Figure 3.

Funnel plot of studies that examined the association between adiponectin levels and osteoarthritis (Egger's regression p-value=0.559). The filled circles represent studies that showed publication bias. The diamonds at the bottom of the figure show summary effect estimates before (open) and after (filled) publication bias adjustment. Std diff: standard difference, Std err: standard error.

Table 1.

Characteristics of individual studies included in the meta-analysis

Author	Country	Ethnicity	Patient		Age (yr)		Sex (female/male)		BMI		OA site	Matched	Quality score
Author	Country	Ethnicity	OA	Control	OA	Control	OA	Control	OA	Control	OA site	Matched	Quality score
Toussirot-1, 2017 [8]	France	European	23	22	64.5±0.2*	59.7±0.1*	23/0	22/0	29.9±0.9*	24.9±0.7*	Knee	Sex	7
Toussirot-2, 2017 [8]	France	European	27	28	64.5±0.2*	59.7±0.1*	0/27	0/28	29.9±0.9*	24.9±0.7*	Knee	Sex	7
Tootsi, 2016 [9]	Estonia	European	70	70	62.0±7.0	60.0±7.0	35/35	34/36	28.0±3.0	26.0±3.0	Knee, hip	Age, sex	7
Cuzdan-1, 2015 [11]	Turkey	Turkish	30	25 6	67.03±12.71	43.08±14.60	27/3	13/12	23.39±1.77	27.45±5.55	Knee	NA	6
Cuzdan-2, 2015 [11]	Turkey	Turkish	30	25 6	64.56±10.60	43.08±14.60	30/0	98/34	33.11±3.42	27.45±5.55	Knee	NA	6
de Boer, 2012 [14]	Netherlands	European	172	132	67.4±8.4	56.5±4.5	119/53	19/5	29.5±5.3	28.1±3.8	Knee	Sex	7
Honsawek, 2010 [10]	Thailand	Asian	76	24	69.8±1.1*	71.2±1.5*	62/14	26/0	26.1±0.6*	25.5±0.6*	Knee, hip	Age, sex, BMI	8
Laurberg-1, 2009 [12]	Denmark	European	22	26	63.0±10.3	46.0±14.4	22/0	0/19	29.9±5.2	NA	Knee	Sex	7
Laurberg-2, 2009 [12]	Denmark	European	13	19	65.0±7.8	54.0±7.4	0/13	20/0	27.1±4.0	NA	Knee	Sex	7
Filkova-1, 2009 [13]	Czech	European	27	20	NA	NA	27/0	20/0	NA	NA	Knee, hip	Sex	6
Filkova-2, 2009 [13]	Czech	European	48	20	NA	NA	48/0	20/0	NA	NA	Knee, hip	Sex	6

Values are presented as number only or mean±standard deviation. OA: osteoarthritis, BMI: body mass index, NA: not available.

^* Standard error.

Table 2.

Meta-analysis of adiponectin levels in patients with OA compared to that in controls

Group	Population	Study (n)	Number		Test of association			Test of heterogeneity
Group	Population	Study (n)	OA	Control	SMD*	95% CI	p-value	Model	p-value	I²
All	Overall	11	538	366	0.745	0.316∼1.174	0.001	R	＜0.001	88.4
Ethnicity	European	8	402	337	0.769	0.218∼1.319	0.006	R	＜0.001	90.6
	Turkish	2	60	25	0.362	−0.017∼0.741	0061	F	0.274	16.2
	Asian	1	76	24	1.377	0.880∼1.874	＜0.001	NA	NA	NA
Sex	Female	4	20	68	0.861	0.099∼1.623	0.027	R	＜0.001	84.4
	Male	2	40	47	1.177	−0.911∼3.316	0.281	R	＜0.001	94.0
Age-, sex-, or BMI-matched	Matched	9	478	341	0.837	0.326∼1.349	0.001	R	＜0.001	90.3
	Not-matched	2	60	25	0.362	−0.017∼0.741	0.061	F	0.274	16.2
OA site	Knee	7	317	252	0.938	0.456∼1.419	＜0.001	R	＜0.001	83.3
	Knee, hip	4	221	114	0.409	−0.377∼1.194	0.308	R	＜ 0.001	90.9

OA: osteoarthritis, SMD: standard mean difference, CI: confidence interval, BMI: body mass index, F: fixed effects model, R: random effects model, NA: not available. *Magnitude of Cohen's d effect size (SMD): 0.2∼0.5, small effect; 0.5∼0.8, medium effect; ≥0.8, large effect.

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