Differential Metabolites in Osteoarthritis: A Systematic Review and Meta-Analysis.

Xu Han, Miao Jiang, Zeqi Liao, Yuhe Wang, Jingru Shi, Yuanyue Zhang, Hongyan Zhao, Lei Zhang, Meijie Liu

Journal: Nutrients 2023;15(19):4191

PMID: 37836475

Plain Language Summary

Early intervention in the prevention and management of osteoarthritis (OA) is essential as it has been associated with improvements to pain and function. Imaging, taking a medical history, and self-reports of symptoms are the current methods for diagnosis, however they are often unreliable and more accurate ways to diagnose OA are needed. Being able to measure biological indicators of OA may be more accurate, however there are no consistent conclusions on which biomarkers may be best for OA diagnosis. This systematic review and meta-analysis of 13 trials aimed to determine differences in biological substances formed during metabolism between individuals with OA and those who were healthy. The results showed that compared to healthy individuals 11 main metabolites were different in individuals with OA, some were increased and some decreased. These consisted of amino acids, with tryptophan, lysine, and leucine all increased and proline, phenylalanine, glutamine, dimethylglycine, creatinine, citrulline, asparagine, and acetylcarnitine all decreased. It was concluded that amino acid levels could be a good candidate biomarker for the prediction of OA. This study could be used by healthcare professionals to understand that research is progressing towards the identification of biomarkers for OA, however further research is needed before one is identified.

Abstract

(1) Many studies have attempted to utilize metabolomic approaches to explore potential biomarkers for the early detection of osteoarthritis (OA), but consistent and high-level evidence is still lacking. In this study, we performed a systematic review and meta-analysis of differential small molecule metabolites between OA patients and healthy individuals to screen promising candidates from a large number of samples with the aim of informing future prospective studies. (2) Methods: We searched the EMBASE, the Cochrane Library, PubMed, Web of Science, Wan Fang Data, VIP Date, and CNKI up to 11 August 2022, and selected relevant records based on inclusion criteria. The risk of bias was assessed using the Newcastle-Ottawa quality assessment scale. We performed qualitative synthesis by counting the frequencies of changing directions and conducted meta-analyses using the random effects model and the fixed-effects model to calculate the mean difference and 95% confidence interval. (3) Results: A total of 3798 records were identified and 13 studies with 495 participants were included. In the 13 studies, 132 kinds of small molecule differential metabolites were extracted, 58 increased, 57 decreased and 17 had direction conflicts. Among them, 37 metabolites appeared more than twice. The results of meta-analyses among four studies showed that three metabolites increased, and eight metabolites decreased compared to healthy controls (HC). (4) Conclusions: The main differential metabolites between OA and healthy subjects were amino acids (AAs) and their derivatives, including tryptophan, lysine, leucine, proline, phenylalanine, glutamine, dimethylglycine, citrulline, asparagine, acetylcarnitine and creatinine (muscle metabolic products), which could be potential biomarkers for predicting OA.

Address: Medical Experimental Center, China Academy of Chinese Medical Sciences, Beijing 100700, China.; Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.; National Data Center of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.

DOI: 10.3390/nu15194191