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Knee Osteoarthritis May Be Triggered By Low Levels Of Estrogen

Women in the age of 40 to 50 years are more prone to osteoarthritis. Researchers thing that sex hormones may play a vital role in the disease because of the inflammation caused in the condition as it worsens.//

A new study has examined the role played by estradiol, the main sex hormone estrogen in premenopausal and early perimenopausal women and how it works in the development of osteoarthritis. The findings appear in the August 2006 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis).

Led by MaryFran R. Sowers of the University of Michigan in Ann Arbor, MI, the study included 842 premenopausal or perimenopausal women from the Southeast Michigan Arthritis Cohort. The women had annual X-rays of both knees along with analysis of blood levels of estradiol and urine levels of 2-hydroxyestrone and 16á-hydroxyestrone, two estrogen metabolites. Patients were also interviewed regarding pain, health, and lifestyle and were followed for three years. The results showed that the women who developed knee OA during the study period had greater odds of having estradiol concentrations and urinary 2-hydroxyestrone levels in the lowest third of the study population, and a higher ratio of 2-hydroxyestrone to 16á-hydroxyestrone, even after adjusting for other risk factors.

"Selected work with animal models provides support for the increased odds of developing OA with lower estradiol concentrations," the authors note. This is one of the few studies that has actually examined hormone concentrations, particularly in relation to new cases of OA, and the first to examine levels of estrogen metabolites. The authors hypothesize that the role of higher 2-hydroxyestrone concentrations in delaying the development of knee OA may be partially through the metabolism of arachidonic acid, a compound from which cells involved in inflammation (such as leukotrienes) are produced, since estrogen metabolites have been shown to play an i
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