Medium- and long-chain acylcarnitines are associated with
osteoarthritis severity and arterial stiffness in end-stage
osteoarthritis patients: a case-control study
and Aare M
Department of Traumatology and Orthopaedics,
Institute of Biomedicine and Translational Medicine,
Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine,
Department of Surgery, University of
Traumatology and Orthopaedics Clinic, Tartu University Hospital, Tartu, Estonia
Aim: Arterial pathology has been suggested to be involved in osteoarthritis (OA). Metabolic proﬁling enables
the determination of low-molecular-weight molecules, which might further explain the pathogenesis of OA and
its relationship with cardiovascular diseases (CVD). The aim of this study was to compare the metabolic proﬁle
of lipid metabolism-related compounds and arterial stiffness in OA patients and in controls.
Method: The serum of 70 end-stage OA patients prior to joint replacement surgery and 82 age-matched controls
were analyzed by the AbsoluteIDQ
p180 kit (BIOCRATES Life Sciences AG, Innsbruck, Austria) using the tar-
geted metabolomic approach. Arterial stiffness was assessed by measuring carotid-femoral and carotid-radial
pulse wave velocity. Aortic-brachial pulse wave velocity ratio (PWV-ratio) was used as the measure of arterial
stiffness gradient. Principal component analysis was performed to analyze the large number of metabolites.
Results: The OA patients had decreased levels of C10:1, C10:2, C12, C12:1, C14, C14:2, C14:1-OH, carnitine
palmitoyltransferase 1 (CPT1) ratio and total AC/C0 compared with age-matched controls. There was indepen-
dent association between acylcarnitines and PWV-ratio in the OA patients. Furthermore, acylcarnitines were
associated with OA radiographic severity. The component that resembles acylcarnitines was an independent pre-
dictor of the PWV-ratio for OA patients.
Conclusion: We found decreased levels of acylcarnitines in OA patients. Furthermore, medium-and long-chain
acylcarnitines associated independently with arterial stiffness and were related to radiographic severity of OA.
Thus, acylcarnities might play an important role in the association between OA and CVD.
Key words: acylcarnitines, arterial stiffness, metabolomics, osteoarthritis.
Osteoarthritis (OA) is the most common joint disease
and one of the leading causes of disability among
the elderly. OA affects all articular tissues over time
and causes different clinical phenotypes depending
on the most damaged tissue. Although OA has previ-
ously been considered a non-inﬂammatory disease,
the paradigm has shifted and systemic changes (low-
grade inﬂammation, oxidative stress) have also been
recognized in the complex pathogenesis of OA. In
recent years a new subtype of OA underlining the
importance of metabolic disturbances in the patho-
genesis of OA has been introduced.
Many of these
Correspondence: Dr Kaspar Tootsi, Department of Traumatol-
ogy and Orthopaedics, University of Tartu, Puusepa 8, Tartu,
Estonia. Email: firstname.lastname@example.org
© 2018 Asia Paciﬁc League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd
International Journal of Rheumatic Diseases 2018; 21: 1211–1218