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s / Osteoarthritis and Cartilage 21 (2013) S63–S312 S251 patients aged < 60 years. Patients aged 60 years showed improved WOMAC Total score for continuous vs intermittent treatment, but statistical significance was not attained. These data may be useful for health care providers in considering the treatment of OA patients. 477 SERUM URIC ACID AS A PREDISPOSING FACTOR OF CLINICORADIOLOGICAL SEVERITY OF OSTEOARTHRITIS KNEE R.N. Srivastava, D. Sanghi, A. Mishra, A. Sharma, S. Raj, S. Natu. KG Med. Univ., Lucknow, India Purpose: Osteoarthritis (OA) is the most common arthritis worldwide. The association with age, obesity, gender and metabolic factors has been studied widely. Evidence suggests that hyperuricemia is significantly associated with OA of multiple joints. The high level of uric acid involved in cartilage degeneration may modulate radiological features of knee OA. Some study reported that uric acid is associated with generalized OA and other reported that it is a danger signal of increasing risk for OA through inflammasome activation and concluded that synovial uric acid is a marker of knee OA severity. Both OA and hyperuricemia are common in India. This study aimed to investigate the association of serum uric acid with clinico-radiological feature of knee OA in Indian population. Methods: 180 patients of OA knee diagnosed according to American College of Rheumatology (ACR) guidelines as cases and equal number of controls were enrolled. Clinical OA outcome: pain, stiffness and functional disability were recorded by knee-specific WOMAC index and knee pain was also measured by 10 point VAS. Radiological grading was done by KL grades. In addition, four individual radiological features (IRF)joint space width, osteophyte, subchondral sclerosis and tibio femoral alignment were also recorded separately. Demographic were recorded by self report. Serum uric acid levels were measured by enzymatic method using Uricase Peroxidase and analyzed for the interlinking associations. Results: OA knee cases had significant higher BMI than controls in overall and in both the genders separately. In females, serum uric acid levels were significantly higher in cases in comparison to controls but such association was not observed in males and in overall subjects. Other biochemical variable like random blood sugar and total proteins were not significantly different between cases and controls in any category. On analyzing serum uric acid level with clinical features, pain (VAS and WOMAC) was significantly associated (p1⁄40.02 and p1⁄40.03) with elevated serum uric acid levels in females; VAS pain alone in overall study population (p1⁄40.024) but not in males. While studying the radiological features, an increase severity of disease (increasing KL grades) was observed with increase in serum uric acid levels (KL grade 4 was 5.26 1.1, KL grade 3 was 4.32 0 .95 and KL grade 2 was 3.63 0.95) in overall subjects and in both the genders separately. No significant association was observed for individual radiological features (IRF). Conclusion: Radiological severity (KL grade) and knee pain was found to be significantly associated with serum uric acid levels in overall subjects and in females in OA knee. 478 PLASMA ADIPOKINES AS MEDIATORS IN EARLY KNEE OSTEOARTHRITIS: DATA FROM COHORT HIP AND COHORT KNEE (CHECK) W.E. van Spil, P.M. Welsing, M.B. Kinds, S.C. Mastbergen, J.W. Bijlsma, F.P. Lafeber. Univ. Med. Ctr. Utrecht, Utrecht, The Netherlands Purpose: Associations of body mass index (BMI) with hand osteoarthritis (OA) have suggested that humoral obesity-related factors may be involved in the pathogenesis of OA. Systemic adipokine levels depend on BMI (amount of fat), gender (different fat distribution between genders), and to a lesser extent age. The purpose of the current study was to determine whether plasma adipokines could be identified as potential mediators of associations of BMI and other demographic variables with radiographic knee parameters in CHECK (Cohort Hip and Cohort Knee), a cohort of (very) early-stage symptomatic knee and/or hip osteoarthritis (OA). Methods: Plasma (p-) leptin, adiponectin, and resistin levels were determined by enzyme-linked immunosorbent assay. Joint space width (JSW; minimum, mean medial, and mean lateral), osteophyte (OP) area, and subchondral bone density (BD) were quantified in detail on posteroanterior knee radiographs using Knee Image Digital Analysis (KIDA). Mediation analysis was performed to determine whether indirect associations through adipokines could explain (part of the) associations of BMI and other demographic variables with radiographic knee parameters. Results: Adipokine and radiographic data were complete for approximately 430 CHECK subjects with knee pain. pLeptin was identified as potential mediator of associations of BMI and female gender with JSW. Likewise, pResistin was a potential mediator of an association of BMI with JSW. None of the adipokines could be identified as potential mediators between demographic variables and OP area. pAdiponectin appeared to be a potential mediator of associations of BMI and female gender with subchondral BD. Although statistically significant, associations of demographic variables and adipokines with radiographic knee parameters were weak and adipokines could explain only part of the associations between demographic variables and knee parameters. Conclusions: Systemic adipokines might be mediators of associations of BMI and gender with JSW and subchondral BD. As such, although their rolemight be limited, theymay play a role in the etiology of (knee) OA. 479 THE ASSOCIATION BETWEEN KNEE FUNCTION AND RADIOGRAPHIC OSTEOARTHRITIS IN A POPULATION BASED COHORT THE MUSCULOSKELETAL ULLENSAKER STUDY B. Oiestad y,z, C. Norstad Engen x, M. Risberg k,y. yNorwegian research centre for Active Rehabilitation, Oslo, Norway; zOslo Univ. Hosp., Oslo, Norway; xOslo Sports Trauma Research Ctr., Oslo, Norway; kNorwegian Sch. of Sport Sci., Oslo, Norway Purpose: The objective of this study was to investigate the association between radiographic knee osteoarthritis and knee function evaluated by both self-reported questionnaires and performance based tests. Methods: The Musculoskeletal Ullensaker study (MUST) is an ongoing population-based study of musculoskeletal disorders performed in Ullensaker municipality representing the Norwegian population. Invitation letters were sent to all the inhabitants between 40 and 79 years (n1⁄412000), and those who self-reported either hand, knee, or hip osteoarthritis, verified by their general practitioner, were invited to a clinical examination including functional, clinical, and radiographic measures of the three joints. Standing radiographs using SynaFlexer frame for standardized positioning were taken of all the invited participants and scored with the Kellgren and Lawrence atlas (grade 0-4). Osteoarthritis was defined as KL grade 2. Knee injury and Osteoarthritis Outcome Score (KOOS) was used for measuring pain, symptoms, and activities of daily living (ADL), function in sport and recreation (sport/rec), and knee-related quality of life (QOL). The 30-second Chair Stand test and 6 min-walk test were included to measure performance based function. Multivariate regression analyses with each KOOS subscale and the performance based tests as dependent variable were associated with radiographic osteoarthritis in one knee, adjusted for gender, age, and body mass index (BMI). Results: Three hundred and twenty three patients were examined between 2010 and 2012 (31% males and 69% females). The mean age was 63.5 8.8 years. Knee osteoarthritis was found in 8.7% for the right knee (n1⁄428), in 6.8 % for the left knee (n1⁄422), and 34 patients (10.5%) had osteoarthritis in both knee joints. Two hundred and twenty seven patients (70%) had no radiographic knee osteoarthritis. Significant associations were found between radiographic osteoarthritis in one knee and the following KOOS subscales: pain (Beta SE: -13.7 3.7, p

Materials and methods This randomized placebo-controlled trial recruited 103 KOA cases as per American College of Rheumatology (ACR) guideline having vitamin D insufficiency (25(OH) D≤50 nmol/L). Enrolled cases were randomly allocated in two groups to receive placebo (51) and vitamin D (52). Primary outcome measures: pain and functional disability which were recorded by knee specific WOMAC index and secondary outcome measure were radiological features (joint space width and osteophytes). The serum levels of vitamin D were assessed by ELISA method using IDS, UK kit. Detection of VDR polymorphisms (Taq1 & Apa I) were done by PCR-RFLP technique. 25(OH)D levels, clinical and radiological features were recorded at baseline and at one year follow up.

femur, distant from the subchondral bone, on plain radiographs, with Knee Images Digital Analysis, using an aluminium step wedge as reference. To allow for adjustment for concurrent radiographic knee and hip OA, the patellofemoral and tibiofemoral knee compartments and hips were scored for joint space narrowing, osteophytes, and subchondral sclerosis according to Altman and Burnett. Results: The majority of subjects did show no or only minimal features of radiographic knee and hip OA. After adjustment for demographic variables (i.e. age, gender, and body mass index) and radiographic knee and hip OA features, bone marker as well as uCTX-II levels, but not the other cartilage markers, showed associations with peripheral bone density (standardized betas1⁄40.103 to 0.183; P1⁄40.003 to 0.027). Conclusions: This study warrants more cautious interpretation of CTXII as marker of (only) cartilage damage, since our data confirm the notion that CTX-II may also originate from peripheral bone changes.