Longitudinal remodeling of acylcarnitine signatures before and after arthroplasty for osteoarthritis: A 7-year cohort study
Authors' conclusion
TJA was associated with partial normalization of select circulating acylcarnitines; however, persistent abnormalities in hydroxy- and dicarboxy-acylcarnitines suggest ongoing alterations in lipid handling. Reduced carnitine buffering capacity and shifts toward alternative oxidation pathways further indicate incomplete restoration of systemic fatty-acid metabolism. Overall, these findings support pathway-specific metabolic remodeling rather than full metabolic normalization following TJA. REGISTERED ON WWW.
Study context
- Population
- Participants with end-stage osteoarthritis (OA) undergoing total joint arthroplasty (TJA) and age- and sex-matched healthy controls without OA70 patients with severe OA undergoing TJA and 82 matched controls without OA
- Participants
- 70 vs 82
- Exposure
- Acylcarnitine concentrations compared between groups and longitudinally within participants, at baseline and 7-year follow-up
- TJAn = 70
- CONTROLSn = 82reference
- Outcome
- Acylcarnitines changing differently between groups over follow-up
- Follow-up
- 7-year follow-up
Methodological detailsage- and sex-matched healthy controls, 7-year follow-up, analyses adjusted for age, sex, body mass index, hypertension status, corrected for multiple comparisons
- Age- and sex-matched healthy controls
- 7-year follow-up
- Analyses adjusted for age, sex, body mass index, hypertension status
- Corrected for multiple comparisons
Main finding
As reported in the abstract
- Acylcarnitine measures and ratios passing quality control
- Forty-eight
- Acylcarnitines changed differently between groups over follow-up
- Fifteen
- Measures differing at baseline
- six
- Measures differing at follow-up
- 12
- Baseline differences normalized
- Five
- New between-group differences emerged
- 11
Observational data: associations, not effects.
Further findings
| Outcome | Ratio (95% CI) |
|---|---|
| Free carnitine (C0), longitudinal change · 7-year follow-up24.8% lower longitudinal change in TJA | 0.75 (0.62–0.91) |
| Total acylcarnitine/free carnitine, longitudinal change · 7-year follow-upIncreased 32.3% more in TJA · baseline group difference resolving by follow-up | 1.32 (1.17–1.50) |
Differential longitudinal change after adjustment for baseline metabolite concentrations · 7-year follow-up
- Acylcarnitines with differential longitudinal change: four short-chain (C5-OH, C5-DC, C5-M-DC, C5:1-DC) and three long-chain (C14:2-OH, C16:2, C18:1)
- seven
- Increase of the four short-chain species, more in TJA than controls
- 19.8-32.0%
Medium- and long-chain acylcarnitines lower at baseline
- Normalized toward control concentrations
Original publication
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