Chris C. Plato

Familial aggregation of osteoarthritis: Data from the Baltimore longitudinal study on aging

OBJECTIVE To evaluate the familial aggregation of osteoarthritis (OA) in a cohort of healthy volunteers drawn from a community setting. METHODS Hand radiographs obtained between 1978 and 1991 and bilateral standing knee radiographs obtained between 1984 and 1991 were read for changes of OA, using Kellgren-Lawrence (K-L) scales. The hand sites were distal interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, and first carpometacarpal (CMC1) joints. For each joint group, the presence of OA in at least 1 joint in a joint group, the number of affected digits in each joint group, and the sum of the K-L grade across all joints were analyzed. Polyarticular OA was recorded if there were OA findings in 2 of 3 hand joint groups plus 1 or both knees. Data from 167 families with hand radiographs, 157 families with knee radiographs, and 148 families with both hand and knee radiographs were analyzed for sib-sib correlations. RESULTS After adjustment for age, sex, and body mass index, clinically relevant sib-sib common correlations were found for OA of the DIP, PIP, and CMC1 joints, for OA at 2 or 3 hand sites, and for polyarticular OA (r = 0.33-0.81) when OA was defined according to the number of affected joints or as the sum of the K-L grade across all joints. CONCLUSION These results from a cohort of volunteers drawn from a community setting and ascertained without regard to OA status demonstrate familial aggregation of OA and contribute to the evidence for heritability of OA.

Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset.

OBJECTIVE--To examine the association between hand and knee osteoarthritis (OA) in a community based population. METHODS--Radiographs of 695 participants aged > or = 40 years in the Baltimore Longitudinal Study of Aging were read for changes of OA, using Kellgren-Lawrence grade > or = 2 as the case definition. RESULTS--Logistic regression analyses, adjusting for age, gender and body mass index, revealed a significant association between OA in the knee and the following joint groups: distal and proximal interphalangeal (DIP, PIP) and Hand2 (OA in two or more hand joint groups) for grade 2-4 and grade 3-4 disease, and the first carpometacarpal (CMC1) joint for grade 3-4 disease. CONCLUSION--There is an association between OA in hand sites and the knee. The strength of the associations increases with increasing disease severity. For the PIP site, there is a trend toward increasing strength of association for increasing numbers of affected joints and bilateral disease.

ALS and PDC of Guam: forty-year follow-up.

BackgroundIt was noticed in the mid-1950s that the incidence of ALS and parkinsonism–dementia complex (PDC) were much higher on Guam than anywhere else in the world. In 1958, a registry of patients and controls was established to ascertain the familial and genetic aspects of these diseases. Patients and individually matched controls and their relatives were registered from 1958 to 1963. The registry was updated and analyzed in 1998 through 1999. ObjectiveTo ascertain whether first-degree relatives of patients had a higher risk for developing ALS or PDC than relatives of controls. MethodsDuring the period of 1958 to 1963, 126 new patients and 126 individually matched controls and their respective first-degree relatives and spouses were evaluated neurologically and registered. Forty years later, the number of new cases among the patient and control relatives were compared to an expected number of new cases based on the age- and sex-specific incidence of ALS and PDC in the population at large. ResultsFrom 1958 to 1999, there were 102 new ALS or PDC cases among relatives of patients and 33 among relatives of controls. These values were compared with the derived expected values. There were more observed than expected new cases among patients’ relatives, and less observed cases than expected among the controls’ relatives. ConclusionsRelatives of patients with ALS or PDC have significantly higher risks for developing the disease than the Guamanian population, whereas relatives of controls have significantly lower risks.

Obesity and osteoarthritis of the hands in women

The association of obesity and body fat distribution with hand osteoarthritis was studied in 317 Caucasian female subjects aged 40 years and above in the Baltimore Longitudinal Study of Aging. Bilateral hand radiographs taken between 1978 and 1991 were read by one investigator for grade of osteoarthritis using Kellgren-Lawrence scales. Possible risk factors, assessed at same visit as the first radiograph during this interval, included age and measures of obesity, per cent body fat, and fat distribution. Results of bivariate analyses showed that increasing grade of hand osteoarthritis was associated with increasing age, greater mean levels of waist-hip ratio and per cent body fat; there was no association with body mass index. After adjustment for age, however, none of these independent variables remained significantly associated with grade of hand osteoarthritis. These data fail to support hypotheses that measures of obesity are associated with hand osteoarthritis in women independent of their known age-related changes.

The relationship of age and gender to prevalence and pattern of radiographic changes of osteoarthritis of the knee: Data from Caucasian participants in the Baltimore Longitudinal Study of Aging

The aim of this study was to estimate the prevalence and pattern of radiographic changes of osteoarthritis (OA) of the knee by age and gender in Caucasian participants in the Baltimore Longitudinal Study of Aging. Bilateral standing weight- bearing radiographs of the knee in 547 male and 351 female subjects (aged 20 and above) were read for changes of knee OA using Kellgren- Lawrence and individual features scales. Prevalence of definite (Kellgren- Lawrence grade ⩾2 changes) knee OA increased with advancing age in both sexes. Approximately 50 percent in both sexes showed bilateral involvement. Men aged 59 and below were more likely to have unilateral impairment than men aged 60 and above; no such differences were found in females. These data demonstrate that age and gender influence both the prevalence and pattern of radiographie changes of knee OA. (Aging Clin. Exp. Res. 6: 353–357, 1994).

Longitudinal study of bone loss in the second metacarpal

SummaryThis longitudinal study was undertaken to ascertain the rate of bone loss and to identify aging, cohort and/or time effects on bone loss in male participants of the Baltimore Longitudinal Study of Aging. Hand-wrist radiographs were obtained from 1958–1981 and were evaluated for total width, medullary width, and length of the second metacarpal. Data were analyzed using an age-time matrix with 8-year intervals for three epochs and nine age groups. The bone measurements were analyzed in three perspectives (cross-sectional, longitudinal and time-series). The results demonstrate that there is both a cross-sectional and longitudinal loss of cortical bone with age in the second metacarpal. Furthermore, the results show that males lose approximately 14% of their cortical bone, at a rate of about 2% per decade, over the adult lifespan. The majority of this loss occurs between the ages of 45 and 69 and is due primarily to aging and is not an artifact of cohort differences or secular change.

Palmar Dermatoglyphics of Down's Syndrome: Revisited

Extract: In previous reports the subclassifications for the terminations of the G line of the palm and for the interdigital palmar areas have been described. These subclassifications, as well as those of Cummins and Midlo for the hypothenar and thenar/I areas, were applied to anthropologic data and showed strong bilateral and racial polymorphism. The present study is an effort to determine the usefulness of these methods in investigations of clinical data. A well defined anomaly, Downs syndrome, which has known dermatoglyphic peculiarities, was chosen for this test. The study involved 145 male and 120 female patients and 108 male and 114 female control subjects. All subjects were unrelated Caucasians. Significant differences between the patient and control subjects were encountered in the subclassifications of the C line terminations and in the hypothenar area patterns. Significant differences were observed in the frequency of patterns in the thenar/I area as well as the expected differences in the simial lines. Sydney line frequencies showed no significant differences.Speculation: The results of the present study suggest that the subclassifications of the palmar patterns and the G line terminations are of value in the investigation of clinical data by offering further diagnostic criteria not revealed by gross dermatoglyphic evaluation.

Digital dermatoglyphics and breast cancer.

SummaryFingerprints of one hundred nineteen Caucasian females were obtained. Of these females, thirty-four had histologically proven breast cancer, fifty-three were at high risk for development of breast cancer, and thirty-two comprised a control group. The digital pattern frequencies and the pattern intensity index were significantly different between the three groups.The presence of six or more whorls appears significant as noted by 32.4% of breast cancer patients possessing this number of whorls as compared to 3.1% controls. Also of note is that 95% of subjects with six or more whorls either had cancer or were at high risk.

Dermatoglyphics in the 18q-Syndrome

Extract: The dermatoglyphics of 6 Caucasian patients with partial deletion of the long arm of chromosome 18 (18q-syndrome) were studied together with those of their parents and normal sibs. A second control sample, consisting of 19 randomly selected Caucasian families, was used for comparison.The patients showed significantly higher pattern intensity index, mainly higher frequency of whorls on their fingers. The direction of the main palmar lines was also significantly more transverse. The distribution of pattern intensity index, however, and the main line terminations of the parents and sibs of the patients were similar to those of the control families.Speculation: The present study indicates the relevance of derma toglyphics as an aid in the diagnosis of the 18q-syndrome, and reveals the usefulness of intrafamily comparisons in establishing dermatoglyphic peculiarities, especially when dealing with small samples.

DERMATOGLYPHICS IN SUDDEN INFANT DEATH SYNDROME

An analysis of digital and palmar dermatoglyphic patterns was conducted in 173 victims of the sudden infant death syndrome (SIDS). The results expose four dermatoglyphic regions with pattern frequencies differing from those in a control population. These are an excess of Sydney creases, hypothenar patterns, open fields (with fewer vestiges) in interdigital region IV, and arches on all digits (females only). These findings indicate a genetic or early intrauterine environmental influence in SIDS infants. An increased incidence of dysmorphism and anomalies including recognition of specific syndromes support this contention. One could speculate that these dermatoglyphic deviations reflect specific genotypes and/or phenotypes particularly vulnerable to postnatal challenges. Differences in multiple dermatoglyphic categories support the concept of heterogeneity of the SIDS population and multicausality of SIDS.