AB0591 ASSESSMENT OF KNEE-RELATED SYMPTOMS, ACTIVITIES, AND QUALITY OF LIFE IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME
Authors: P. Kabakchieva, T. Georgiev, A. Gateva, Z. Kamenov
Journal: Annals of the Rheumatic Diseases (2021)

Background: Osteoarthritis (OA) is a slowly progressive disease that probably begins in young adulthood when a timely treatment would present the possibility to reverse or slow down the disease process. Obesity and sex hormones play an essential role in the pathogenesis of OA in women and their influence on joint function persists throughout the whole life [1]. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age characterized by sex-hormonal disbalance, metabolic abnormalities, and most commonly obesity. It seems that PCOS presents the best opportunity to study the complex interactions among hormonal disbalance, obesity, and (pre)osteoarthritis. Objectives: Our study aims to assess the knee-related symptoms, activities, and quality of life in young women with PCOS and to compare them with healthy volunteers using Knee Injury and Osteoarthritis Outcome Score (KOOS) developed for younger and more active individuals [2]. Methods: Fifty-four patients with PCOS who met the Rotterdam criteria were compared with 26 healthy women. Both groups were matched by age and body mass index (BMI). The exclusion criteria of the study were: the presence of inflammatory/autoimmune rheumatic disease and/or another endocrine disorder. Pregnant women and participants, who used systemic corticosteroids, antiandrogens, or insulin-sensitive drugs in the last 3 months were also excluded from the study. After written informed consent all participants filled in the questionnaire. KOOS was scored in each of its 5 domains: pain, symptoms, activities of daily living (ADL), sport and recreation function, and knee-related quality of life (QoL). Additionally, detailed anthropometric data, clinical examination, and hormonal assessment (testosterone, dehydroepiandrosterone sulfate [DHEAS], androstenedione, 17-OH-progesterone, luteinizing hormone [LH], follicle stimulating hormone [FSH], and estradiol) were carried out in all overnight-fasted participants during a follicular phase of a menstrual cycle. Results: Patients and healthy volunteers had similar anthropometric and demographic characteristics but PCOS women were expectedly more hyperandrogenic and hirsute than controls. Patients and controls did not differ significantly in their knee pain, knee-related QoL, and sport and recreation function. Knee-related symptoms were more prominent in the PCOS group compared to controls (p = 0.035). ADL associated with the knee joint were also more impaired in patients (p = 0.001). Obese PCOS women had a significantly lower score in the ADL domain than normal and overweight patients (p = 0.035). In the PCOS group, both knee-related ADL and sport and recreation function correlated significantly with weight (p = 0.025 and p = 0.034, respectively) and waist circumference (p = 0.011 and p = 0.016, respectively), among all studied anthropometric parameters. Sex hormones did not correlate with any of the evaluated KOOS subscales. Conclusion: PCOS patients may experience impaired physical function related to daily life due to knee problems. Obesity may further contribute to knee-related ADL dysfunction. Hormonal disturbances did not show any association with knee complaints in our study. References: [1]Georgiev T, Angelov AK. Modifiable risk factors in knee osteoarthritis: treatment implications. Rheumatol Int. 2019 Jul;39(7):1145-1157 [2]Roos EM, Toksvig-Larsen S. Knee injury and Osteoarthritis Outcome Score (KOOS) - validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 2003;1:17. Acknowledgements: The study was performed with the financial support of Medical University-Sofia, Bulgaria, Young Investigator 2020, Project No 8378/20.11.2019, Contract D-85/24.06.2020. Disclosure of Interests: None declared.