Assessment of systemic inflammatory markers in individuals with hand osteoarthritis: A retrospective case-control...

Hand osteoarthritis (HOA) is a common musculoskeletal condition characterized by joint pain and structural changes; however, the role of systemic inflammation in its pathogenesis remains unclear. This retrospective case-control study aimed to evaluate both traditional and novel systemic inflammatory markers in patients with HOA and to examine their associations with Kellgren-Lawrence grade and erosive disease. A total of 175 patients with HOA and 94 age- and sex-matched controls were included. C-reactive protein and C-reactive protein/albumin ratio (CAR) levels were higher in patients with HOA compared with controls (P = .015 and P = .004, respectively), while albumin levels were lower (P = .044). No significant differences were observed for erythrocyte sedimentation rate or hematologic inflammatory indices including systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio (all P > .05). When stratified by Kellgren-Lawrence grade, no associations were found between inflammatory markers and radiographic severity (all P > .05). In subgroup analysis, CAR levels were higher in both erosive and nonerosive HOA groups compared with controls (P = .046 and P = .021, respectively), whereas no significant differences were observed between erosive and nonerosive HOA groups (P = .593). In multivariable logistic regression analysis, no individual inflammatory marker showed an independent association with the presence of HOA (all P > .05). Receiver operating characteristic analysis showed that CAR had limited discriminative ability for HOA (area under the curve = 0.594, standard error = 0.036, P = .011). In conclusion, although C-reactive protein and CAR levels were elevated in patients with HOA, these markers were not independently associated with disease presence and were not related to disease severity or erosive status. These findings suggest that systemic inflammatory markers may have a limited role in reflecting disease processes in HOA, and that inflammatory activity may be partly localized and not fully captured by circulating markers. Further prospective studies are needed to better define the inflammatory profile of HOA.