Musculoskeletal Medicine and PainORIGINAL ARTICLE

The association of folate deficiency with clinical and radiological severity of knee osteoarthritis

Majid Abedi, MD; Hasan Mollashahi Javan, MD; Asal Khosravi, MD; Reza Rohani, MD; and Ghasem Mohammadsharifi, MD
Notes and Affiliations
Notes and Affiliations

Received: February 8, 2023

Accepted: November 27, 2023

Published: February 9, 2024

  • Majid Abedi, MD, 

    Knee Surgery Fellow and Assistant Professor of Orthopedics, Zabol University of Medical Sciences, Zabol, Iran

  • Hasan Mollashahi Javan, MD, 

    General Physician and Assistant Professor of Orthopedics, Zabol University of Medical Sciences, Zabol, Iran

  • Asal Khosravi, MD, 

    General Physician and Assistant Professor of Orthopedics, Zabol University of Medical Sciences, Zabol, Iran

  • Reza Rohani, MD, 

    Assistant Professor of Neurosurgery, Department of Neurosurgery, Zabol University of Medical Sciences, Zabol, Iran

  • Ghasem Mohammadsharifi, MD, 

    Assistant Professor of Orthopedics, Zabol University of Medical Sciences, Zabol, Iran

Abstract

Context: Folate deficiency is often observed in patients with inflammatory diseases, raising questions about its role in knee osteoarthritis (OA) progression.

Objectives: This study aimed to assess the association of folate deficiency with the clinical and radiological severity of knee OA.

Methods: A prospective cross-sectional study was conducted from January 1, 2019 to January 1, 2020. Primary knee OA patients referred to orthopedic clinics in Zabol, Iran were included. Radiographic severity was gauged utilizing the Kellgren–Lawrence (KL) classification. For clinical severity, patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. IBM SPSS v.27 facilitated the statistical analysis.

Results: Forty-nine knee OA patients, averaging 67.45±13.44 years in age, were analyzed. Spearman correlation analysis revealed a negative correlation between folate levels and both WOMAC and KL scores. The correlation was stronger between folate and KL score (Spearman correlation coefficient: −0.75) than between folate and WOMAC total score (Spearman correlation coefficient: −0.46). Additionally, a significantly higher KL score was observed in patients with folate deficiency (p=0.004).

Conclusions: Our study highlights a significant correlation between folate deficiency and increased severity of OA, which is evident in radiological and clinical assessments. These findings suggest that folate plays a key role in OA pathogenesis and could be a modifiable factor in its management.

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