Alkylresorcinol, a biomarker for whole grain intake, is not associated with Osteoarthritis: The MOST Study

Authors: ZERTUCHE, JUAN-PABLO - Boston University; RABASA, GABRIELA - Boston University; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; NEVITT, MICHAEL - University Of California; TORNER, JAMES - University Of Iowa; LEWIS, CORA - University Of Alabama; MISRA, DEVYANI - Beth Israel Deaconess Medical Center; FELSON, DAVID - Boston University

Submitted to: Osteoarthritis and Cartilage
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/5/2022
Publication Date: 10/1/2022
Citation: Zertuche, J., Rabasa, G., Lichtenstein, A.H., Matthan, N., Nevitt, M., Torner, J., Lewis, C.E., Misra, D., Felson, D.T. 2022. Alkylresorcinol, a biomarker for whole grain intake, is not associated with Osteoarthritis: The MOST Study. Osteoarthritis and Cartilage. 30(10):1337-1343. https://doi.org/10.1016/j.joca.2022.07.004.
DOI: https://doi.org/10.1016/j.joca.2022.07.004

Interpretive Summary: Higher intake of fiber has been associated with lower risk of incident symptomatic osteoarthritis and knee pain worsening. We examined whether an indicator of whole grain intake, a major source of fiber in the U.S. diet, termed alkylresorcinol, was associated with incident radiographic osteoarthritis (loss of the protective tissue at the ends of bones [cartilage]), and incident symptomatic osteoarthritis (joint pain, aching and stiffness). The participants were older adults. There was no significant association between plasma alkylresorcinol concentrations at baseline (beginning of the observational period) and incident symptomatic or radiographic osteoarthritis incidence at any of the subsequent time points assessed (15, 30 or 60 months). We also did not observe a significant association of alkylresorcinol concentrations with worsening knee pain (30 months). Despite prior reports suggesting benefits of fiber intake, primarily from wheat, on incident symptomatic osteoarthritis and worsening of knee pain, an objective biomarker of intake, alkylresorcinol, was not associated with these outcomes.

Technical Abstract: OBJECTIVE: Higher intake of fiber has been associated with lower risk of incident symptomatic osteoarthritis (OA) and worsening knee pain. We examined whether levels of alkylresorcinol (AR), a marker of whole grain intake, were associated with OA outcomes or knee pain in subjects in The Multicenter Osteoarthritis (MOST) Study. DESIGN: Knee x-rays and knee pain were assessed at baseline and through 60-months. Stored baseline fasting plasma samples were analyzed for AR homologues (C17:0, C19:0, C21:0, C23:0, C25:0) and total AR levels (AR sum). Two nested case-control studies, one for incident radiographic OA and one for incident symptomatic OA were performed with participants re-assessed at 15, 30 and 60 months. Multivariable conditional logistic regression with baseline covariates including age, sex, BMI, physical activity, quadriceps strength, smoking, depressive symptoms and knee injury tested the association of log transformed AR levels with OA outcomes. Also, data from both case control studies were combined to examine the relation of AR levels with WOMAC pain worsening over 30 months using linear regression. RESULTS: Seven hundred seventy-seven subjects were, on average, in their 60's, and most were women. There was no significant association between quartiles of AR concentration and incident radiographic (test for trend p=0.56) or symptomatic OA (p = 0.25). No significant nor suggestive associations were observed between AR C19:0, AR C21:0 or the AR sum and worsening knee pain. CONCLUSION: Despite studies suggesting benefits of fiber intake, AR levels were not associated with risk of OA or worsening knee pain in the MOST cohort.