We determined the levels of chondroitin sulfate (CS) isomers in the synovial fluid of patients with hip osteoarthritis (OA) to investigate their significance as markers reflecting extracellular matrix metabolism in joint tissues. A cross-sectional study of synovial fluid aspirated from 50 hip joints of 50 patients with OA was performed. Concentrations of chondroitin-4- sulfate (C4S) and chondroitin-6-sulfate (C6S) were determined by high- performance liquid chromatography. Levels of each marker molecule were investigated in relation to age and radiological stage of the disease. In all disease stages, the dominant CS isomer in synovial fluid was C6S. There was a significant negative correlation between levels of C6S and age. A significant inverse correlation was also observed between the ratio of C6S to C4S and age. Results of analysis of covariance in which age was covariate showed that the ratio of C6S to C4S in advanced and terminal stage OA was lower than that in early stage OA. The present results indicate that the ratio of CS isomers in synovial fluid in hip OA varies with the severity of disease. These molecules in synovial fluid may serve as a useful marker reflecting extracellular matrix metabolism in OA.
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