Chao Zeng

• Medical Doctor at Xiangya Hospital of Central South University

Background Unhealthy sleep behaviors may contribute to osteoarthritis (OA), but their interrelated nature complicates evaluation and longitudinal studies examining the correlation between overall sleep behaviors and OA incidence are lacking. We explored the impact of sleep patterns on OA incidence and investigated whether genetic susceptibility pla...

Obesity is associated with skeletal deterioration and increased fracture risk, but the underlying mechanism is unclear. Herein, it is shown that obese gut microbiota promotes skeletal deterioration by inducing bone marrow macrophages (BMMs) senescence and grancalcin (GCA) secretion. Obese mice and those receiving obese fecal microbiota transplants...

Objective Intramuscular fat infiltration (IMFI) in the thigh is linked to metabolic inflammation and muscle dysfunction, which could contribute to osteoarthritis development. However, no longitudinal studies have examined the associations between thigh IMFI and incident knee and hip osteoarthritis. Methods We conducted a cohort study using UK Biob...

Objective Observational studies have found that cigarette smoking increased the prevalence and incidence of sarcopenia, whereas alcohol consumption appeared to decrease the risk. These findings, however, may be susceptible to either confounding bias or reverse causation. We conducted a Mendelian randomisation (MR) study to appraise the causal relat...

Whether a gut-joint axis exists to regulate osteoarthritis is unknown. In two independent cohorts, we identified altered microbial bile acid metabolism with reduced glycoursodeoxycholic acid (GUDCA) in osteoarthritis. Suppressing farnesoid X receptor (FXR)—the receptor of GUDCA—alleviated osteoarthritis through intestine-secreted glucagon-like pept...

Importance The 2023 American College of Rheumatology and American Association of Hip and Knee Surgeons Clinical Practice Guideline concluded that obesity alone should not delay joint replacement. Therefore, a substantially increased utilization of joint replacement among patients with obesity could be expected. However, patients with obesity are at...

The infiltration and excessive polarization of M1 macrophages contribute to the induction and persistence of low‐grade inflammation in joint‐related degenerative diseases such as osteoarthritis (OA). The lipid metabolism dysregulation promotes M1 macrophage polarization by coordinating the compensatory pathways of the inflammatory and oxidative str...

Aims For displaced femoral neck fractures (FNFs) in geriatric patients, there remains uncertainty regarding the effect of total hip arthroplasty (THA) compared with hemiarthroplasty (HA) in the guidelines. We aimed to compare 90-day surgical readmission, in-hospital complications, and charges between THA and HA in these patients. Methods The Hospi...

Importance Clinicians often approach urate-lowering therapy (ULT) cautiously in patients with gout and impaired kidney function because they are concerned about the risk of progression to severe or end-stage kidney disease. However, evidence from randomized clinical trials of this association remains inconclusive. Objective To evaluate the associa...

Objective Weight loss is conditionally recommended for gout management; however, its impact on incident gout and recurrent gout flares among individuals who were overweight and obese remains unknown. We investigate the relationship between weight loss rate following treatment with anti‐obesity medications and the risk of incident gout and recurrent...

The accumulation and systemic propagation of senescent cells contributes to physiological aging and age-related pathology. However, which cell types are most susceptible to the aged milieu and could be responsible for the propagation of senescence has remained unclear. Here we found that physiologically aged bone marrow monocytes/macrophages (BMMs)...

Background Synovitis has long been considered a common and modifiable inflammatory feature of osteoarthritis (OA), but current disease-modifying anti-inflammatory treatments appear ineffective in OA clinical trials. Elucidating the temporal relationship between synovitis and OA could provide insight into the role of synovitis in OA. Methods We con...

Background Memantine, which is an FDA-proven drug for the treatment of dementia, exerts its function by blocking the function of NMDA (N-methyl-D-aspartate) receptor, a calcium-permeable ion channel that reduces cytotoxic calcium overload. Chondrocyte senescence is a crucial cellular event that contributes to articular cartilage degeneration during...

Objective Although hand synovitis is prevalent in the older population, the etiology remains unclear. Hyperuricemia, a modifiable metabolic disorder, may serve as an underlying mechanism of hand synovitis, but little is known about their relationship. We assessed the association between hyperuricemia and hand synovitis in a large population‐based s...

Objectives Early-onset osteoarthritis (OA) is an emerging health issue amidst the escalating prevalence of overweight and obesity. However, there are scant data on its disease, economic burden and attributable burden due to high body mass index (BMI). Methods Using data from the Global Burden of Diseases Study 2019, we examined the numbers of inci...

Background Identification of knee osteoarthritis (OA) pain phenotypes, their transition patterns, and risk factors for worse phenotypes, may guide prognosis and targeted treatment; however, few studies have described them. We aimed to investigate different pain phenotypes, their transition patterns, and potential risk factors for worse pain phenoty...

Melatonin exhibits potential for pain relief and long‐term safety profile. We examined the analgesic effects of oral melatonin on osteoarthritis (OA) and investigated the underlying mechanism. Using data from a UK primary care database, we conducted a cohort study in individuals with OA to compare the number of oral analgesic prescriptions and the...

Background Limited studies have examined the benefits of early arthroplasty within 48 hours from admission to surgery for femoral neck fractures (FNFs). Using the national inpatient database, we aimed to investigate the trends in early arthroplasty within 48 hours for FNFs in China and to assess its effect on in-hospital complications and 30-day re...

Objectives The incidence of gout in the UK appears to have declined since 2013; however, whether such a trend occurred across participants born in different years (ie, birth cohort) is unknown. We aimed to examine the effects of the birth cohort on gout incidence using an age-period-cohort (APC) model. Design Cross-sectional study. Setting Nation...

Objective The current guidelines recommend weight loss for patients with overweight or obesity and knee or hip osteoarthritis (OA); however, there is a paucity of data on the relation of weight loss to death among patients with OA. We aimed to examine the relation of the rate of weight loss induced by antiobesity medications over one year to all‐ca...

Objective The pathogenesis of hand osteoarthritis (OA) remains unknown. Hyperuricaemia, which is related to inflammation, may play a role in hand OA, but evidence is lacking. In a large population-based study, we examined the association between hyperuricaemia and hand OA. Methods Participants were from the Xiangya OA Study, a community-based obse...

Objectives Knee synovitis is a highly prevalent and potentially curable condition for knee pain; however, its pathogenesis remains unclear. We sought to assess the associations of the gut fungal microbiota and the fungi–bacteria correlation network with knee synovitis. Methods Participants were derived from a community-based cross-sectional study....

Background Since gut microbiome dysbiosis can cause inflammatory disorders by affecting host metabolism, we postulate that the gut microbiome and related metabolites could play a role in hand osteoarthritis. We characterised gut microbiome-related metabolites in people with symptomatic hand osteoarthritis (SHOA) in two independent cohorts. Methods...

Hand osteoarthritis is a common heterogeneous joint disorder with unclear molecular mechanisms and no disease-modifying drugs. In this study, we performed single-cell RNA sequencing analysis to compare the cellular composition and subpopulation-specific gene expression between cartilage with macroscopically confirmed osteoarthritis (n = 5) and cart...

Objective Synovial abnormalities, which are modifiable treatment targets for knee pain, affect ~25% of adults. Ultrasound is a safe, inexpensive, and easily accessible imaging modality for assessing synovial abnormalities, but its diagnostic accuracy is still controversial. We conducted a meta‐analysis by comparing ultrasound with the “reference st...

Introduction Decrease in allogenic red blood cell (RBC) transfusion rates following total hip arthroplasty (THA) has been reported in the United States, but whether other countries share the same trend remains unclear. Additionally, the relation of allogenic RBC transfusion to the risk of complications in THA remains controversial. Using the Chines...

Metabolites’ connection to sarcopenia through inflammation and mitochondrial dysfunction is presumed, but their impact remains unclear due to limitations in conventional observational studies caused by confounding bias and reverse causation. We conducted a Mendelian randomization (MR) analysis to elucidate the association of serum metabolites with...

Importance: Recurrent flares are the hallmark of clinical manifestation of gout. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been associated with a lower risk of incident gout; however, their association with recurrent flares is unknown. Objective: To examine the association of SGLT2i vs active comparators (ie, glucagonlike peptide-1...

Importance: Vitamin D deficiency is commonly associated with sarcopenia; however, the latest International Clinical Practice Guidelines for Sarcopenia do not recommend vitamin D supplementation for sarcopenia owing to a lack of an apparent therapeutic effect on the indices of sarcopenia among participants with replete vitamin D concentration (ie,...

Background: The rural-urban disparities in postoperative complications and costs among patients undergoing knee arthroplasty (KA) have not been thoroughly explored. This study aimed to determine whether such differences exist in this patient population. Material and methods: The study was conducted using data from the national Hospital Quality M...

Objective Gout is associated with a higher risk of fracture; however, findings on the associations of hyperuricemia and urate‐lowering therapy (ULT) with the risk of fracture have been inconsistent. We examined whether lowering serum urate (SU) levels with ULT to a target level (i.e., <360 μmoles/liter) reduces the risk of fracture among individual...

Background: There are limited data on the resource utilization of total knee arthroplasty (TKA) in China. This study aimed to examine the length of stay (LOS) and inpatient charges of TKA in China, and to investigate their determinants. Methods: We included patients undergoing primary TKA in the Hospital Quality Monitoring System in China betwee...

Objective To estimate the effect of denosumab compared with oral bisphosphonates on reducing the risk of type 2 diabetes in adults with osteoporosis. Design Population based study involving emulation of a randomized target trial using electronic health records. Setting IQVIA Medical Research Data primary care database in the United Kingdom, 1995-...

Objective To compare the risk of SARS-CoV-2 infection and its related severe sequelae between patients with systemic lupus erythematosus (SLE) and the general population according to COVID-19 vaccination status. Methods We performed cohort studies using data from The Health Improvement Network to compare the risks of SARS-CoV-2 infection and sever...

Objective: Synovial abnormalities are modifiable targets for hand pain and osteoarthritis. We examined the prevalence and distribution of ultrasound-detected hand synovial abnormalities in a community-derived sample of older people in China. Methods: Within a community-based study, we assessed synovial hypertrophy (SH), joint effusion, and Power...

Abstract Background Both BNT162b2 (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (Oxford–AstraZeneca) vaccines have shown high efficacy against COVID-19 in randomized controlled trials. However, their comparative effectiveness against COVID-19 is unclear in the real world. We evaluated the comparative effectiveness of the BNT162b2 and ChAdOx1 nCoV-19 vaccin...

Background: National epidemiological data in China are absent for revision total knee arthroplasty (TKA). This study aimed to investigate the burden and characteristics of revision TKA in China. Methods: We reviewed 4,503 revision TKA cases registered in the Hospital Quality Monitoring System in China between 2013 and 2018 using International Cl...

Objectives: Hand synovitis, a potentially modifiable pathological lesion, is common and associated with pain and hand osteoarthritis; nevertheless, its pathogenesis remains uncertain. This study investigated the relationship between gut microbiota dysbiosis and hand synovitis prevalence and evaluated whether bile acids mediate the association. Me...

Objective Although most frequently used in experimental osteoarthritis (OA) pain induction, intra-articular mono-iodoacetate (MIA) injection lacks concluded references for dose selection and timing of intervention. Herein, we aimed to compare the pain intensity of rats induced by different doses of MIA and explored the trajectory of pain. Design P...

Objective Clinical guidelines recommend exercise as a core treatment for knee or hip osteoarthritis (OA). However, how its analgesic effect compares to analgesics, for example, oral non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol—the most commonly used analgesics for OA, remains unknown. Design Network meta-analysis. Data sources P...

Purpose To compare postoperative outcomes of four different femoral drilling techniques in anterior cruciate ligament (ACL) reconstruction (ACLR). Methods Three databases were searched for randomized controlled trials (RCTs) comparing any two or more of the following femoral drilling techniques in ACLR: standard transtibial (sTT), anteromedial por...

Objective Gout patients often have multiple comorbidities, making them susceptible to SARS–CoV‐2 infection and poor outcomes. This study was undertaken to examine the association between gout and the risk of SARS–CoV‐2 infection and severe outcomes, especially in patients who have received a SARS–CoV‐2 vaccine. Methods We conducted 2 cohort studie...

Objective To determine whether patients with rheumatoid arthritis (RA) are at higher risks for SARS–CoV‐2 infection and its severe outcomes before and after COVID‐19 vaccination. Methods Using a UK primary care database, we conducted 2 cohort studies to compare the risks of SARS–CoV‐2 infection, hospitalization, and death from COVID‐19 between pat...

Objectives: Angiotensin II is implicated in giant cell arteritis (GCA) pathology. We examined whether the use of angiotensin receptor blockers (ARB) is associated with GCA risk, compared with ACE inhibitors (ACEi) or other antihypertensives. Methods: We performed a matched cohort study including adults who were initiators of antihypertensives in...

Background We aimed to: (1) perform a nationwide trend analysis of staggered and simultaneous bilateral knee arthroplasty (KA); (2) investigate patient demographics and hospital characteristics in two groups; and (3) compare the outcomes of two groups with a focus on complications, length of stay (LOS) and hospitalization costs. Methods Utilizing...

Objective To examine efficacy and safety of tramadol for knee or hip osteoarthritis (OA). Methods PubMed, Embase, Cochrane Library, and Web of Science were searched up to May 2020 for randomized controlled trials (RCTs) comparing any of the following interventions: tramadol 100 mg/day, 200 mg/day, and 300 mg/day, and placebo for knee or hip OA. Pa...

PurposePrevious studies highlighted an increased risk of venous thromboembolism (VTE) among patients with anterior cruciate ligament reconstruction (ACLR); however, the risk for those with ACL tear but without undergoing ACLR has not been reported yet. The aim of this study was to evaluate the risk of VTE among ACL tear individuals with or without...

Background: Several studies have examined gut microbiota and sarcopenia using 16S ribosomal RNA amplicon sequencing; however, this technique may not be able to identify altered specific species and functional capacities of the microbes. We performed shotgun metagenomic sequencing to compare the gut microbiome composition and function between indiv...

Background Dietary magnesium deficiency, which is common in modern diet, has been associated with osteoarthritis (OA) susceptibility. Despite this clinical association, no study has addressed if dietary magnesium deficiency accelerates OA development, especially at molecular level. This study aimed to explore aggravating effects of dietary magnesiu...

Background Limited data exist on readmission following knee arthroplasty (KA) in countries without well-established referral or extended care systems. This study aimed to investigate the incidence, patterns and risk factors for readmission following KA in China. Material and methods In this national retrospective cohort study, we reviewed 167,265...

Aims: Previous studies reported proton pump inhibitors (PPIs) use may increase the risk of fracture; however, the findings may be susceptible to indication bias since peptic ulcer disease (PUD), one major indication for PPIs, may affect skeletal health. Determining whether PUD would increase hip fracture risk may help identify high risk population...

Background Emerging evidence suggests that dysbiosis in gut microbiota may contribute to the occurrence or development of several rheumatic diseases. Since gut microbiota dysbiosis is potentially modifiable, it has been postulated to be a promising preventive or therapeutic target for rheumatic diseases. However, the current understanding on the po...

Objective : Routine vaccinations are associated with an increased risk of gout flares. We examined the association between COVID-19 vaccination, an immunization program implemented to a large proportion of population, and the risk of gout flares. Methods : We conducted a time-stratified case-crossover study among patients with gout who experienced...

Objective Hyperuricemia is a precursor to gout and is often present in other metabolic diseases that are promoted by microbiome dysbiosis. We undertook this study to examine the association of gut microbiota with hyperuricemia and serum urate levels in humans. Methods Study participants were derived from a community‐based observational study, the...

Objective Patients with rheumatoid arthritis (RA) are at an increased risk of acquiring infections owing to immunologic dysfunction and use of potent immunomodulatory medications; however, few data are available on their risk of COVID‐19. We estimated the rate of COVID‐19 among RA participants and compared it with that of the general population. M...

Aims Previous studies have found high sodium intake to be associated with increased risks of cardiovascular disease (CVD) and all-cause mortality among individuals with hypertension; findings on the effect of intake among individuals without hypertension have been equivocal. We aimed to compare the risks of incident CVD and all-cause mortality amon...

Background: Two recent randomized clinical trials of escalating doses of allopurinol for the progression of chronic kidney disease (CKD) reported no benefits but potentially increased risk for death. Whether the risk could occur in patients with gout and concurrent CKD remains unknown. Objective: To examine the relation of allopurinol initiation...

Objective Proton pump inhibitors (PPIs) are among the most commonly used medications for patients with osteoarthritis (OA). Various types of PPIs have different impacts on lowering serum magnesium level that may affect knee OA progression. We aimed to compare the risk of clinically relevant endpoint of knee replacement (KR) among initiators of five...

Metformin is hypothesized to have a beneficial effect on venous thromboembolism (VTE); however, there is a paucity of data supporting this hypothesis. Among individuals aged 40-90 years with a diagnosis of type 2 diabetes in the Health Improvement Network database (2000–2019), we compared the risk of incident VTE, pulmonary embolism (PE), and deep...

Introduction: Symptomatic treatments for osteoarthritis (OA) provide only small-to-moderate efficacy over placebo in randomised controlled trials (RCTs). Treatment guidelines therefore have emphasised the need to identify predictors of treatment response through subgroup and multiple regression analysis. Individual participant data (IPD) meta-anal...

Objective Systemic inflammatory factors have been implicated in symptomatic hand osteoarthritis (OA). Gut microbiome dysbiosis promotes systemic inflammation. The aim of this study was to examine the association between the gut microbiome and the presence of symptomatic hand OA in a population‐based study. Methods Study participants were subjects...

Objectives There is still a large unmet need for novel osteoarthritis (OA) treatments that could provide clinically important effects on long-term pain relief (≥12 months). We examined the relation of bariatric surgery along with weight loss to analgesic prescription and all-cause mortality among individuals with OA. Methods We conducted a cohort...

Abstract Background There is paucity of data on the prevalence of ultrasound-detected synovial abnormalities in the general population, and the relationship between synovial changes and knee pain remains unclear. We examined the prevalence of synovial abnormalities on ultrasound and the relationship of these features with knee pain and radiographic...

Objective Current global guidelines regarding the first-line analgesics (acetaminophen, topical or oral non-steroidal anti-inflammatory drugs [NSAIDs]) for knee osteoarthritis remain controversial and their comparative risk-benefit profiles have yet to be adequately assessed. Design Pubmed, Embase, Cochrane Library, and Web of Science were searche...

We appreciate the interest of Sirufo et al. in our manuscript describing the association between gut microbiota and symptomatic hand osteoarthritis (SHOA) (1). Hand osteoarthritis (OA) is a common joint disorder. Individuals with hand OA often reported pain symptom and functional limitation, including difficulty in undertaking daily activities. To...

Objective To assess the relation of symptomatic knee osteoarthritis (OA), knee pain, and radiographic knee OA to All‐cause mortality and to identify mediators in the causal pathway. Methods Participants from the Osteoarthritis Initiative were divided into 4 groups: 1) symptomatic knee OA (i.e., both radiographic knee OA [Kellgren/Lawrence grade ≥2...

Objective Smoking represents a major issue for global public health. Owing to methodologic challenges, findings of an association between smoking and risk of knee osteoarthritis (OA) are inconsistent. We sought to assess the relation of onset of smoking cessation to the risk of OA sequelae, i.e., knee replacement, and to perform sub-cohort analysis...

Background Physical distancing measures taken to contain COVID-19 transmission may substantially reduce physical activity levels and cause individuals to adopt a more sedentary lifestyle. Objective The objective of this study is to determine if there was any change in daily steps, an important component of daily physical activity, and examine risk...

Objectives: Osteoarthritis is a leading cause of immobility and joint replacement, two strong risk factors for venous thromboembolism (VTE). We aimed to examine the relation of knee, hip and hand osteoarthritis to the risk of VTE and investigate joint replacement as a potential mediator. Methods: We conducted three cohort studies using data from...

Background: To examine the relation between inflammatory potential of diet and incident knee osteoarthritis (OA) and the role of BMI in the association of interest. Methods: In the Osteoarthritis Initiative, the energy-adjusted dietary inflammatory index (E-DII™) scores were calculated based on the Block Brief 2000 Food Frequency Questionnaire a...

Objectives: To examine trends in the initial prescription of commonly-prescribed analgesics and patient- as well as practice-level factors related to their selection in incident OA. Methods: Patients consulting with incident clinical OA between 2000-2016 were identified within The Health Improvement Network in the United Kingdom (UK) general pra...

BACKGROUND Physical distancing measures taken to contain COVID-19 transmission may substantially reduce physical activity levels and cause individuals to adopt a more sedentary lifestyle. OBJECTIVE The objective of this study is to determine if there was any change in daily steps, an important component of daily physical activity, and examine risk...

Previous studies comparing risk of fracture among Proton Pump Inhibitors (PPIs) users with that among non-users were susceptible to confounding by indication. Epidemiologic studies of this association using an active medication as a comparator would appropriately address this bias. We conducted a propensity-score matched cohort study to compare the...

Background To examine the relation between inflammatory potential of diet and incident knee osteoarthritis (OA) and the role of BMI in the association of interest. Methods In the Osteoarthritis Initiative, the Dietary inflammatory index (DII®) was calculated based on the Block Brief 2000 Food Frequency Questionnaire and categorized into sex-specifi...