Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Cis-9-Cetylmyristoleate Containing Fatty Acids Complex Extracted from Vegetable Oils on Knee Pain in Patients with Osteoarthritis

Cetyl Myristoleate를 주성분으로 하는 식물성 복합 지방산의 퇴행성 슬관절염 환자에 대한 통증 감소 효과

  • Ha, Tae-Guk (Department of Family Medicine, Seoul National University Hospital) ;
  • Kang, Joo-Hyoung (Department of Family Medicine, Seoul National University Hospital) ;
  • Lee, In-Bum (Department of Family Medicine, Seoul National University Hospital) ;
  • Ahn, Cheol-Soo (Department of Family Medicine, Seoul National University Hospital) ;
  • Lee, Chi-Hoon (Department of Family Medicine, Seoul National University Hospital) ;
  • Lee, Sang-Chul (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital) ;
  • Kang, Seung-Wan (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital)
  • 하태국 (서울대학교병원 가정의학과) ;
  • 강주형 (서울대학교병원 가정의학과) ;
  • 이인범 (서울대학교병원 가정의학과) ;
  • 안철수 (서울대학교병원 가정의학과) ;
  • 이치훈 (서울대학교병원 가정의학과) ;
  • 이상철 (서울대학교병원 마취통증의학과) ;
  • 강승완 (서울대학교병원 마취통증의학과)
  • Received : 2008.09.20
  • Accepted : 2009.12.19
  • Published : 2010.01.20
⟨ Previous Next ⟩

Abstract

Background: Previous study suggested that beef tallow extract including cis-9-cetylmyristoleate was a safe and effective treatment for patients with osteoarthritis. We used extract of vegetable oils containing cetyl myristoleate. This study assessed the effect of this supplementation on knee pain and function in patients with osteoarthritis. Methods: The 70 patients who manifested the symptoms and signs of osteoarthritis of knee were randomly assigned to placebo (36) and plant-fatty acids complex (FAC) group (34). Two capsules of placebo (corn starch 350 mg) and plant- FAC (12% cetyl myristoleate in 350 mg) were orally administered to placebo and plant-FAC group three times a day for 60 day, respectively. Visual analogue scale (VAS) and Korean version of Western Ontario and McMaster's Universities Osteoarthritis Index (KWOMAC) were assessed before and after the intervention and we monitored any adverse effects. Results: The 6 of 36 patients (16.7%) in the placebo and the 5 of 34 patients (14.7%) in the plant-FAC group were missed due to low compliance. In the plant-FAC group, the VAS score was improved by mean 0.76 (P = 0.03) but the improvement was lower than that of placebo group. The KWOMAC was improved by mean 8.90 and 8.13 in the plant-FAC and placebo group, respectively. But the independent t-test showed no statistical significance (P = 0.47). Conclusion: We failed to show the superiority of plant-FAC to placebo on the pain and function of patients with osteoarthritis of the knee.

연구배경: Cetyl myristoleate를 주성분으로 한 쇠기름 추출 복합지방산(fatty aicd complex, FAC)이 퇴행성 슬관절염의 통증 조절에 효과적이라는 보고가 있었다. 본 연구는 식물에서 cetyl myristoleate를 함유한 복합지방산을 추출하여, 이보충제가 슬관절염 환자의 통증 감소 및 관절기능 향상에 효과적인지 알아보고자 하였다. 방법: 퇴행성 슬관절염으로 진단된 46-77세의 피험자 70명을 이중맹검 무작위 할당 방식으로 식물성 FAC군(N=34) 및 위약군(N=36)에 배정하였다. 식물성 FAC군은 2정의 FAC (350 mg 중 cetyl myristoleate 12% 함유)를, 위약군은 동일 제형의 위약 2정을 각각 하루 3회 총 60일간 복용하였다. 관절 통증 척도로서 visual analogue scale (VAS)과 관절기능 척도로서 Korean version of Western Ontario and McMaster's Universities Osteoarthritis Index (KWOMAC)를 투약기간 전후로 측정하였 다. 결과: 위약군 36명 중 6명(16.7%), 식물성 FAC군 34명 중 5명 (14.7%)이 탈락하여 결과 분석에는 위약군 및 식물성 FAC군 각각 30명, 29명이 포함되었다. 위약군에서 VAS 변화량은 평균 1.01점(6.18${\rightarrow}$5.17)으로 16.34% 감소하였다. 식물성 FAC군에서 VAS 변화량은 평균 0.76점(5.45${\rightarrow}$4.69)으로 13.94% 감소하였으나(P=0.03), 위약군보다 낮은 감소를 보였다. KWOMAC은 식물성 FAC군 및 위약군에서 각각 평균 8.90점(40.83${\rightarrow}$31.93) 및 8.13점(45.63${\rightarrow}$37.50) 감소하였으나, 독립표본 t-검정 결과 통계적으로 유의한 차이를 보이지 않았다(P=0.47). 결론: Cetyl myristoleate를 주성분으로 하는 식물에서 추출한 복합지방산은 슬관절염 환자의 관절통증 및 관절기능 향상에 있어서 위약보다 나은 효과를 보이지 않았다.

Keywords

References

  1. Felson DT. Clinical practice. Osteoarthritis of the knee. N Engl J Med 2006;354:841-8. https://doi.org/10.1056/NEJMcp051726
  2. McAlindon TE, Cooper C, Kirwan JR, Dieppe PA. Knee pain and disability in the community. Br J Rheumatol 1992;31:189- 92. https://doi.org/10.1093/rheumatology/31.3.189
  3. Moon WN, Moon WN, Lee KS, Oh HJ. Frequency of radiographic knee osteoarthritis in women having knee joint pain. J Korean Rheum Assoc 2003;10:9-15.
  4. Schurman DJ, Smith RL. Osteoarthritis: current treatment and future prospects for surgical, medical, and biologic intervention. Clin Orthop Relat Res 2004;427 Suppl:S183-9. https://doi.org/10.1097/01.blo.0000143555.33848.c4
  5. Griffin MR, Piper JM, Daugherty JR, Snowden M, Ray WA. Nonsteroidal anti-inflammatory drug use and increased risk for peptic ulcer disease in elderly persons. Ann Intern Med 1991;114:257-63. https://doi.org/10.7326/0003-4819-114-4-257
  6. Fries JF, Williams CA, Bloch DA. The relative toxicity of nonsteroidal antiinflammatory drugs. Arthritis Rheum 1991;34:1353-60.
  7. Pelletier JP, Martel-Pelletier J, Raynauld JP. Most recent developments in strategies to reduce the progression of structural changes in osteoarthritis: today and tomorrow. Arthritis Res Ther 2006;8:206. https://doi.org/10.1186/ar1932
  8. Farahat MN, Yanni G, Poston R, Panayi GS. Cytokine expression in synovial membranes of patients with rheumatoid arthritis and osteoarthritis. Ann Rheum Dis 1993;52:870-5. https://doi.org/10.1136/ard.52.12.870
  9. Benito MJ, Veale DJ, FitzGerald O, van den Berg WB, Bresnihan B. Synovial tissue infl ammation in early and late osteoarthritis. Ann Rheum Dis 2005;64:1263-7. https://doi.org/10.1136/ard.2004.025270
  10. Ameye LG, Chee WS. Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of scientifi c evidence. Arthritis Res Ther 2006;8:R127. https://doi.org/10.1186/ar2016
  11. Lee SH, Kim JH, Cho WS, Seo SW, Kim SK, Oh JH. Th e effi cacy and safety of beef tallow extract including cis-9-cetylmyristoleate in patients with osteoarthritis: as an adjuvant pharmacological treatment. J Food Sci Nutr 2005;10:285-9. https://doi.org/10.3746/jfn.2005.10.3.285
  12. Peat G, Thomas E, Duncan R, Wood L, Hay E, Croft P. Clinical classification criteria for knee osteoarthritis: performance in the general population and primary care. Ann Rheum Dis 2006;65:1363-7. https://doi.org/10.1136/ard.2006.051482
  13. Treadwell MJ, Franck LS, Vichinsky E. Using quality improvement strategies to enhance pediatric pain assessment. Int J Qual Health Care 2002;14:39-47. https://doi.org/10.1093/intqhc/14.1.39
  14. Bellamy N. The WOMAC knee and hip osteoarthritis indices: development, validation, globalization and influence on the development of the AUSCAN hand osteoarthritis indices. Clin Exp Rheumatol 2005;23(5 Suppl 39):S148-53.
  15. Bae SC, Lee HS, Yun HR, Kim TH, Yoo DH, Kim SY. Crosscultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and lequesne osteoarthritis indices for clinical research. Osteoarthritis Cartilage 2001;9:746-50. https://doi.org/10.1053/joca.2001.0471
  16. Calder PC, Yaqoob P, Th ies F, Wallace FA, Miles EA. Fatty acids and lymphocyte functions. Br J Nutr 2002;87 Suppl 1:S31-48. https://doi.org/10.1079/BJN2001455
  17. Kremer JM, Lawrence DA, Petrillo GF, Litts LL, Mullaly PM, Rynes RI, et al. Effects of high-dose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinfl ammatory drugs. Clinical and immune correlates. Arthritis Rheum 1995;38:1107-14. https://doi.org/10.1002/art.1780380813
  18. Revell PA, Mayston V, Lalor P, Mapp P. The synovial membrane in osteoarthritis: a histological study including the characterisation of the cellular infiltrate present in inflammatory osteoarthritis using monoclonal antibodies. Ann Rheum Dis 1988;47:300-7. https://doi.org/10.1136/ard.47.4.300
  19. Diehl HW, May EL. Cetyl myristoleate isolated from Swiss albino mice: an apparent protective agent against adjuvant arthritis in rats. J Pharm Sci 1994;83:296-9. https://doi.org/10.1002/jps.2600830307
  20. Hunter KW Jr, Gault RA, Stehouwer JS, Tam-Chang SW. Synthesis of cetyl myristoleate and evaluation of its therapeutic efficacy in a murine model of collagen-induced arthritis. Pharmacol Res 2003;47:43-7. https://doi.org/10.1016/S1043-6618(02)00239-6
  21. Hesslink R Jr, Armstrong D 3rd, Nagendran MV, Sreevatsan S, Barathur R. Cetylated fatty acids improve knee function in patients with osteoarthritis. J Rheumatol 2002;29:1708-12.
  22. Kraemer WJ, Ratamess NA, Maresh CM, Anderson JA, Tiberio DP, Joyce ME, et al. Effects of treatment with a cetylated fatty acid topical cream on static postural stability and plantar pressure distribution in patients with knee osteoarthritis. J Strength Cond Res 2005;19:115-21.
  23. Morelli V, Naquin C, Weaver V. Alternative therapies for traditional disease states: osteoarthritis. Am Fam Physician 2003;67:339-44.

Cited by

  1. 슬관절 밸런스 테이핑 요법이 노인의 무릎 통증과 관절가동범위에 미치는 효과 vol.16, pp.6, 2010, https://doi.org/10.14400/jdc.2018.16.6.213