Evaluation of the Effect of Mega MSM on Improving Joint Function in Populations Experiencing Joint Degeneration

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1 Interntionl journl of Biomedicl science ORIGINAL ARTICLE Evlution of the Effect of Meg MSM on Improving Joint Function in opultions Experiencing Joint Degenertion Gng Xu 1, Tin Zhou 2, Yqin Gu 3, Qinping Wng 3, Min Shriff 4, ingping Gu 4, Tuong Nguyen 4, Rong Shi 1, Jinyu Ro 5 1 School of ublic Helth, Shnghi Jio Tong University, Chin; 2 Beijing University of Chinese Medicine; 3 Tngqio Community Helth Service Center, udong New District, Chin; 4 Deprtment of Reserch, DRM Resources, 1683 Sunflower Avenue, Cost Mes, CA 92626, USA; 5 Deprtment of thology nd Lbortory Medicine, in UCLA Medicl Center, University of Cliforni, Los Angeles, CA, USA Abstrct Joint degenertion hs become commonplce problem in ging popultions. The min clinicl mnifesttions include joint pin, joint stiffness nd joint swelling with functionl disorder. Meg MSM is nutritionl supplement tht my provide potentil relief for joint problems ssocited with joint degenertion. The current experiment performed ws 12-week, rndomized, double-blind, controlled study conducted on popultions in Chin experiencing joint degenertion. The objective of the study ws to determine whether the dily use of Meg MSM cpsules could improve joint function, relieve symptoms of joint degenertion nd improve the qulity of life in ging popultions. A totl of 100 mle nd femle prticipnts over 50 yers old who hd t lest one of the relted symptoms of joint degenertion (joint pin, joint stiffness, joint swelling, difficulty wlking, difficulty getting up from bed nd difficulty going down stirs) were recruited nd their symptoms of joint degenertion before nd fter the intervention were recorded. In this study, Meg MSM shows positive effects in improving joint function, relieving symptoms ssocited with joint degenertion nd improving the qulity of life in ging popultions. (Int J Biomed Sci 2015; 11 (2): 54-60) Keywords: Joint degenertion; joint pin; joint stiffness; joint swelling; Meg MSM; qulity of life INTRODUCTION Corresponding uthor: Rong Shi, School of ublic Helth, Shnghi Jio Tong University, Chin. E-mil: shirong61@163.com. Jinyu Ro, Deprtment of thology nd Lbortory Medicine, in UCLA Medicl Center, University of Cliforni, Los Angeles, CA, USA. E-mil: jro@mednet. ucl.edu. Received April 28, 2015; Accepted June 4, 2015 Copyright: 2015 Gng Xu et l. This is n open-ccess rticle distributed under the terms of the Cretive Commons Attribution License ( cretivecommons.org/licenses/by/2.5/), which permits unrestricted use, distribution, nd reproduction in ny medium, provided the originl uthor nd source re credited. Joint degenertion hs become commonplce problem in ging popultions (1). The min clinicl mnifesttions includes joint pin, joint stiffness nd joint swelling with functionl disorder (2). Joint concerns hve become very common mong the elderly popultions, nd re mjor cuse of impired ctivities of the elderly (3). The prevlence rtes of joint concerns mong men nd women ged bove 60 yers were, respectively, 21.5% nd 42.8% in Beijing (4), nd 24.0% 54

2 nd 41.6% in udong New District, Shnghi (5) where the study ws held. reventing nd controlling the symptoms of joint degenertion effectively cn not only improve the life qulity of the elderly nd reduce the knee replcement rte for joint helth ptients (6), but cn lso reduce the economic burden of the whole society (7). Meg MSM is nutritionl supplement contining ingredients such s methylsulfonylmethne, vitmin C nd collgen tht help promote helthy joint crtilge synthesis to id joint strength, comfort, mobility nd flexibility. It is theorized tht by supporting joint crtilge formtion, Meg MSM might provide potentil relief of joint problems ssocited with joint degenertion. The current experiment performed ws rndomized, double-blind, controlled study conducted on popultions in Chin suffering from joint degenertion. A totl of 100 eligible prticipnts were recruited nd rndomly llocted into two groups to receive either Meg MSM or plcebo cpsules. All prticipnts were followed up for 12 weeks. The chnges of relted symptoms (including joint pin, joint stiffness, joint swelling, difficulty wlking, difficulty getting up from bed nd difficulty going down stirs) nd self-reported qulity of life were recorded to ssess the efficcy of Meg MSM on improving joint flexibility nd elsticity. The objective of the study ws to determine whether the dily use of Meg MSM cpsules could relieve symptoms of joint degenertion nd improve joint function in ging popultions. METHODS rticipnts A totl of 100 prticipnts were recruited from the outptient deprtment of the community helth service center of Tngqio in Shnghi, Chin, from September 29, 2013, to November 26, All potentil prticipnts were ssessed by physicl exmintions. All of the prticipnts were men nd women over 50 yers old who hd t lest one of the relted symptoms of joint degenertion (joint pin, joint stiffness, joint swelling, difficulty wlking, difficulty getting up from bed nd difficulty going down stirs). The study excluded individuls who hd cncer, cogultion dysfunction history, gllstones, stomch ulcers nd those who hd used bromelin, ntibiotics (such s moxicillin or tetrcycline) or nti-pltelet drugs within 30 dys. All prticipnts provided written, informed consent for the study. Technicl Informtion All of the 100 eligible prticipnts were rndomly ssigned into the Meg MSM group or the plcebo group with the rtio of 1:1. Ech prticipnt received continer mrked with different-colored lbels (which ws blinded for both study subjects nd reserchers) nd detiled instructions of dministrting the cpsules. The unmsking ws done t the end of the intervention. All ptients were required to complete questionnire which recorded their dte of birth, gender, ethnicity, medicl history, fmily history, smoking nd drinking hbits, current mediction nd symptoms of joint degenertion, s well s 36-item Short-Form Helth Survey (SF-36 scle). The Meg MSM nd plcebo cpsules were both mnufctured by Robinson hrm, Inc (Cost Mes, Cliforni, USA). rticipnts in the Meg MSM group took two Meg MSM cpsules orlly, twice dily (fter brekfst nd lunch). rticipnts in the control group (plcebo group) lso took two plcebo cpsules orlly, twice dily (fter brekfst nd lunch). The ctive components of the Meg MSM cpsules comprised of vitmin C, methylsulfonylmethne, collgen (from chicken), neem (Azdircht indic) extrct nd corydlis (Corydlis ynhusuo) extrct. The min ingredient of the plcebo cpsules ws flour. The SF-36 scle is widely recognized helth-relted qulity of life (HRQoL) ssessment tool used in Europe nd Americ to evlute both physicl nd mentl helth (3). SF-36 includes eight dimensions, including physiologicl functioning (F), role-physicl (R), bodily pin (B), generl helth (GH), vitlity (VT), socil functioning (SF), role-emotionl (RE) nd mentl helth (MH). In ddition, there is n item indictor helth trnsition (HT) in the SF-36 scle to ssess the chnges in helth in the pst yer. The totl intervention period lsted for 12 weeks. All prticipnts were followed up once per month. Cpsules were dispensed with follow-ups. All follow-ups for both the Meg MSM group nd plcebo group were completed on Februry 26, A totl of 99 cses completed the lst follow-up nd finl survey, (49 cses in the Meg MSM group, 50 cses in the plcebo group). One volunteer in the Meg MSM group dropped out. Sttisticl nlysis EpiDt 3.02 softwre ws used for the estblishment of the dtbse. SSS 20.0 softwre ws used for sttisticl nlysis. Vribles were compred between the two groups by pplying Student s t-test for quntittive vri- Int J Biomed Sci vol. 11 no. 2 June

3 bles nd Chi-squre test for ctegorized vribles. The lph level chosen ws Anlyses were conducted using intent-to-tret (ITT) nlysis. All p-vlues reported were 2-sided. RESULTS Bseline dt At the bseline nd t the end of the intervention period, physicins evluted the symptoms for every prticipnt through physicl exmintions, ssigning scores rnging from 1 to 5, with 1 indicting the bsence of given symptom nd 5 indicting severe degree of the symptom. The ge, gender, smoking history, lcohol intke history, medicl history nd mediction history of ll prticipnts were lso collected t the bseline. Along with the follow-ups, self-reported side effects nd dherences were recorded. The bseline chrcteristics between the two groups were comprble on ge, gender, smoking history, lcohol intke history nd mediction history. In the Meg MSM group there were 14 mles (28.6%) nd 35 femles (71.4%), while in the plcebo group there were 9 mles (18.0%) nd 41 femles (82.0%). The verge ge of prticipnts ws ± 8.19 yers in the Meg MSM group nd ± 9.98 yers in the plcebo group. The drinking rte in the Meg MSM group nd the plcebo group were 6.1% nd 10.0%, respectively. The smoking rte ws 6.1% in the Meg MSM group nd 2.0% in the plcebo group. Between the two groups, there were no significnt differences in totl SF-36 scores, scores of ech dimension nd physicl composite scores (CS), nd mentl composite scores (MCS). The only exception were the scores for mentl helth (MH) (Tble 1). There were no significnt differences between verge scores nd ll of the self-reported joint symptom scores between the two groups, except for the symptom of difficulty going down stirs (Tble 2). There were no significnt differences on joint exmintion scores nd the verge score between the two groups, except in the score of skin redness (Tble 3). Generlly, the two rms blnced well t bseline through rndomiztion. Dimension Tble 1. SF-36 scores t bseline Meg MSM (n=49) SF-36 ( ± S) lcebo (n=50) F ± ± R ± ± * B ± ± GH ± ± VT ± ± SF ± ± RE ± ± MH ± ± HT ± ± CS ± ± MCS ± ± Totl score ± ± t Tble 2. Self-reported joint symptoms scores t bseline Self-reported joint symptoms ( ± S) Meg MSM (n=49) lcebo (n=50) t Joint pin 3.31 ± ± Joint stiffness 2.31 ± ± Joint swelling 1.78 ± ± Difficulty wlking 2.49 ± ± Difficulty getting up from bed 2.10 ± ± Difficulty going down stirs 3.24 ± ± Averge Score 2.54 ± ±

4 Results fter intervention SF-36 scores fter the intervention. After the 12- week intervention, the score of physiologicl functioning (F) in the Meg MSM group ws ± 17.11, which ws significntly higher thn the score of ± in the plcebo group (p=0.005). The score of MH in the Meg MSM group ws ± 8.83 nd ws lso significntly higher thn the score of ± in the plcebo group (p<0.001). Also, the MCS score in Meg MSM group ws ± 45.30, compred to the score of ± in the plcebo group (p=0.049) (Tble 4). There ws insufficient evidence to distinguish the effects of Meg MSM nd the plcebo for other spects. Self-reported joint symptom scores fter the intervention. After the intervention, the score of joint pin in the Meg MSM group ws 2.51 ± 0.82, lower thn the score of 3.04 ± 0.93 in the plcebo group (p=0.003). The verge Tble 3. Joint exmintion scores t bseline Joint exmintion scores ( ± S) Meg MSM lcebo t (n=49) (n=50) Skin redness 1.31 ± ± Swelling 1.88 ± ± Het 1.43 ± ± in 3.39 ± ± Joint movement disorder 3.08 ± ± Averge Score 2.22 ± ± score in the Meg MSM group ws 2.02 ± 0.70, which ws lso significntly lower thn the score of 2.32 ± 0.68 in the plcebo group (p=0.036) (Tble 5). There ws insufficient evidence to suggest ny differences between Meg MSM nd the plcebo for other self-reported symptoms. Joint exmintion scores fter the intervention. After the intervention, the score of skin redness in the Meg MSM group ws 1.16 ± 0.47 compred to the score of 1.02 ± 0.14 in the plcebo group (p=0.046), nd the score of pin in the Meg MSM group ws 2.75 ± 0.76, which ws significntly lower thn the score of 3.08 ± 0.83 in the pl- Dimension Tble 4. SF-36 scores fter the intervention Meg MSM (n=49) SF-36 ( ± S) lcebo (n=50) F ± ± R ± ± B ± ± GH ± ± VT ± ± SF ± ± RE ± ± MH ± ± HT ± ± CS ± ± MCS ± ± Totl score ± ± t Tble 5. Self-reported joint symptoms scores fter the intervention s Self-reported joint symptoms ( ± S) Meg MSM (n=49) lcebo (n=50) t Joint pin 2.51 ± ± Joint stiffness 2.00 ± ± Joint swelling 1.51 ± ± Difficulty wlking 1.98 ± ± Difficulty getting up from bed 1.76 ± ± Difficulty going down stirs 2.37 ± ± Averge Score 2.02 ± ± Int J Biomed Sci vol. 11 no. 2 June

5 cebo group (p=0.002). Also, the score of joint movement disorder in the Meg MSM group ws 2.37 ± 0.70, lower thn tht in the plcebo group (p=0.004) (Tble 6). The improvement rtes on self-reported joint symptoms, nd the joint exmintion scores before nd fter the intervention. improvement ws defined s the scores of self-reported joint symptoms or if the joint exmintion reduced by 1 point or bove. Improvement rtes were lso clculted nd compred between the two groups (Tble 7). The chnges of SF-36 scores before nd fter the intervention. The chnges of F, R, B, SF, CS, MCS nd the totl score in the Meg MSM group were lrger thn those in the plcebo group (Tble 8). The rte of dverse events. The rte of dverse events ws 10.2% in the Meg MSM group nd 8.0% in the plcebo group, respectively, with no significnt difference noted (χ 2 =0.001,p=0.975). The only side effect reported in the Meg MSM group ws stomch discomfort (stomch bloting). DISCUSSION Joint degenertion is common condition ffecting mjor ging popultions. Over long-term dministrtion, current routine therpies, such s non-steroidl nti-inflmmtory drugs (NSAIDs), could led to dverse effects. This clinicl tril ws designed to determine whether dily dministrtion of Meg MSM, s n lterntive, could relieve symptoms in ging popultions experiencing joint degenertion. Meg MSM ws found to hve positive effects in improving joint function nd relieving joint problems ssoci- Tble 6. Joint exmintion scores fter the intervention Joint exmintion scores ( ± S) Meg MSM (n=49) lcebo (n=50) t Skin redness 1.16 ± ± Swelling 1.49 ± ± Het 1.33 ± ± in 2.75 ± ± Joint movement disorder 2.37 ± ± Averge Score 1.78 ± ± Tble 7. The improvement rtes on self-reported joint symptoms nd the joint exmintion scores before nd fter the intervention The improvement rte (%) Meg MSM (n=49) lcebo (n=50) 1 Joint pin Joint stiffness Joint swelling Difficulty wlking Difficulty getting up from bed Difficulty going down stirs Skin redness Swelling Het in Joint movement disorder χ 2 58

6 Tble 8. The chnges of SF-36 scores before nd fter the intervention (Wilcoxon two-smple rnk sum test) Dimension Meg MSM (n=49) Averge rnk lcebo (n=50) Averge rnk F R B GH VT SF RE MH HT CS MCS Totl score ted with joint degenertion including joint pin, joint stiffness, joint swelling, difficulty wlking, difficulty getting up from bed nd difficulty going down stirs. It ws lso found to improve overll qulity of life especilly in the dimensions F, R, B, SF, CS, MCS, etc. No serious, dverse rections from tking Meg MSM were found in the study. Meg MSM exhibited potent effects in relieving symptoms such s joint stiffness nd improving joint functions. The improved rte of nine dimensions were higher in the Meg MSM group thn in the plcebo group. Overll, Meg MSM hd positive effects on relieving joint problems. This study lso showed tht prticipnts in the Meg MSM group experienced better qulity of life fter tking the Meg MSM cpsules compred to those tking the plcebo. As mentioned in the results section, fter 12- week intervention, the physiologicl functions score ws pproximtely 10 points greter in the Meg MSM group compred to the plcebo group. Also, the mentl composite score ws 20 points higher thn the plcebo group. The scores of physiologicl functions, role-physicl, bodily pin nd vitlity chnged in the Meg MSM group fter the intervention. The physicl composite score nd mentl composite score were rised, too. z As in mny rndomized controlled tril studies, we followed ITT policy, ignoring nondherence. Subjects were compred bsed on initil rndomiztion intervention groups. This method llowed us to void potentil bises in comprison bsed on per-protocol nlysis, since there ws no evidence to suggest tht nondherence ws rndomly distributed, though this method might induce the underestimtion of the effect size. There were lso severl limittions in this study. Some potentil confounding fctors such s weight, lifestyle nd dietry hbits were not controlled in the study. But s the two groups were well-blnced in the bseline chrcteristics, we expected tht the effects of differences in these, or other potentil confounding fctors, would be miniml. The results could only be responsible for this study rnge. When inferences re mde to popultions different from the study popultion we specified, there could be generlizing problem. Further study is needed to confirm these inferences out of the rnges we mentioned. Another limittion ws the use of questionnire to collect bseline informtion, which relies on prticipnts recll. Thus, the results from this prt my be prone to recll bis. Finlly, ll of our prticipnts were volunteers, i.e. those eligible who did not wish to prticipte were excluded. If those who were excluded were not exctly comptible with those enrolled for the study, the results would suffer selection bis. CONCLUSION In summry, Meg MSM shows positive effects in improving joint function, relieving symptoms ssocited with joint degenertion including joint pin, joint stiffness, joint swelling, difficulty wlking, difficulty getting up from bed nd difficulty going down stirs nd improving qulity of life, in elderly popultions. CONFLICTS OF INTEREST The uthors declre tht no conflicting interests exist. REFERENCES 1. Singh AK, Klivni M, Krishnn A, et l. revlence of Osteorthritis of Knee Among Elderly ersons in Urbn Slums Using Americn College of Rheumtology (ACR) Criteri [J]. J. Clin. Dign. Res. 2014; 8 (9): Sski E, Tsud E, Ymmoto Y, et l. Nocturnl knee pin increses with the severity of knee osteorthritis, disturbing ptient sleep qulity [J]. Arthritis Cre Res (Hoboken). 2014; 66 (7): Int J Biomed Sci vol. 11 no. 2 June

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