The association of body mass index and osteoarthritis of the knee joint - An examination of genetic and environmental influences
The association of body mass index and osteoarthritis of the knee joint - An examination of genetic and environmental influences
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DOI：
10.1002/art.10884
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发表时间：
2003-04-01
影响因子：
--
通讯作者：
MacGregor, AJ
中科院分区：
文献类型：
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作者：
Manek, NJ;Hart, D;MacGregor, AJ
Objective.研究遗传和环境因素对体重指数（BNH）和膝关节骨关节炎（OA）之间已知关联的影响，使用成年双胞胎数据。双侧膝关节X线片来自785对健康女性双胞胎（平均年龄54.5 ± 7.8岁），来自St.托马斯医院成人双胞胎登记处（261对单卵[MZ]和524对双卵[DZ]双胞胎）。根据Kellgren和Lawrence（K/L）评分系统，以0-4的顺序量表对胫股膝关节OA进行分级。膝关节OA的存在定义为膝关节两侧的K/L等级大于或等于2。测量体重和身高，并将受试者分为BMI的四分位数。通过逻辑回归评估BMI和膝关节OA的跨特质跨双胞胎关联，以评估遗传或环境影响是否解释BMI-膝关节OA联系。遗传（遗传力）和环境的贡献，每个措施估计使用路径模型。高BMI与膝关节OA之间存在强相关性（BMI最高与最低四分位数的比值比为3.90; P = 0.0001）。膝关节OA的遗传度为50.4%（95%置信区间[95% CI] 34-62%），BMI的遗传度为55.7%（95% CI 35-72%）。然而，跨性状跨双胞胎协会没有显着不同的团结在任何MZ或DZ双胞胎对，这表明共享的遗传影响是不太可能解释的协会。通径模型表明，包含加性遗传因子、共同环境因子和独特环境因子的模型总体上与数据拟合最好。BMI和膝关节OA之间的共享遗传路径可以在模型拟合不恶化的情况下被丢弃。高BMI和膝关节OA之间的强相关性不太可能由共同的遗传因素介导。结果表明，BMI的环境改变可以影响膝关节OA。
Objective. To examine the genetic and environmental influences on the known association between body mass index (BNH) and knee osteoarthritis (OA), using adult twin data.Methods. Bilateral knee radiographs were obtained from 785 pairs of healthy female twins (mean age 54.5 +/- 7.8 years) from the St. Thomas' Hospital Adult Twin Registry (261 monozygotic [MZ] and 524 dizygotic [DZ] twin pairs). Tibiofemoral knee OA was graded according to the Kellgren and Lawrence (K/L) scoring system on an ordinal scale of 0-4. Presence of knee OA was defined as a K/L grade of greater than or equal to2 on either side of the knee joint. Body weight and height were measured and the subjects were stratified into quartiles of BMI. Cross-trait cross-twin association of BMI and knee OA was assessed by logistic regression, to assess whether genetic or environmental influences explain the BMI-knee OA link. The genetic (heritability) and environmental contributions to each of the measures were estimated using path modeling.Results. A strong association was found between high BMI and the presence of knee OA (odds ratio 3.90 for highest versus lowest quartile of BMI; P = 0.0001). The heritability of knee OA was 50.4% (95% confidence interval [95% CI] 34-62%) and that of BMI was 55.7% (95% CI 35-72%). However, cross-trait cross-twin associations were not significantly different from unity in either the MZ or DZ twin pairs, indicating that shared genetic influences were unlikely to explain the association. Path modeling showed that the model containing additive genetic factors, common environmental factors, and unique environmental factors had the best fit to the data overall. The shared genetic path between BMI and knee OA could be dropped without deterioration in the fit of the model.Conclusion. The strong association between high BMI and knee OA is not likely to be mediated by shared genetic factors. The results imply that environmental modification of BMI can influence knee OA.