Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve-month randomized controlled trial.
Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve-month randomized controlled trial.
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DOI：
10.1002/acr.22504
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发表时间：
2015-05
影响因子：
4.7
通讯作者：
Bliddal H
中科院分区：
文献类型：
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作者：
Christensen R;Henriksen M;Leeds AR;Gudbergsen H;Christensen P;Sørensen TJ;Bartels EM;Riecke BF;Aaboe J;Frederiksen R;Boesen M;Lohmander LS;Astrup A;Bliddal H
比较膝骨关节炎（OA）肥胖患者的结果，这些患者在强化减肥方案后接受1年的饮食支持（D）、膝关节运动计划（E）或“不注意”（C;对照组）。我们进行了一项随机、2期、平行组试验。共入组了192名患有膝关节OA的肥胖受试者;平均年龄为62.5岁，81%为女性，平均入组体重为103.2 kg。在第一阶段，所有参与者被随机分配到3组中的1组，并开始16周（2个8周阶段）的400-810和1，250千卡/天的饮食方案，以实现重大的体重减轻。第2阶段包括D、E或C组52周的维持治疗。根据风湿病-骨关节炎研究协会国际标准的结果测量，结果是100 mm视觉模拟量表上疼痛、体重和反应相对于随机化的变化。第1阶段的平均体重减轻为12.8 kg。维持治疗1年后，D组的体重（11.0 kg，95%置信区间[95% CI] 9.0，12.8 kg）低于E组（6.2，95% CI 4.4，8.1 kg）和C组（8.2，95% CI 6.4，10.1 kg）（协方差分析[ANCOVA]，P = 0.002）。E组的依从性较低。所有组均具有统计学显著性疼痛减轻（D：6.1; E：5.6;和C：5.5 mm），组间无差异（ANCOVA，P = 0.98）。在每组中，D、E和C组分别有32名（50%）、26名（41%）和33名（52%）参与者对治疗有反应，反应者数量无统计学显著差异（P = 0.41）。1年维持计划的显著体重减轻改善了膝关节OA症状，与维持计划无关。
To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or “no attention” (C; control group). We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400–810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria. Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41). A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.