Dietary Patterns and Progression of Knee Osteoarthritis: Data from the Osteoarthritis Initiative.
Dietary Patterns and Progression of Knee Osteoarthritis: Data from the Osteoarthritis Initiative.
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DOI：
10.1093/ajcn/nqz333
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发表时间：
2020-01
期刊：
影响因子：
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通讯作者：
Chang Xu;N. Marchand;J. Driban;T. McAlindon;C. Eaton;B. Lu
中科院分区：
文献类型：
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作者：
Chang Xu;N. Marchand;J. Driban;T. McAlindon;C. Eaton;B. Lu
虽然某些食物和营养素与膝关节骨关节炎（KOA）进展有关，但饮食模式与KOA进展之间的关联很少受到研究关注。目的本研究的目的是确定是否饮食模式，来自主成分分析（PCA），与膝骨性关节炎的进展。方法在骨关节炎倡议（OAI）中，在马里兰州、俄亥俄州、宾夕法尼亚州和罗得岛的临床中心进行了前瞻性队列研究，对2757名患有KOA（平均年龄62岁）和基线饮食评估的参与者进行了≤72个月的随访。通过使用五氯苯甲醚，得出了西式和谨慎的饮食模式。采用2种单独的测量方法评估放射学KOA进展，1种完全Kelling-Lawrence（KL）分级增加和关节间隙宽度（JSW）损失。症状性KOA进展定义为西安大略和麦克马斯特大学关节炎指数（WOMAC）的2个最高分类类别之一增加或保持不变。结果坚持西方和谨慎的饮食模式与KOA的影像学和症状进展显著相关。随着西方模式评分的增加，KL恶化的风险增加（与四分位数1相比，四分位数4的HR：1.30; 95% CI：1.05，1.61; P趋势< 0.01）和进展至更高WOMAC评分的几率增加（与四分位数1相比，四分位数4的OR：1.39; 95% CI：1.18，1.63; P趋势< 0.01），但JSW丢失无显著变化。随着谨慎模式评分的增加，KL恶化风险降低（与四分位数1相比，四分位数4的HR：0.79; 95% CI：0.64，0.98; P趋势= 0.02），JSW丢失减少（四分位数1：0.46 mm;四分位数4：0.38 mm; P趋势< 0.01），以及WOMAC进展较高的几率降低（与四分位数1相比，四分位数4的OR为0.73; 95% CI：0.62，0.86; P趋势< 0.01）。结论：坚持西方饮食模式与放射学和症状性KOA进展增加相关，而遵循谨慎的饮食模式与进展减少相关。一般来说，对于已经诊断为KOA的人来说，吃富含水果，蔬菜，鱼，全谷物和豆类的饮食可能与减少放射学和症状性疾病进展有关。
BACKGROUND While some individual foods and nutrients have been associated with knee osteoarthritis (KOA) progression, the association between dietary patterns and KOA progression has received little research attention. OBJECTIVE The objective of this study was to determine whether dietary patterns, derived by principal components analysis (PCA), are associated with KOA progression. METHODS In the Osteoarthritis Initiative (OAI), a prospective cohort with clinical centers in Maryland, Ohio, Pennsylvania, and Rhode Island, 2757 participants with existing KOA (mean age 62 y) and diet assessed at baseline were followed for ≤72 mo. Using PCA, Western and prudent dietary patterns were derived. Radiographic KOA progression was assessed using 2 separate measures, 1 full Kellgren-Lawrence (KL) grade increase and loss in joint space width (JSW). Symptomatic KOA progression was defined as an increase in or remaining in 1 of the 2 highest classification categories of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). RESULTS Adherence to Western and prudent dietary patterns was significantly associated with radiographic and symptomatic progression of KOA. With increasing Western pattern score, there was increased KL-worsening risk (compared with quartile 1, HR for quartile 4: 1.30; 95% CI: 1.05, 1.61; P-trend < 0.01) and increased odds of progression to higher WOMAC score (compared with quartile 1, OR for quartile 4: 1.39; 95% CI: 1.18, 1.63; P-trend < 0.01) but no significant change in JSW loss. With increasing prudent pattern score there was decreased KL-worsening risk (compared with quartile 1, HR for quartile 4: 0.79; 95% CI: 0.64, 0.98; P-trend = 0.02), decreased JSW loss (quartile 1: 0.46 mm; quartile 4: 0.38 mm; P-trend < 0.01), and decreased odds of higher WOMAC progression (compared with quartile 1, OR for quartile 4 0.73; 95% CI: 0.62, 0.86; P-trend < 0.01) in multivariable adjusted models. CONCLUSIONS Adherence to a Western dietary pattern was associated with increased radiographic and symptomatic KOA progression, while following a prudent pattern was associated with reduced progression. In general, for people already diagnosed with KOA, eating a diet rich in fruits, vegetables, fish, whole grains, and legumes may be related to decreased radiographic and symptomatic disease progression.