Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial.
Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial.
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DOI：
10.1001/jama.2013.277669
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发表时间：
2013-09-25
影响因子：
120.7
通讯作者：
Loeser, Richard F.
中科院分区：
文献类型：
--
作者：
Messier, Stephen P.;Mihalko, Shannon L.;Legault, Claudine;Miller, Gary D.;Nicklas, Barbara J.;DeVita, Paul;Beavers, Daniel P.;Hunter, David J.;Lyles, Mary F.;Eckstein, Felix;Williamson, Jeff D.;Carr, J. Jeffery;Guermazi, Ali;Loeser, Richard F.
膝骨关节炎 (OA) 是慢性疼痛和残疾的常见原因，具有生物力学和炎症起源，并且会因肥胖而加剧。旨在确定通过饮食引起的体重减轻 ≥10%（无论有或没有运动）是否比单独运动更能改善机械和临床结果。 2006 年 7 月至 2011 年 4 月在维克森林大学进行的单盲、为期 18 个月的随机临床试验。饮食和运动干预以中心为基础，运动组可选择过渡到家庭计划。参与者是 454 名超重和肥胖的社区居民老年人（年龄≥55 岁，体重指数为 27-41），患有疼痛和放射学膝骨关节炎。强化饮食诱导减肥加运动、强化饮食诱导减肥或运动。机制主要结果：膝关节压缩力和血浆 IL-6 水平；次要临床结果：自我报告的疼痛（范围，0-20）、功能（范围，0-68）、活动能力和健康相关的生活质量（范围，0-100）。 18 个月时，399 名参与者 (88%) 完成了研究。与运动参与者相比，饮食参与者的膝盖压缩力较低，饮食和饮食+运动参与者的 IL-6 水平较低。差异显着。在患有膝骨关节炎的超重和肥胖成年人中，18个月后，饮食+运动和节食组的参与者比运动组的体重减轻更多，IL-6水平降低幅度更大；饮食组的膝盖压缩力比运动组的减少幅度更大。 ClinicalTrials.gov 标识符：NCT00381290
Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity. To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone. Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. Participants were 454 overweight and obese older community-dwelling adults (age ≥55 years with body mass index of 27–41) with pain and radiographic knee OA. Intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise. Mechanistic primary outcomes: knee joint compressive force and plasma IL-6 levels; secondary clinical outcomes: self-reported pain (range, 0–20), function (range, 0–68), mobility, and health-related quality of life (range, 0–100). At 18 months, 399 participants (88%) completed the study. Compared with exercise participants, knee compressive forces were lower in diet participants and IL-6 levels were lower in diet and diet + exercise participants. Differences were significant. Among overweight and obese adults with knee OA, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group; those in the diet group had greater reductions in knee compressive force than those in the exercise group. clinicaltrials.gov Identifier: NCT00381290
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