Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative
Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative
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DOI：
10.1148/radiol.2017161005
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发表时间：
2017-08-01
期刊：
影响因子：
19.7
通讯作者：
Link, Thomas M.
中科院分区：
文献类型：
--
作者：
Gersing, Alexandra S.;Schwaiger, Benedikt J.;Link, Thomas M.
目的：研究相关的体重减轻与进展的软骨变化在磁共振（MR）成像超过48个月的超重和肥胖的参与者相比，稳定weight.Materials和方法：机构审查委员会的四个参与中心批准了这项符合健康保险责任法案的研究。（a）640名参与者（平均年龄62.9岁6 9.1 [标准差]; 398名女性）超重或肥胖（体重指数临界点分别为25和30 kg/ m2），有骨关节炎风险因素或轻度至中度骨关节炎影像学结果，分为以下组：（a）体重减轻超过10%（n = 82），（B）体重减轻5%-10%（n = 238），或（c）48个月内体重稳定（n = 320）。参与者的年龄、性别、基线体重指数和Kelly-Lawrence评分频率匹配。两名放射科医师使用改良的全器官磁共振成像评分（蠕虫）评估基线和48个月时右膝3-T MR图像上的软骨和半月板缺损。结果：48个月后，体重减轻5%-10%组的软骨蠕虫的校正平均增加量明显较小（1.6; 95%置信区间[CI]：1.3，1.9; P =.002），体重减轻超过10%的组甚至更小（1.0; 95% CI：0.6，1.4; P =.001），与体重稳定组（2.3; 95% CI：2.0，2.7）相比。此外，体重变化的百分比与软骨蠕虫的增加显著相关（B = 0.2; 95% CI：0.02，0.4; P = 0.007）。结论：根据MR成像评估，体重减轻超过48个月的参与者显示出显著较低的软骨变性;随着体重减轻，进展率较低。
Purpose: To investigate the association of weight loss with progression of cartilage changes at magnetic resonance (MR) imaging over 48 months in overweight and obese participants compared with participants of stable weight.Materials and Methods: The institutional review boards of the four participating centers approved this HIPAA-compliant study. Included were (a) 640 participants (mean age, 62.9 years 6 9.1 [standard deviation]; 398 women) who were overweight or obese (body mass index cutpoints of 25 and 30 kg/ m2, respectively) from the Osteoarthritis Initiative, with risk factors for osteoarthritis or mild to moderate radiographic findings of osteoarthritis, categorized into groups with (a) weight loss of more than 10% (n = 82), (b) weight loss of 5%-10% (n = 238), or (c) stable weight (n = 320) over 48 months. Participants were frequency-matched for age, sex, baseline body mass index, and Kellgren-Lawrence score. Two radiologists assessed cartilage and meniscus defects on right knee 3-T MR images at baseline and 48 months by using the modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). Progression of the subscores was compared between the weight loss groups by using multivariable logistic regression models.Results: Over 48 months, adjusted mean increase of cartilage WORMS was significantly smaller in the 5%-10% weight loss group (1.6; 95% confidence interval [CI]: 1.3, 1.9; P =.002) and even smaller in the group with more than 10% weight loss (1.0; 95% CI: 0.6, 1.4; P =.001) when compared with the stable weight group (2.3; 95% CI: 2.0, 2.7). Moreover, percentage of weight change was significantly associated with increase in cartilage WORMS (b = 0.2; 95% CI: 0.02, 0.4; P =.007).Conclusion: Participants who lost weight over 48 months showed significantly lower cartilage degeneration, as assessed with MR imaging; rates of progression were lower with greater weight loss.