Structural severity, phase angle, and quadriceps strength among patients with knee osteoarthritis: the SPSS-OK study
Structural severity, phase angle, and quadriceps strength among patients with knee osteoarthritis: the SPSS-OK study
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DOI：
10.1007/s10067-020-05056-w
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发表时间：
2020-04-27
影响因子：
3.4
通讯作者：
Mizuno, Kiyonori
中科院分区：
文献类型：
--
作者：
Wada, Osamu;Kurita, Noriaki;Mizuno, Kiyonori
引言/目的膝骨关节炎（KOA）的严重程度与相位角（PhA）之间的关系以及KOA患者的PhA与股四头肌力量之间的关系尚不清楚。本研究检查了（1）KOA的结构严重程度是否影响PhA和（2）PhA是否影响KOA患者的股四头肌力量。方法对科比骨科队列研究中的1093例KOA患者进行肌肉减少症筛查。通过生物阻抗测定PhA。使用手持式测力计测量股四头肌力量。KOA的结构严重程度采用Kelling-Lawrence放射学分级量表确定。拟合了一系列一般线性模型，以估计KOA严重程度差异导致的PhA差异幅度和PhA差异导致的股四头肌强度差异幅度。结果患者平均年龄72.8岁，78%为女性。KOA严重程度增加与PhA降低相关，尤其是在男性中。在女性中，只有4级KOA与PhA降低相关（相互作用P = 0.048）。每条腿的PhA与每条腿的股四头肌力量呈正相关，与年龄、性别、腿部肌肉质量、疼痛和KOA严重程度无关（每增加1度的平均差异= 7.54 Nm，95%置信区间= 5.51-9.57 Nm）。PhA和股四头肌力量之间的关联既不因性别也不因KOA严重程度而不同（相互作用的P值分别为0.133和0.185）。结论PhA随着KOA严重程度的增加而降低，PhA的增加与股四头肌力量的增加有关。因此，临床医生应评价PhA以评估KOA患者的股四头肌力量。
Introduction/objectives The associations between severity of knee osteoarthritis (KOA) and phase angle (PhA) and between PhA and quadriceps strength in patients with KOA are unclear. This study examined (1) whether the structural severity of KOA affects PhA and (2) whether PhA affects quadriceps strength in patients with KOA. Method Data of 1093 patients with KOA, obtained from Screening for People Suffering Sarcopenia in the Orthopedic cohort of Kobe study, were analyzed. PhA was determined by bioimpedance. Quadriceps strength was measured using a handheld dynamometer. Structural severity of KOA was determined using Kellgren-Lawrence radiographic grading scale. A series of general linear models were fitted to estimate the magnitude of differences in PhA by differences in KOA severity and quadriceps strength by differences in PhA. Results The mean age of the patients was 72.8 years, and 78% were women. Increasing KOA severity was associated with decreasing PhA, especially in men. In women, only grade 4 KOA was associated with a decrease in PhA (P for interaction = 0.048). PhA per leg was positively associated with quadriceps strength per leg, independent of age, sex, leg muscle mass, pain, and KOA severity (mean difference per 1 degrees increase = 7.54 Nm, 95% confidence interval = 5.51-9.57 Nm). The association between PhA and quadriceps strength differed neither by sex nor by KOA severity (P for interaction = 0.133 and 0.185, respectively). Conclusions PhA decreased with increasing KOA severity, and increasing PhA was associated with increasing quadriceps strength. Clinicians should, therefore, evaluate PhA to assess quadriceps strength in patients with KOA.