Is obesity a risk factor for progressive radiographic knee osteoarthritis?
Is obesity a risk factor for progressive radiographic knee osteoarthritis?
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DOI：
10.1002/art.24337
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发表时间：
2009-03-15
影响因子：
--
通讯作者：
Felson, D. T.
中科院分区：
文献类型：
--
作者：
Niu, J.;Zhang, Y. Q.;Torner, J.;Nevitt, M.;Lewis, C. E.;Aliabadi, P.;Sack, B.;Clancy, M.;Sharma, L.;Felson, D. T.
检查肥胖是否会增加膝关节骨关节炎（OA）进展的风险。我们使用了多中心骨关节炎研究的数据，这是一项对膝关节OA患者或膝关节OA高危人群的纵向研究。在基线和30个月时使用后前位固定屈曲X线片和Kellgren/Lawrence（K/L）分级对OA进行表征，并在全肢X线片上评估对线。在基线时患有OA的膝关节（K/L 2级或3级）中，进展定义为30个月X线片上的胫股关节间隙变窄。在基线时无OA的膝关节（K/L 0级或1级）中，OA事件定义为30个月时发生放射学OA。基线时的体重指数（BMI）分为正常（<25 kg/m2）、超重（25-<30 kg/m2）、肥胖（30-<35 kg/m2）和非常肥胖（≥35 kg/m2）。在所有膝关节和根据对线分类的亚组中检测进展风险。分析调整了年龄，性别，膝关节损伤和骨密度。在2，623例受试者（5，159例膝关节）中，60%为女性，平均± SD年龄为62.4 ± 8.0岁。超过80%的受试者超重或肥胖。基线时，36.4%的膝关节有胫股OA，其中只有三分之一是中性对线。与BMI正常的受试者相比，肥胖或非常肥胖的受试者发生OA的风险增加（相对风险分别为2.4和3.2 [趋势P < 0.001]）;该风险延伸至所有对线组的膝关节。在基线时患有OA的膝关节中，高BMI与OA进展风险之间没有总体相关性;然而，在中立而非内翻对线的膝关节中观察到进展风险增加。在外翻对线的患者中，肥胖的影响居中。尽管肥胖是膝关节OA发生的危险因素，但我们观察到肥胖与膝关节OA进展之间没有总体关系。肥胖与膝关节内翻对线的OA进展无关;然而，它确实增加了膝关节中性或外翻对线的进展风险。因此，体重减轻可能无法有效预防内翻对线OA膝关节结构损伤的进展。
To examine whether obesity increases the risk of progression of knee osteoarthritis (OA). We used data from the Multicenter Osteoarthritis Study, a longitudinal study of persons with or at high risk of knee OA. OA was characterized at baseline and 30 months using posteroanterior fixed-flexion radiographs and Kellgren/Lawrence (K/L) grading, with alignment assessed on full-extremity films. In knees with OA at baseline (K/L grade 2 or 3), progression was defined as tibiofemoral joint space narrowing on the 30-month radiograph. In knees without OA at baseline (K/L grade 0 or 1), incident OA was defined as the development of radiographic OA at 30 months. Body mass index (BMI) at baseline was classified as normal (<25 kg/m2), overweight (25–<30 kg/m2), obese (30–<35 kg/m2), and very obese (≥35 kg/m2). The risk of progression was tested in all knees and in subgroups categorized according to alignment. Analyses were adjusted for age, sex, knee injury, and bone density. Among the 2,623 subjects (5,159 knees), 60% were women, and the mean ± SD age was 62.4 ± 8.0 years. More than 80% of subjects were overweight or obese. At baseline, 36.4% of knees had tibiofemoral OA, and of those, only one-third were neutrally aligned. Compared with subjects with a normal BMI, those who were obese or very obese were at an increased risk of incident OA (relative risk 2.4 and 3.2, respectively [P for trend < 0.001]); this risk extended to knees from all alignment groups. Among knees with OA at baseline, there was no overall association between a high BMI and the risk of OA progression; however, an increased risk of progression was observed among knees with neutral but not varus alignment. The effect of obesity was intermediate in those with valgus alignment. Although obesity was a risk factor for incident knee OA, we observed no overall relationship between obesity and the progression of knee OA. Obesity was not associated with OA progression in knees with varus alignment; however, it did increase the risk of progression in knees with neutral or valgus alignment. Therefore, weight loss may not be effective in preventing progression of structural damage in OA knees with varus alignment.
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影响因子：
--
作者：
LaValley, MP;McLaughlin, S;Felson, DT
通讯作者：
Felson, DT
DOI：
10.1002/art.22475
发表时间：
2007-02-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Belo, J. N.;Berger, M. Y.;Bierma-Zeinstra, S. M. A.
通讯作者：
Bierma-Zeinstra, S. M. A.
影响因子：
3.6
作者：
Paradowski, Przemyslaw T;Englund, Martin;Roos, Ewa M
通讯作者：
Roos, Ewa M
影响因子：
27.4
作者：
Reijman, M.;Pols, H. A. P.;Bierma-Zeinstra, S. M. A.
通讯作者：
Bierma-Zeinstra, S. M. A.
影响因子：
7
作者：
Dieppe, PA;Cushnaghan, J;Shepstone, L
通讯作者：
Shepstone, L