The association between objectively measured physical activity and knee structural change using MRI
The association between objectively measured physical activity and knee structural change using MRI
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DOI：
10.1136/annrheumdis-2012-201691
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发表时间：
2013-07-01
影响因子：
27.4
通讯作者：
Jones, Graeme
中科院分区：
文献类型：
--
作者：
Dore, Dawn A.;Winzenberg, Tania Maree;Jones, Graeme
目的研究客观评估的体力活动(PA)与MRI测量膝关节结构变化之间的纵向联系。方法对405名51~81岁的社区成年人在基线和大约2.7年后进行测量。在基线和随访时对右膝关节进行MRI检查，以评估骨髓损害(BMLS)、半月板病理、软骨缺陷和软骨体积。结果每天步行10000步与BML增加相关(RR1.97，95%可信区间1.19~3.27，P=0.009)。每天步行10000步的受试者增加半月板病理评分的风险增加1.52倍(95%可信区间为1.05to2.20，p=0.027)，而在基线时半月板病变为阴性的受试者增加到2.49%(95%CI1.05to3.93p=0.002)。每天做10000步与基线水平的BMLS患者增加软骨缺损评分的风险更大(RR1.36，95%可信区间1.03至1.69，p=0.013)。每日步数对基础软骨体积较大的患者具有保护作用，但在基础软骨体积较小的患者中会导致软骨丢失增加。(交互作用P=0.046)。结论PA与膝关节结构改变密切相关，尤其是那些既有膝关节结构异常的患者。这表明膝盖异常的人应该避免每天走10000步。为了维持健康的其他方面所需的PA水平，可能需要替代负重活动。
Objectives This study describes the longitudinal association between objectively assessed physical activity (PA) and knee structural change measured using MRI.Methods 405 community-dwelling adults aged 51-81 years were measured at baseline and approximately 2.7 years later. MRI of the right knee at baseline and follow-up was performed to evaluate bone marrow lesions (BMLs), meniscal pathology, cartilage defects, and cartilage volume. PA was assessed at baseline by pedometer (steps/day).Results Doing >= 10 000 steps/day was associated with BML increases (RR 1.97, 95% CI 1.19 to 3.27, p=0.009). Participants doing >= 10 000 steps/day had a 1.52 times (95% CI 1.05 to 2.20, p=0.027) greater risk of increasing meniscal pathology score, which increased to 2.49 (95% CI 1.05 to 3.93, p=0.002) in those with adverse meniscal pathology at baseline. Doing >= 10 000 steps/day was associated with a greater risk of increasing cartilage defect score in those with prevalent BMLs at baseline (RR 1.36, 95% CI 1.03 to 1.69, p=0.013). Steps/day was protective against volume loss in those with more baseline cartilage volume but led to increased cartilage loss in those with less baseline cartilage volume. (p=0.046 for interaction).Conclusions PA was deleteriously associated with knee structural change, especially in those with pre-existing knee structural abnormalities. This suggests individuals with knee abnormalities should avoid doing >= 10 000 steps/day. Alternatives to weight-bearing activity may be needed in order to maintain PA levels required for other aspects of health.