Dietary Fiber Intake in Relation to Knee Pain Trajectory.
Dietary Fiber Intake in Relation to Knee Pain Trajectory.
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DOI：
10.1002/acr.23158
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发表时间：
2017-09
影响因子：
4.7
通讯作者：
Zhang Y
中科院分区：
文献类型：
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作者：
Dai Z;Lu N;Niu J;Felson DT;Zhang Y
膳食纤维可以通过降低体重和炎症来减轻膝盖疼痛。在这项研究中，我们评估了纤维摄入量是否与膝关节疼痛的发展模式有关。在骨关节炎倡议的一项前瞻性、多中心队列研究中，4，796名年龄在45-79岁之间的男性和女性患有膝关节炎或有膝关节炎风险，参与者每年随访一次，持续8年。在基线时使用经验证的食物频率问卷估计膳食纤维。基于组的轨迹建模用于确定WOMAC疼痛轨迹，使用多分类回归模型评估其与膳食纤维摄入量的相关性。在4，470例合格受试者（8，940例膝关节）中[平均年龄：61.3（SD：9.1）岁，58%为女性]，4.9%接受了膝关节置换术，并在手术时删失。确定了四种不同的膝关节疼痛模式：无疼痛（34.5%）、轻度疼痛（38.1%）、中度疼痛（21.2%）和重度疼痛（6.2%）。膳食总纤维与中度或重度疼痛组的成员资格呈负相关（趋势均为p ≤0.006）。总纤维最高与最低四分位数的受试者属于中度疼痛（OR=0.76，95%CI：0.61，0.93）和重度疼痛模式（OR=0.56，95%CI：0.41，0.78）的风险较低。对于具有这两种疼痛模式的颗粒纤维，发现了类似的结果。我们的研究结果表明，高膳食总纤维或谷物纤维，特别是推荐的每日纤维平均摄入量为每天25克，与随着时间的推移属于中度和重度膝关节疼痛发展模式的风险降低有关。
Dietary fiber may reduce knee pain in part by lowering body weight and inflammation. In this study, we assessed whether fiber intake was associated with knee pain development patterns. In a prospective, multicenter cohort of 4,796 men and women aged 45-79 years with or at risk of knee osteoarthritis in Osteoarthritis Initiative, participants were followed up annually for 8 years. Dietary fiber was estimated using a validated food frequency questionnaire at baseline. Group-based trajectory modeling was used to identify WOMAC pain trajectories, which were assessed for the associations with dietary fiber intake using polytomous regression models. Of the 4,470 eligible participants (8,940 knees) [mean age: 61.3 (SD: 9.1) years, 58% women], 4.9% underwent knee replacement and were censored at the time of surgery. Four distinct knee pain patterns were identified: no pain (34.5%), mild pain (38.1%), moderate pain (21.2%) and severe pain (6.2%). Dietary total fiber was inversely related to membership in the moderate or severe pain group (both p for trend ≤0.006). Subjects in the highest versus lowest quartile of total fiber had lower risks of belonging to moderate pain (OR=0.76, 95% CI: 0.61, 0.93) and severe pain patterns (OR=0.56, 95% CI: 0.41, 0.78). Similar results were found for grain fiber with these two pain patters. Our findings suggest that high dietary total or grain fiber, particularly in the recommended daily fiber average intake of 25g per day, was associated with lower risks of belonging to moderate and severe knee pain development patterns over time.