Effects of running and walking on osteoarthritis and hip replacement risk.
Effects of running and walking on osteoarthritis and hip replacement risk.
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DOI：
10.1249/mss.0b013e3182885f26
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发表时间：
2013-07
影响因子：
4.1
通讯作者：
Williams PT
中科院分区：
文献类型：
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作者：
Williams PT
跑步和其他剧烈运动据称会增加骨关节炎（OA）的风险，比散步和不剧烈的运动更严重。因此，进行了分析，以测试跑步、步行和其他运动是否会影响OA和髋关节置换术的风险，并评估BMI在这些关系中的中介作用。医生诊断的OA和髋关节置换术患者报告与运动能量消耗（代谢当量，METs）的比例风险分析。74,752名跑步者在7.1年的随访中报告了2004例OA和259例髋关节置换，而14,625名步行者在5.7年的随访中报告了695例OA和114例髋关节置换。与跑步<1.8 METhr/d相比，1.8 ~ 3.6 METhr/d的OA和髋关节置换术风险分别降低18.1% （P=0.01）和35.1% (P=0.03)；2) 3.6 ~ 5.4 METhr/d组，分别为16.1% （P=0.03）和50.4% (P=0.002)；3)≥5.4 METhr/d时，风险降低率分别为15.6% （P=0.02）和38.5% (P=0.01)，表明风险降低主要发生在1.8 METhr/d时。基线BMI与OA（每kg/m2增加5.0%，P=2 × 10−8）和髋关节置换术风险（每kg/m2增加9.8%，P=4.8 × 10−5）密切相关，BMI调整大大降低了OA（从16.5%，P=0.01到8.6%，P=0.21）和髋关节置换术（从40.4%，P=0.005到28.5%，P=0.07）的风险降低。超过1.8 METhr/d的OA和髋关节置换风险的降低在跑步者和步行者之间没有显著差异。其他（非跑步）运动使OA的风险增加2.4% (P=0.009)，髋关节置换术的风险增加5.0% (P=0.02)，与BMI无关。其他运动增加骨性关节炎和髋关节置换术的风险，而跑步显著降低风险，部分原因是跑步与较低的身体质量指数有关。
Running and other strenuous sports activities are purported to increase osteoarthritis (OA) risk, more so than walking and less-strenuous activities. Analyses were therefore performed to test whether running, walking, and other exercise affect OA and hip replacement risk, and to assess BMI’s role in mediating these relationships. Proportional hazards analyses of patients’ report of having physician-diagnosed OA and hip replacement vs. exercise energy expenditure (metabolic equivalents, METs). 74,752 runners reported 2004 OA and 259 hip replacements during 7.1-year follow-up, while the 14,625 walkers reported 695 OA and 114 hip replacements over 5.7 years. Compared to running <1.8 METhr/d, the risks for OA and hip replacement decreased: 1) 18.1% (P=0.01) and 35.1% (P=0.03), respectively, for 1.8 to 3.6 METhr/d run; 2) 16.1% (P=0.03) and 50.4% (P=0.002), respectively, for 3.6 to 5.4 METhr/d run; and 3) 15.6% (P=0.02) and 38.5% (P=0.01), respectively, for ≥5.4 METhr/d run, suggesting that the risk reduction mostly occurred by 1.8 METhr/d. Baseline BMI was strongly associated with both OA (5.0% increase per kg/m2, P=2x10−8) and hip replacement risks (9.8% increase per kg/m2, P=4.8x10−5), and adjustment for BMI substantially diminished the risk reduction from running ≥1.8 METhr/d for OA (from 16.5%, P=0.01 to 8.6%, P=0.21) and hip replacement (from 40.4%, P=0.005 to 28.5%, P=0.07). The reductions in OA and hip replacement risk by exceeding 1.8 METhr/d did not differ significantly between runners and walkers. Other (non-running) exercise increased the risk of OA by 2.4% (P=0.009) and hip replacement by 5.0% per METhr/d (P=0.02), independent of BMI. Whereas other exercise increased OA and hip replacement risk, running significantly reduced their risk due, in part, to running’s association with lower BMI.