The relative contribution of mechanical stress and systemic processes in different types of osteoarthritis: the NEO study
The relative contribution of mechanical stress and systemic processes in different types of osteoarthritis: the NEO study
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DOI：
10.1136/annrheumdis-2013-205012
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发表时间：
2015-10-01
影响因子：
27.4
通讯作者：
Kloppenburg, M.
中科院分区：
文献类型：
--
作者：
Visser, A. W.;de Mutsert, R.;Kloppenburg, M.
目的研究负重和非负重关节的机械应力和全身过程与骨关节炎（OA）的相关性。方法荷兰肥胖流行病学研究是一项以人群为基础的队列研究，包括6673名参与者（年龄范围45-65岁，56%为女性，中位体重指数26 kg/m2）。测量体重（kg）和脂肪质量（kg），计算去脂肪质量（kg）。根据成人治疗组III标准定义代谢综合征。膝关节和手OA的定义是根据美国流变学学会的临床标准，进行逻辑回归分析，以关联机械应力的替代物（如体重、去脂量）和全身过程（如代谢综合征）仅膝关节、膝关节和手或仅手患有OA，根据年龄、性别、身高、吸烟、教育和种族进行调整，结果膝关节、膝关节和手、手OA分别占10%、4%和8%。经代谢因素校正后，膝关节OA与体重和去脂质量相关（OR分别为1.49（95% CI 1.32 - 1.68）和2.05（1.60 - 2.62））。膝关节和手部OA的结果相似（OR分别为1.51（95% CI 1.29 - 1.78）和2.17（95% CI 1.52 - 3.10））。手OA与代谢综合征相关，调整体重（OR 1.46（95%CI 1.06至2.02））。结论在膝关节OA，无论是否与手OA同时发生，机械应力的替代品是最重要的危险因素，而在手OA单独，全身过程的替代品是最重要的危险因素。
Objective To study the relative contribution of surrogates for mechanical stress and systemic processes with osteoarthritis (OA) in weight-bearing and non-weight-bearing joints.Methods The Netherlands Epidemiology of Obesity study is a population-based cohort including 6673 participants (range 45-65 years, 56% women, median body mass index 26 kg/m(2)). Weight (kg) and fat mass (kg) were measured, fat-free mass (kg) was calculated. The metabolic syndrome was defined following the Adult Treatment Panel III criteria. Knee and hand OA were defined according to the American College of Rheumatology clinical criteria.Logistic regression analyses were performed to associate surrogates for mechanical stress (such as weight, fat-free mass) and systemic processes (such as metabolic syndrome) with OA in knees alone, knees and hands or hands alone, adjusted for age, sex, height, smoking, education and ethnicity, and when appropriate for metabolic factors and weight.Results Knee, knee and hand, and hand OA were present in 10%, 4% and 8% of the participants, respectively. Knee OA was associated with weight and fat-free mass, adjusted for metabolic factors (OR 1.49 (95% CI 1.32 to 1.68) and 2.05 (1.60 to 2.62), respectively). Similar results were found for OA in knees and hands (OR 1.51 (95% CI 1.29 to 1.78) and 2.17 (95% CI 1.52 to 3.10) respectively). Hand OA was associated with the metabolic syndrome, adjusted for weight (OR 1.46 (95% CI 1.06 to 2.02)).Conclusions In knee OA, whether or not in co-occurrence with hand OA, surrogates for mechanical stress are suggested to be the most important risk factors, whereas in hand OA alone, surrogates for systemic processes are the most important risk factors.