Cartilage defects are associated with physical disability in obese adults
Cartilage defects are associated with physical disability in obese adults
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DOI：
10.1093/rheumatology/kep246
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发表时间：
2009-10-01
期刊：
影响因子：
5.5
通讯作者：
March, Lyn
中科院分区：
文献类型：
--
作者：
Anandacoomarasamy, Ananthila;Smith, Garett;March, Lyn
目标。描述肥胖成人身体残疾措施与膝关节软骨缺损之间的关系。从腹腔镜可调节胃束带或运动/饮食减肥计划中招募了111名肥胖受试者。所有受试者完成疾病特异性（WOMAC）和一般健康状况（SF-36）问卷，并评估膝关节活动范围、胫股线和股四头肌力量。膝关节软骨缺损按既定方案进行MRI分级。回归分析调整了年龄、性别、BMI和临床膝关节oa的存在。在该肥胖队列中，证实了较高的全室软骨缺损评分与BMI、年龄和临床膝关节OA升高之间的关联（r = 0.27, P = 0.01; r = 0.26, P = 0.007; P < 0.0001），而与膝关节活动范围减小之间存在新的关联（r = 0.5, P < 0.0001）。没有发现缺损评分和股四头肌力量之间的关联。内翻畸形与较高的内侧软骨缺损评分相关（r = 0.33, P = 0.013）。较高水平的疼痛、僵硬和身体残疾（WOMAC, SF-36）与较高的内侧隔室和髌骨软骨缺损评分相关。膝关节软骨缺损随着肥胖的增加而增加，并与客观和自我报告的身体残疾措施有关。需要纵向研究来评估随着体重减轻软骨缺损的改变或改善的潜力。
Objective. To describe the associations between physical disability measures and knee cartilage defects in obese adults.Methods. One hundred and eleven obese subjects were recruited from laparoscopic adjustable gastric banding or exercise/diet weight loss programmes. All subjects completed disease-specific (WOMAC) and general health status (SF-36) questionnaires, and were assessed for range of knee motion, tibiofemoral alignment and quadriceps strength. Knee cartilage defects were graded on MRI according to established protocol. Regression analysis was adjusted for age, gender, BMI and presence of clinical knee OA.Results. The association between higher whole compartment cartilage defect scores and increasing BMI, age and clinical knee OA was confirmed in this obese cohort (r = 0.27, P = 0.01; r = 0.26, P = 0.007; P < 0.0001, respectively), whereas new associations were found with reduced knee range of motion (r = 0.5, P < 0.0001). No associations were found between defect scores and quadriceps strength. Varus malalignment was associated with higher medial cartilage defect scores (r = 0.33, P = 0.013). Higher levels of pain, stiffness and physical disability (WOMAC, SF-36) were associated with higher medial compartment and patella cartilage defect scores.Conclusions. Knee cartilage defects increase with increasing obesity and are associated with both objective and self-reported measures of physical disability. Longitudinal studies are required to assess the potential for change or improvement in cartilage defects with weight loss.