Factors that affect knee structure in healthy women

在所有慢性病中，骨关节炎（OA）对晚年疾病负担的影响最大，女性比男性更常受到影响。OA的重要性已被列入澳大利亚第七大健康优先事项——肌肉骨骼疾病。女性的发病率是男性的4倍。减缓或阻止OA进展的治疗是有限的，因此预防必须发挥关键作用。随着疾病严重程度的增加，关节软骨丢失。我们最近开发了一种通过磁共振成像（MRI）扫描来测量关节软骨的方法，该方法能够评估膝关节结构变化的严重程度。使用这种方法将允许我们评估两个问题：1)肥胖是膝关节OA唯一确定的可改变的危险因素。然而，人们对其机制知之甚少。如果减肥计划与保持肌肉质量的计划相结合，可能会更有效地降低OA的风险。2)骨在膝关节OA的发展中起重要作用，但其作用尚不清楚。了解骨代谢与膝关节炎风险之间的关系可以帮助我们预防疾病。骨比软骨更容易对药物操作产生反应。因此，它可能被证明是一个比软骨更有效的干预目标。吉隆骨质疏松症研究始于1994年，目的是研究澳大利亚（城市和农村）妇女的骨骼健康。在过去十年中收集了许多与OA风险相关的信息。通过现在和2年后对膝关节进行MRI检查，我们将确定不同的肥胖和骨代谢指标对易患OA的膝关节结构变化的影响。由于这两个因素（肥胖和骨代谢）都是可以改变的，本研究可能为预防和治疗膝关节OA提供新的途径。随着人们年龄的增长，这有可能促进更好的生活质量，并减轻社区中膝关节OA的经济负担。

Osteoarthritis (OA) has the largest impact of any chronic disease on burden of disease borne in later life, affecting women more often than men. The importance of OA has been acknowledged by its listing within musculoskeletal disease, the 7th health priority in Australia. It is 4 times as common in women as in men.Treatments which slow or prevent OA progressing are limited, so prevention must play a key role. With increasing disease severity, joint cartilage is lost. We have recently developed a method to measure joint cartilage from magnetic resonance imaging (MRI) scans which is able to assess the severity of structural changes in the knee. Using this method will allow us to assess 2 issues: 1) Obesity is the only identified modifiable risk factor for knee OA. However, the mechanism is poorly understood. Weight loss programs may be more effective at reducing the risk of OA if they are combined with programs aimed at maintaining muscle mass. 2) Bone is important in development of Knee OA, but its role is poorly understood. Understanding how bone metabolism relates to risk of knee OA may allow us to prevent disease. Bone is more likely to respond to pharmacological manipulation than cartilage. Thus it may prove a more effective target for intervention than cartilage. The Geelong Osteoporosis Study was begun in 1994 to study bone health in Australian women (urban and rural). Much information relevant to the risk of OA has been collected over the past decade. By performing MRI of the knee now and in 2 years time, we will determine the effect of different measures of obesity and bone metabolism on structural change at the knee which predisposes to OA. Since both of these factors (obesity and bone metabolism) are potentially modifiable, this study may offer new avenues of prevention and therapy in knee OA. This has the potential to promote a better quality of life as people age and to reduce the economic burden of knee OA in the community.