Oliveria S A, Felson D T, Cirillo P A, Reed J I, Walker A M
Department of Epidemiology, Harvard School of Public Health, Harvard University, Cambridge, MA, USA.
Epidemiology. 1999 Mar;10(2):161-6.
Studies have shown a positive association between obesity and knee osteoarthritis. Studies evaluating hand or hip osteoarthritis and weight, however, have assessed x-ray osteoarthritis or been cross-sectional, or both, and results of these have been inconsistent. We assessed the association between body weight, body mass index, and incident symptomatic osteoarthritis in 134 matched case-control pairs of women who were part of a case-control study on estrogen replacement therapy and osteoarthritis. We identified incident symptomatic osteoarthritis cases of the hand, hip, and knee in women ages 20-89 years who were members of a health plan between January 1, 1990 and December 31, 1993. For each case we selected a control woman who was matched by closest date of birth to the case. Medical records were reviewed to obtain weight and height information for the period before disease onset. After controlling for estrogen use, smoking status, height, and health care use, we found that body weight was a predictor of incident osteoarthritis of the hand, hip, and knee. Odds ratios ranged from 3.0 to 10.5 for women in the upper tertiles of weight compared with women in the lowest tertile. Similar associations were observed for body mass index. Our results suggest that obesity is associated with the development of incident osteoarthritis at all joints studied.
研究表明肥胖与膝关节骨关节炎之间存在正相关。然而,评估手部或髋部骨关节炎与体重关系的研究,要么评估的是X线骨关节炎,要么是横断面研究,或者两者皆有,而这些研究的结果并不一致。我们在一项关于雌激素替代疗法与骨关节炎的病例对照研究中,对134对匹配的病例对照女性进行了体重、体重指数与新发症状性骨关节炎之间关联的评估。我们确定了1990年1月1日至1993年12月31日期间参加健康计划的20 - 89岁女性中手部、髋部和膝关节的新发症状性骨关节炎病例。对于每一例病例,我们选择了一名出生日期与病例最接近的对照女性。查阅医疗记录以获取疾病发作前时期的体重和身高信息。在控制了雌激素使用、吸烟状况、身高和医疗保健使用情况后,我们发现体重是手部、髋部和膝关节新发骨关节炎的一个预测因素。与体重最低三分位数的女性相比,体重最高三分位数的女性的优势比在3.0至10.5之间。体重指数也观察到了类似的关联。我们的结果表明,肥胖与所研究的所有关节的新发骨关节炎的发生有关。