Flugsrud Gunnar B, Nordsletten Lars, Espehaug Birgitte, Havelin Leif I, Meyer Haakon E
Orthopaedic University Clinic, Ullevål Hospital, Oslo, Norway.
Arthritis Rheum. 2002 Mar;46(3):675-82. doi: 10.1002/art.10115.
To identify prospectively the possible risk factors for total hip replacement (THR) due to primary osteoarthritis in a large cohort.
Data from a cardiovascular screening were matched with 9 years of national data on THR. Mean age at the start of followup was 54.9 years, and the 50,034 participants were followed up for an average of 9 years. During followup, 672 persons had a first THR due to primary osteoarthritis.
We found dose-response associations between body mass index (BMI), body weight, and the level of physical activity at work and THR for primary osteoarthritis. The highest versus the lowest quarter of BMI had a relative risk of 2.0 (95% confidence interval [95% CI] 1.4-2.9) among men and 3.0 (95% CI 2.1-4.1) among women. The highest versus the lowest quarter of body weight had a relative risk of 2.1 (95% CI 1.4-3.2) among men and 3.4 (95% CI 2.4-4.9) among women. Intensive versus sedentary physical activity at work had a relative risk of 2.1 (95% CI 1.5-3.0) among men and 2.1 (95% CI 1.3-3.3) among women. No association was found between physical activity in leisure and THR for primary osteoarthritis.
Intensive physical activity at work and a high BMI each contribute significantly to the overall risk of undergoing THR due to primary osteoarthritis. Lowering the exposure to these risk factors may substantially reduce the need for hip replacement.
前瞻性地确定大型队列中因原发性骨关节炎行全髋关节置换术（THR）的可能风险因素。
心血管筛查数据与9年的全国THR数据相匹配。随访开始时的平均年龄为54.9岁，50,034名参与者平均随访9年。随访期间，672人因原发性骨关节炎首次接受THR。
我们发现体重指数（BMI）、体重以及工作时的体力活动水平与原发性骨关节炎的THR之间存在剂量反应关系。BMI最高四分位数与最低四分位数相比，男性的相对风险为2.0（95%置信区间[95%CI]1.4 - 2.9），女性为3.0（95%CI 2.1 - 4.1）。体重最高四分位数与最低四分位数相比，男性的相对风险为2.1（95%CI 1.4 - 3.2），女性为3.4（95%CI 2.4 - 4.9）。工作时高强度体力活动与久坐相比，男性的相对风险为2.1（95%CI 1.5 - 3.0），女性为2.1（95%CI 1.3 - 3.3）。未发现休闲时的体力活动与原发性骨关节炎的THR之间存在关联。
工作时的高强度体力活动和高BMI均显著增加了因原发性骨关节炎接受THR的总体风险。降低这些风险因素的暴露可能会大幅减少髋关节置换的需求。
