Flugsrud Gunnar B, Nordsletten Lars, Espehaug Birgitte, Havelin Leif I, Meyer Haakon E
Orthopaedic Centre, Ullevål University Hospital, Oslo, Norway.
Epidemiology. 2003 Sep;14(5):578-84. doi: 10.1097/01.ede.0000081800.83206.92.
We examined the effect of adult weight change on risk for total hip replacement resulting from primary osteoarthritis, using a prospective study design.
We linked data on body mass index and body weight from 3 screening surveys in 3 Norwegian counties (mean ages at screenings 34, 43, and 47 y; n = 38,868) with follow-up data on total hip replacement (n = 572). Mean age at the start of follow up was 55 years, and mean duration of follow up was 9 years. For each participant we calculated a rate of weight change (weight slope) by linear regression of body weight versus time from the first through the third screening.
Among men, mean weight change from first to last screening was +9.8 kg in the highest quartile and -3.7 kg in the lowest quartile. In women, the corresponding figures were +9.5 kg in the highest quartile and -5.2 kg in the lowest quartile. There was no association of weight slope, absolute weight change, or relative weight change between screenings with later total hip replacement resulting from primary osteoarthritis. We saw no change in the association between body mass index and later hip arthroplasty as the participants' age increased from 34 to 47 years at the 3 screenings.
The risk for later total hip replacement resulting from primary osteoarthritis was unaffected by weight change during the fourth and fifth decades of life. The dose-response association between adult body mass index and later total hip replacement was similar across these age groups.
我们采用前瞻性研究设计，研究了成年期体重变化对原发性骨关节炎导致的全髋关节置换风险的影响。
我们将挪威3个郡3次筛查调查（筛查时的平均年龄分别为34岁、43岁和47岁；n = 38868）中的体重指数和体重数据与全髋关节置换的随访数据（n = 572）相联系。随访开始时的平均年龄为55岁，平均随访时长为9年。对于每位参与者，我们通过对从第一次到第三次筛查期间体重与时间进行线性回归，计算出体重变化率（体重斜率）。
在男性中，从第一次到最后一次筛查，体重变化的均值在最高四分位数组为增加9.8千克，在最低四分位数组为减少3.7千克。在女性中，相应的数据分别为最高四分位数组增加9.5千克，最低四分位数组减少5.2千克。筛查期间的体重斜率、绝对体重变化或相对体重变化与后来因原发性骨关节炎导致的全髋关节置换之间没有关联。随着参与者在3次筛查时的年龄从34岁增加到47岁，我们未发现体重指数与后来髋关节置换术之间的关联有变化。
成年期体重变化对第四和第五个十年期间原发性骨关节炎导致的后期全髋关节置换风险没有影响。在这些年龄组中，成年人体重指数与后期全髋关节置换之间的剂量反应关联相似。
