Abbate Lauren M, Stevens June, Schwartz Todd A, Renner Jordan B, Helmick Charles G, Jordan Joanne M
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7280, USA.
Obesity (Silver Spring). 2006 Jul;14(7):1274-81. doi: 10.1038/oby.2006.145.
Increased BMI is a well-recognized risk factor for radiographic knee osteoarthritis (rKOA); however, the contributions of the components of body composition, body fat distribution, and height to this association are not clear.
We examined 779 women > or = 45 years of age from the Johnston County Osteoarthritis Project. Body composition was assessed using DXA, and rKOA was defined as Kellgren-Lawrence grade > or = 2. Logistic regression models examined the association between rKOA and the fourth compared with the first quartiles of anthropometric, body composition, and fat distribution measures adjusting for age, ethnicity, and prior knee injury.
The adjusted odds ratios and 95% confidence interval of BMI and weight were 5.27 (3.05, 9.13) and 5.28 (3.05, 9.16), respectively. In separate models, higher odds of rKOA were also found for fat mass [4.54 (2.68, 7.69)], percent fat mass [3.84 (2.26, 6.54)], lean mass [3.94 (2.22, 6.97)], and waist circumference [4.15 (2.45, 7.02)]. Waist-to-hip ratio was not associated with rKOA [1.45 (0.86, 2.43)], and percent lean mass was associated with lower odds [0.20 (0.11, 0.35)]. Taller women had higher odds of rKOA after adjustment for BMI [1.77 (1.05, 3.00)].
This study confirms that BMI and weight are strongly associated with rKOA in women and suggests that precise measurements of body composition and measures of fat distribution may offer no advantage over the more simple measures of BMI or weight in assessment of risk of rKOA.
体重指数(BMI)升高是影像学膝关节骨关节炎(rKOA)公认的危险因素;然而,身体成分、体脂分布和身高各组成部分对这种关联的作用尚不清楚。
我们对约翰斯顿县骨关节炎项目中779名年龄≥45岁的女性进行了研究。使用双能X线吸收法(DXA)评估身体成分,rKOA定义为凯尔格伦-劳伦斯分级≥2级。逻辑回归模型在调整年龄、种族和既往膝关节损伤后,比较了rKOA与人体测量、身体成分和脂肪分布指标的第一个四分位数与第四个四分位数之间的关联。
BMI和体重调整后的比值比及95%置信区间分别为5.27(3.05,9.13)和5.28(3.05,9.16)。在单独的模型中,脂肪量[4.54(2.68,7.69)]、脂肪量百分比[3.84(2.26,6.54)]、去脂体重[3.94(2.22,6.97)]和腰围[4.15(2.45,7.02)]也与rKOA较高的发病几率相关。腰臀比与rKOA无关[1.45(0.86,2.43)],去脂体重百分比与较低的发病几率相关[0.20(0.11,0.35)]。在调整BMI后,身高较高的女性患rKOA的几率更高[1.77(1.05,3.00)]。
本研究证实BMI和体重与女性rKOA密切相关,并表明在评估rKOA风险方面,身体成分的精确测量和脂肪分布测量可能并不比更简单的BMI或体重测量更具优势。