Liu B, Balkwill A, Banks E, Cooper C, Green J, Beral V
Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK.
Rheumatology (Oxford). 2007 May;46(5):861-7. doi: 10.1093/rheumatology/kel434. Epub 2007 Feb 4.
To examine the effect of height, weight and body mass index (BMI) on the risk of hip and knee replacement in middle-aged women.
In a prospective cohort study 490 532 women aged 50-69 yrs who were recruited in the UK in 1996-2001 were followed over 2.9 yrs for incident primary hip and knee replacements.
Height, weight and BMI were all associated with the risk of hip and knee replacement. Comparing the tallest group (>or=170 cm) with the shortest (<155 cm) the relative risks were 1.90 (95%CI 1.55-2.32) for hip replacement and 1.55 (95%CI 1.19-2.00) for knee replacement. Comparing the heaviest group (>or=75 kg) with the lightest (<60 kg) the relative risks of hip and knee replacement were 2.37 (95%CI 2.04-2.75) and 9.71 (95%CI 7.39-12.77), respectively. Comparing obese women (BMI >or= 30 kg/m(2)) to women with a BMI < 22.5 kg/m(2), the relative risks for hip and knee replacement were 2.47 (95%CI 2.11-2.89) and 10.51 (95%CI 7.85-14.08), respectively. These effects did not vary according to age, education, alcohol and tobacco consumption, or with use of hormonal therapies. Currently, an estimated 27% of hip replacements and 69% of knee replacements in middle-aged women in the UK are attributable to obesity.
In middle-aged women, the risk of having a hip or knee replacement increases with both increasing height and increasing BMI. From a clinical perspective, relatively small increases in average BMI among middle-aged women are likely to have a substantial impact on the already increasing rates of joint replacement in the UK.
研究身高、体重和体重指数（BMI）对中年女性髋关节和膝关节置换风险的影响。
在一项前瞻性队列研究中，对1996年至2001年在英国招募的490532名年龄在50至69岁之间的女性进行了2.9年的随访，以观察初次髋关节和膝关节置换的发生情况。
身高、体重和BMI均与髋关节和膝关节置换风险相关。将最高组（≥170厘米）与最矮组（<155厘米）进行比较，髋关节置换的相对风险为1.90（95%置信区间1.55 - 2.32），膝关节置换的相对风险为1.55（95%置信区间1.19 - 2.00）。将最重组（≥75千克）与最重组（<60千克）进行比较，髋关节和膝关节置换的相对风险分别为2.37（95%置信区间2.04 - 2.75）和9.71（95%置信区间7.39 - 12.77）。将肥胖女性（BMI≥30千克/平方米）与BMI<22.5千克/平方米的女性进行比较，髋关节和膝关节置换的相对风险分别为2.47（95%置信区间2.11 - 2.89）和10.51（95%置信区间7.85 - 14.08）。这些影响不因年龄、教育程度、酒精和烟草消费或激素疗法的使用而有所不同。目前，在英国中年女性中，估计27%的髋关节置换和69%的膝关节置换可归因于肥胖。
在中年女性中，髋关节或膝关节置换的风险随着身高和BMI的增加而增加。从临床角度来看，中年女性平均BMI相对较小的增加可能会对英国本已不断上升的关节置换率产生重大影响。
