Teichtahl Andrew J, Wang Yuanyuan, Wluka Anita E, Szramka Maxine, English Dallas R, Giles Graham G, O'Sullivan Richard, Cicuttini Flavia M
Department of Epidemiology and Preventive Medicine, Central and Eastern Clinical School, Alfred Hospital, Monash University, Melbourne, VIC, Australia.
Obesity (Silver Spring). 2008 Feb;16(2):421-7. doi: 10.1038/oby.2007.37.
Although obesity is a risk factor for patellofemoral osteoarthritis (OA), it is unclear whether the components of body composition, such as muscle and fat mass, are major determinants of articular cartilage properties at the patella.
The aim of this study was to determine whether anthropometric and body composition measures, assessed over 10 years, were related to articular patella cartilage volume and defects in healthy adults with no clinical knee OA.
Two hundred and ninety-seven healthy, community-based adults aged 50-79 years with no clinical history of knee OA were recruited. Anthropometric and body composition (fat-free mass and fat mass) data were measured at baseline (1990-1994) and follow-up (2003-2004). Patella cartilage volume and defects were assessed at follow-up (2003-2004) using magnetic resonance imaging (MRI).
After adjustment for potential confounders, increased measures of obesity (weight, BMI, waist circumference, and fat mass) at baseline and follow-up were associated with an increased risk for the presence of patella cartilage defects at follow-up for both men and women (all P < or = 0.03). Increased baseline values for these variables tended to be associated with reduced patella cartilage volume at follow-up for women (all P < or = 0.11), but not men (all P < or = 0.87).
We have demonstrated that increased anthropometric measures of obesity, as well as fat mass, are associated with an increased risk for the presence of patella cartilage defects in both men and women. Women, but not men, with greater baseline body mass, particularly adipose-derived mass, appear to have an associated reduction in their patella cartilage volume. Interventions targeting a reduction in adipose tissue may help reduce the risk for the onset and progression of patellofemoral OA, particularly in women.
尽管肥胖是髌股关节骨关节炎（OA）的一个风险因素，但身体成分的组成部分，如肌肉和脂肪量，是否是髌骨处关节软骨特性的主要决定因素尚不清楚。
本研究的目的是确定在10年期间评估的人体测量和身体成分指标是否与无临床膝关节OA的健康成年人的髌骨软骨体积和缺损相关。
招募了297名年龄在50 - 79岁、无膝关节OA临床病史的健康社区成年人。在基线期（1990 - 1994年）和随访期（2003 - 2004年）测量人体测量和身体成分（去脂体重和脂肪量）数据。在随访期（2003 - 2004年）使用磁共振成像（MRI）评估髌骨软骨体积和缺损。
在对潜在混杂因素进行调整后，基线期和随访期肥胖指标（体重、BMI、腰围和脂肪量）的增加与男性和女性随访期出现髌骨软骨缺损的风险增加相关（所有P≤0.03）。这些变量的基线值增加往往与女性随访期髌骨软骨体积减少相关（所有P≤0.11），但与男性无关（所有P≤0.87）。
我们已经证明，肥胖的人体测量指标以及脂肪量的增加与男性和女性出现髌骨软骨缺损的风险增加相关。基线体重较大，尤其是脂肪来源体重较大的女性，而非男性，其髌骨软骨体积似乎会相应减少。针对减少脂肪组织的干预措施可能有助于降低髌股关节OA发病和进展的风险，尤其是在女性中。
