Franklin J, Ingvarsson T, Englund M, Lohmander L S
Department of Orthopaedics, Clinical Sciences Lund, Lund University, Sweden.
Ann Rheum Dis. 2009 Apr;68(4):536-40. doi: 10.1136/ard.2007.086868. Epub 2008 May 26.
To examine the association between body mass index (BMI) and osteoarthritis (OA) leading to total hip (THR) or knee (TKR) joint replacement.
Case-control study design. All patients still living in Iceland who had had a THR or TKR resulting from OA before the end of 2002 were invited to participate. First-degree relatives of participating patients served as controls. A total of 1473 patients (872 women) and 1103 controls (599 women), all born between 1910 and 1939 and who had answered a questionnaire including questions about height and weight, were analysed. A randomly selected sample, representative of the Icelandic population, was used as a secondary control group.
The OR, adjusted for age, occupation and presence of hand OA, for having a THR was 1.1 (95% CI 0.9 to 1.5) for overweight men and 1.7 (95% CI 1.0 to 2.9) for obese men. The OR for having a TKR was 1.7 (95% CI 1.1 to 2.6) for overweight men and 5.3 (95% CI 2.8 to 10.1) for obese men. The OR for having a THR was 1.0 (95% CI 0.8 to 1.3) for overweight women and 1.0 (95% CI 0.6 to 1.5) for obese women. The OR for having a TKR was 1.6 (95% CI 1.1 to 2.2) for overweight women and 4.0 (95% CI 2.6 to 6.1) for obese women.
This study supports a positive association between high BMI and TKR in both sexes, but for THR the association with BMI seems to be weaker, and possibly negligible for women.
研究体重指数（BMI）与导致全髋关节置换术（THR）或全膝关节置换术（TKR）的骨关节炎（OA）之间的关联。
采用病例对照研究设计。邀请了所有在2002年底前因OA接受THR或TKR且仍居住在冰岛的患者参与研究。参与患者的一级亲属作为对照。对总共1473例患者（872名女性）和1103名对照（599名女性）进行了分析，所有患者均出生于1910年至1939年之间，并回答了一份包括身高和体重问题的问卷。一个随机抽取的、代表冰岛人口的样本用作第二对照组。
在调整了年龄、职业和手部OA的存在情况后，超重男性进行THR的比值比（OR）为1.1（95%可信区间0.9至1.5），肥胖男性为1.7（95%可信区间1.0至2.9）。超重男性进行TKR的OR为1.7（95%可信区间1.1至2.6），肥胖男性为5.3（95%可信区间2.8至10.1）。超重女性进行THR的OR为1.0（95%可信区间0.8至1.3），肥胖女性为1.0（95%可信区间0.6至1.5）。超重女性进行TKR的OR为1.6（95%可信区间1.1至2.2），肥胖女性为4.0（95%可信区间2.6至6.1）。
本研究支持高BMI与男女TKR之间存在正相关，但对于THR，与BMI的关联似乎较弱，对女性可能可忽略不计。
