Teichtahl A J, Wluka A E, Wang Y, Hanna F, English D R, Giles G G, Cicuttini F M
Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, Australia.
Ann Rheum Dis. 2009 Jun;68(6):909-13. doi: 10.1136/ard.2008.093310. Epub 2008 Jul 16.
The aim of this study was to determine whether measures of obesity and adiposity are associated with the rate of patella cartilage volume loss in healthy adults.
297 community-based adults aged 50-79 years with no clinical knee osteoarthritis were recruited at baseline (2003-4). 271 (62% female) subjects were re-examined at follow-up (2006-7). Measures of obesity (body mass index (BMI) and weight) and adiposity (fat mass and percentage fat mass), as well as patella cartilage volume, were determined by established protocols.
Patella cartilage volume was lost at an annual rate of 1.8% (95% CI 1.4% to 2.1%). Increased baseline BMI, weight, fat mass and percentage fat mass were all associated with an increased rate of patella cartilage volume loss after adjustment for confounders (all p< or =0.04). The direction and magnitude of the effects were similar for both sexes but the number of men examined was considerably smaller and the associations were not statistically significant. There were no significant associations observed between change in any of the obesity and adiposity measures and the rate of patella cartilage volume loss.
This study demonstrated that increased levels of obesity and adiposity are associated with an increased annual rate of patella cartilage volume loss in healthy adults. Weight-loss interventions that reduce body mass, or specifically target a reduction in fat mass, may help to reduce the rate at which patella cartilage volume is lost, and subsequently the risk of patellofemoral osteoarthritis.
本研究旨在确定肥胖和肥胖程度的测量指标是否与健康成年人的髌骨软骨体积流失率相关。
在基线期（2003 - 2004年）招募了297名年龄在50 - 79岁、无临床膝关节骨关节炎的社区成年人。271名（62%为女性）受试者在随访期（2006 - 2007年）接受了重新检查。肥胖指标（体重指数（BMI）和体重）、肥胖程度指标（脂肪量和脂肪量百分比）以及髌骨软骨体积，均通过既定方案进行测定。
髌骨软骨体积以每年1.8%的速率流失（95%置信区间为1.4%至2.1%）。在对混杂因素进行调整后，基线BMI、体重、脂肪量和脂肪量百分比的增加均与髌骨软骨体积流失率的增加相关（所有p≤0.04）。男女的效应方向和大小相似，但接受检查的男性数量少得多，且相关性无统计学意义。在任何肥胖和肥胖程度测量指标的变化与髌骨软骨体积流失率之间均未观察到显著相关性。
本研究表明，肥胖和肥胖程度的增加与健康成年人中髌骨软骨体积的年流失率增加相关。减轻体重的干预措施，或专门针对减少脂肪量的措施，可能有助于降低髌骨软骨体积流失的速率，进而降低髌股关节骨关节炎的风险。
