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肥胖与膝、髋和/或手部骨关节炎:一项对普通人群进行的为期10年随访的流行病学研究。

Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up.

作者信息

Grotle Margreth, Hagen Kare B, Natvig Bard, Dahl Fredrik A, Kvien Tore K

机构信息

National resource centre for rehabilitation in rheumatology, Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, POBox 23 Vinderen, 0319 Oslo, Norway.

出版信息

BMC Musculoskelet Disord. 2008 Oct 2;9:132. doi: 10.1186/1471-2474-9-132.

Abstract

BACKGROUND

Obesity is one of the most important risk factors for osteoarthritis (OA) in knee(s). However, the relationship between obesity and OA in hand(s) and hip(s) remains controversial and needs further investigation. The purpose of this study was to investigate the impact of obesity on incident osteoarthritis (OA) in hip, knee, and hand in a general population followed in 10 years.

METHODS

A total of 1854 people aged 24-76 years in 1994 participated in a Norwegian study on musculoskeletal pain in both 1994 and 2004. Participants with OA or rheumatoid arthritis in 1994 and those above 74 years in 1994 were excluded, leaving n = 1675 for the analyses. The main outcome measure was OA diagnosis at follow-up based on self-report. Obesity was defined by a body mass index (BMI) of 30 and above.

RESULTS

At 10-years follow-up the incidence rates were 5.8% (CI 4.3-7.3) for hip OA, 7.3% (CI 5.7-9.0) for knee OA, and 5.6% (CI 4.2-7.1) for hand OA. When adjusting for age, gender, work status and leisure time activities, a high BMI (> 30) was significantly associated with knee OA (OR 2.81; 95%CI 1.32-5.96), and a dose-response relationship was found for this association. Obesity was also significantly associated with hand OA (OR 2.59; 1.08-6.19), but not with hip OA (OR 1.11; 0.41-2.97). There was no statistically significant interaction effect between BMI and gender, age or any of the other confounding variables.

CONCLUSION

A high BMI was significantly associated with knee OA and hand OA, but not with hip OA.

摘要

背景

肥胖是膝关节骨关节炎(OA)最重要的危险因素之一。然而,肥胖与手部和髋部骨关节炎之间的关系仍存在争议,需要进一步研究。本研究的目的是调查肥胖对普通人群10年随访中髋部、膝部和手部新发骨关节炎(OA)的影响。

方法

1994年共有1854名年龄在24 - 76岁的人参与了一项挪威的肌肉骨骼疼痛研究,1994年和2004年都参与了。排除1994年患有骨关节炎或类风湿关节炎的参与者以及1994年74岁以上的参与者,剩余1675人进行分析。主要结局指标是基于自我报告的随访时骨关节炎诊断。肥胖定义为体重指数(BMI)达到30及以上。

结果

在10年随访时,髋部骨关节炎的发病率为5.8%(95%置信区间4.3 - 7.3),膝部骨关节炎为7.3%(95%置信区间5.7 - 9.0),手部骨关节炎为5.6%(95%置信区间4.2 - 7.1)。在调整年龄、性别、工作状态和休闲活动后,高BMI(> 30)与膝部骨关节炎显著相关(比值比2.81;95%置信区间1.32 - 5.96),并且发现了这种关联的剂量反应关系。肥胖也与手部骨关节炎显著相关(比值比2.59;1.08 - 6.19),但与髋部骨关节炎无关(比值比1.11;0.41 - 2.97)。BMI与性别、年龄或任何其他混杂变量之间没有统计学上显著的交互作用。

结论

高BMI与膝部骨关节炎和手部骨关节炎显著相关,但与髋部骨关节炎无关。

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