肥胖和膝骨关节炎与成年人股四头肌特定强度的降低无关。
Obesity and knee osteoarthritis are not associated with impaired quadriceps specific strength in adults.
机构信息
Department of Orthopaedics and Rehabilitation, 200 Hawkins Dr, 0728 JPP, The University of Iowa, Iowa City, IA 52242-1088, USA.
出版信息
PM R. 2011 Apr;3(4):314-23; quiz 323. doi: 10.1016/j.pmrj.2010.12.011.
OBJECTIVE
To assess whether adults, aged 50-59 years, who are obese or moderately to severely obese have impaired quadriceps strength and muscle quality in comparison with adults who are not obese, both groups with and without knee osteoarthritis (OA).
DESIGN
Cross-sectional observational study.
SETTING
Rural community acquired sample.
SUBJECTS
Seventy-seven men and 84 women, aged 50-59 years.
METHODS
Comparisons by using mixed models for clustered data (2 lower limbs per participant) between groups defined by body mass index (BMI) (<30 kg/m(2), 30-35 kg/m(2), and ≥35 kg/m(2)), with and without knee OA MAIN OUTCOME MEASUREMENT: The slope of the relationship between quadriceps muscle cross-sectional area (CSA) and isokinetic knee extensor strength (dynamometer) in each BMI and OA group.
RESULTS
There were 113 limbs (48.7% women), 101 limbs (38.6% women), and 89 limbs (73.0% women) in the <30 kg/m(2), 30-35 kg/m(2), and ≥35 kg/m(2) BMI groups, respectively; knee OA was present in 10.6%, 28.7%, and 58.4% of the limbs in each of these respective groups. Quadriceps CSA did not significantly differ among BMI groups in either gender or between subjects with and without knee OA. Peak quadriceps strength also did not significantly differ by BMI group or by the presence of knee OA. Multivariable analyses also demonstrated that peak quadriceps strength did not differ by BMI group, even after adjusting for (a) gender, (b) OA status, (c) intramuscular fat, or (d) quadriceps attenuation. The slopes for the relationships between quadriceps strength and CSA did not differ by BMI group, OA status, or their interaction.
CONCLUSIONS
Individuals who were obese and at risk for knee OA did not appear to have altered muscle strength or muscle quality compared with adults who were not obese and were aged 50-59 years. The absence of a difference in the relationship between peak quadriceps strength and CSA provided further evidence that there was not an impairment in quadriceps muscle quality in this cohort, which suggests that factors other than strength might mediate the association between obesity and knee OA.
目的
评估 50-59 岁的成年人中，肥胖或超重者与非肥胖者（无论是否患有膝骨关节炎 [OA]）相比，其股四头肌力量和肌肉质量是否受损。
设计
横断面观察性研究。
地点
农村社区获得样本。
受试者
77 名男性和 84 名女性，年龄 50-59 岁。
方法
使用混合模型对根据体重指数（BMI）（<30 kg/m(2)、30-35 kg/m(2)和≥35 kg/m(2)）分组的两组参与者（每参与者 2 条下肢）之间进行比较，比较包括有和没有膝 OA。
主要观察指标
在每个 BMI 和 OA 组中，股四头肌横截面积（CSA）与等速膝关节伸肌强度（测力计）之间的关系斜率。
结果
<30 kg/m(2)、30-35 kg/m(2)和≥35 kg/m(2)BMI 组分别有 113 条（48.7%为女性）、101 条（38.6%为女性）和 89 条（73.0%为女性）肢体；在每个 BMI 组中，分别有 10.6%、28.7%和 58.4%的肢体患有膝 OA。在男性或女性、或膝 OA 存在与否的情况下，股四头肌 CSA 在 BMI 组之间均无显著差异。股四头肌峰值强度也不因 BMI 组或膝 OA 而有显著差异。多变量分析还表明，即使在调整性别（a）、OA 状态（b）、肌内脂肪（c）或股四头肌衰减（d）后，股四头肌峰值强度也不因 BMI 组而有差异。股四头肌强度与 CSA 之间关系的斜率不因 BMI 组、OA 状态或其相互作用而有差异。
结论
与非肥胖且年龄在 50-59 岁的成年人相比，肥胖且有膝 OA 风险的个体似乎没有改变肌肉力量或肌肉质量。股四头肌峰值强度与 CSA 之间关系无差异，进一步证明了在该队列中股四头肌肌肉质量没有受损，这表明除了力量之外，其他因素可能介导了肥胖与膝 OA 之间的关联。
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