Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, PR China.
Joint Bone Spine. 2012 May;79(3):291-7. doi: 10.1016/j.jbspin.2011.05.015. Epub 2011 Jul 30.
Excess bodyweight, expressed as increased body mass index, is associated with osteoarthritis risk, especially in weight bearing joints. However, the strength of the association was inconsistent. The study was conducted to quantitatively assess the association between body mass index and the risk of knee osteoarthritis and investigate the difference of the strength stratified by sex, study type and osteoarthritis definition.
We used published guidelines of the Meta-analysis of Observational Studies in Epidemiology Group (MOOSE) to perform the meta-analysis. The search strategy employed included computerized bibliographic searches of MEDLINE, PubMed, EMBASE, The Cochran Library and references of published manuscripts. Study-specific incremental estimates were standardized to determine the risk of knee osteoarthritis associated with a 5 kg/m(2) increase in BMI.
Twenty-one studies were included in the study. The results showed that body mass index was significantly positive associated with osteoarthritis risk in knee site. A 5-unit increase in body mass index was associated with an 35% increased risk of knee osteoarthritis (RR: 1.35; 95%CI: 1.21, 1.51). Magnitude of the association was significantly stronger in women than that in men with significant difference (men, RR: 1.22; 95%CI: 1.19, 1.25; women, RR: 1.38; 95%CI: 1.23, 1.54; p=0.04). The summary effect size was 1.25(95%CI: 1.18, 1.32) in case-control studies and 1.37 (95%CI: 1.19, 1.56) in cohort studies (p=0.28). Body mass index was positively associated with knee osteoarthritis defined by radiography and/or clinical symptom (RR: 1.25, 95%CI: 1.17, 1.35) and clinical surgery (RR: 1.54, 95%CI: 1.29, 1.83). The latter tended to be stronger than the former (p<0.01).
Increased body mass index contribute to a substantially increased risk of knee OA. The magnitude of the association varies by sex and OA definition.
超重表现为体重指数增加，与骨关节炎风险相关，尤其是在负重关节。然而，这种关联的强度并不一致。本研究旨在定量评估体重指数与膝关节骨关节炎风险之间的关联，并探讨按性别、研究类型和骨关节炎定义分层的关联强度差异。
我们使用观察性研究荟萃分析流行病学组（MOOSE）的出版指南进行荟萃分析。使用的检索策略包括计算机检索 MEDLINE、PubMed、EMBASE、Cochrane 图书馆和已发表文献的参考文献。对特定研究的增量估计值进行标准化，以确定 BMI 每增加 5kg/m²与膝关节骨关节炎相关的风险。
共有 21 项研究纳入研究。结果表明，体重指数与膝关节骨关节炎风险呈显著正相关。体重指数增加 5 个单位与膝关节骨关节炎风险增加 35%相关（RR：1.35；95%CI：1.21，1.51）。在女性中的关联强度明显强于男性，且差异具有统计学意义（男性，RR：1.22；95%CI：1.19，1.25；女性，RR：1.38；95%CI：1.23，1.54；p=0.04）。病例对照研究的汇总效应大小为 1.25（95%CI：1.18，1.32），队列研究为 1.37（95%CI：1.19，1.56）（p=0.28）。体重指数与影像学和/或临床症状（RR：1.25，95%CI：1.17，1.35）和临床手术（RR：1.54，95%CI：1.29，1.83）定义的膝关节骨关节炎呈正相关。后者的关联强度大于前者（p<0.01）。
体重指数增加与膝关节 OA 的风险显著增加相关。这种关联的强度因性别和 OA 定义而异。
