Center for Rehabilitation and Rheumatology, Amsterdam, The Netherlands.
Arthritis Care Res (Hoboken). 2011 Nov;63(11):1535-42. doi: 10.1002/acr.20571.
To identify subgroups or phenotypes of knee osteoarthritis (OA) patients based on similarities of clinically relevant patient characteristics, and to compare clinical outcomes of these phenotypes.
Data from 842 knee OA patients of the Osteoarthritis Initiative were used. A cluster analysis method was performed, in which clusters were formed based on similarities in 4 clinically relevant, easily available variables: severity of radiographic OA, lower extremity muscle strength, body mass index, and depression. Univariable and multivariable regression analyses were used to compare phenotypes on clinical outcomes (pain and activity limitations), taking into account possible confounders.
Five phenotypes of knee OA patients were identified: "minimal joint disease phenotype," "strong muscle phenotype," "nonobese and weak muscle phenotype," "obese and weak muscle phenotype," and "depressive phenotype." The "depressive phenotype" and "obese and weak muscle phenotype" showed higher pain levels and more severe activity limitations than the other 3 phenotypes.
Five phenotypes based on clinically relevant patient characteristics can be identified in the heterogeneous population of knee OA patients. These phenotypes showed different clinical outcomes. Interventions may need to be tailored to these clinical phenotypes.
根据临床相关患者特征的相似性，确定膝骨关节炎（OA）患者的亚组或表型，并比较这些表型的临床结果。
使用骨关节炎倡议（Osteoarthritis Initiative）的 842 例膝关节 OA 患者的数据。采用聚类分析方法，根据 4 个临床相关、易于获得的变量（放射学 OA 的严重程度、下肢肌肉力量、体重指数和抑郁）的相似性形成聚类。采用单变量和多变量回归分析，考虑可能的混杂因素，比较表型在临床结果（疼痛和活动受限）方面的差异。
确定了 5 种膝关节 OA 患者的表型：“最小关节疾病表型”、“强壮肌肉表型”、“非肥胖和弱肌肉表型”、“肥胖和弱肌肉表型”和“抑郁表型”。“抑郁表型”和“肥胖和弱肌肉表型”的疼痛程度更高，活动受限更严重，比其他 3 种表型更严重。
可以根据膝关节 OA 患者的临床相关特征确定 5 种不同的表型。这些表型显示出不同的临床结果。干预措施可能需要针对这些临床表型进行调整。
