MRC Unit for Lifelong Health and Ageing, University College London, 33 Bedford Place, London WC1B 5JU, UK.
Ann Rheum Dis. 2012 May;71(5):655-60. doi: 10.1136/ard.2011.154021. Epub 2011 Oct 6.
The authors examined how body mass index (BMI) across life is linked to the risk of midlife knee osteoarthritis (OA), testing whether prolonged exposure to high BMI or high BMI at a particular period has the greatest influence on the risk of knee OA.
A population-based British birth cohort of 3035 men and women underwent clinical examination for knee OA at age 53 years.Heights and weights were measured 10 times from 2 to 53 years. Analyses were stratified by gender and adjusted for occupation and activity levels.
The prevalence of knee OA was higher in women than in men (12.9% (n=194) vs 7.4% (n=108)). In men, the association between BMI and later knee OA was evident at 20 years (p=0.038) and remained until 53 years (OR per z-score 1.38 (95% CI 1.11 to 1.71)). In women, there was evidence for an association at 15 years (p=0.003); at 53 years, the OR was 1.89 (95% CI 1.59 to 2.24) per z-score increase in BMI. Changes in BMI from childhood in women and from adolescence in men were also positively associated with knee OA. A structured modelling approach to disentange the way in which BMI is linked to knee OA suggested that prolonged exposure to high BMI throughout adulthood carried the highest risk and that there was no additional risk conferred from adolescence once adult BMI had been accounted for.
This study suggests that the risk of knee OA accumulates from exposure to a high BMI through adulthood.
作者研究了一生中的体重指数 (BMI) 与中年膝关节骨关节炎 (OA) 风险之间的关系，检验了长期处于高 BMI 或特定时期高 BMI 是否对膝关节 OA 的风险影响最大。
对 3035 名男性和女性进行了一项基于人群的英国出生队列研究，这些人在 53 岁时接受了膝关节 OA 的临床检查。身高和体重在 2 至 53 岁期间测量了 10 次。分析按性别分层，并根据职业和活动水平进行了调整。
女性膝关节 OA 的患病率高于男性（12.9%（n=194）比 7.4%（n=108））。在男性中，BMI 与后期膝关节 OA 的关联在 20 岁时明显（p=0.038），并持续到 53 岁（每 Z 分数的 OR 为 1.38（95%CI 1.11 至 1.71））。在女性中，15 岁时有证据表明存在关联（p=0.003）；在 53 岁时，BMI 每增加一个 Z 分数，OR 为 1.89（95%CI 1.59 至 2.24）。女性从儿童期到青春期 BMI 的变化与膝关节 OA 也呈正相关。一种用于解析 BMI 与膝关节 OA 之间关系的结构化建模方法表明，成年期长期处于高 BMI 状态的风险最高，并且在考虑了成年 BMI 后，青春期不再增加风险。
本研究表明，膝关节 OA 的风险随着成年期暴露于高 BMI 而累积。
