Northwestern University, Chicago, IL 60611, USA.
Arthritis Care Res (Hoboken). 2013 Jan;65(1):53-61. doi: 10.1002/acr.21754.
To investigate the public health impact of obesity and other modifiable risk factors related to physical inactivity in adults with knee osteoarthritis (OA).
The frequency of inactivity as defined by the US Department of Health and Human Services was assessed from objective accelerometer monitoring of 1,089 participants (ages 49-84 years) with radiographic knee OA during the Osteoarthritis Initiative 48-month visit (2008-2010). The relationship between modifiable factors (weight status, dietary fat, fiber, smoking, depressive symptoms, knee function, knee pain, and knee confidence) with inactivity was assessed using odds ratios (ORs) and attributable fractions (AFs), controlling for descriptive factors (age, sex, race, education, lives alone, employment, frequent knee symptoms, and comorbidity).
Almost half (48.9%) of participants with knee OA were inactive. Being overweight (OR 1.8, 95% confidence interval [95% CI] 1.2-2.5) or obese (OR 3.9, 95% CI 2.6-5.7), having inadequate dietary fiber intake (OR 1.6, 95% CI 1.2-2.2), severe knee dysfunction (OR 1.9, 95% CI 1.3-2.8), and severe pain (OR 1.7, 95% CI 1.1-2.5) were significantly related to inactivity, controlling for descriptive factors. Modifiable factors with significant average AFs were being overweight or obese (AF 23.8%, 95% CI 10.5-38.6%) and inadequate dietary fiber (AF 12.1%, 95% CI 0.1-24.5%), controlling for all factors.
Being obese or overweight, the quality of the diet, severe pain, and severe dysfunction are significantly associated with physical inactivity in adults with knee OA. All components should be considered in designing physical activity interventions that target arthritis populations with low activity levels.
探讨肥胖和与身体活动不足相关的其他可改变的危险因素对膝骨关节炎(OA)成年人的公共卫生影响。
在 Osteoarthritis Initiative 的 48 个月访视期间(2008-2010 年),通过客观的加速度计监测 1089 名有放射学膝关节 OA 的参与者(年龄 49-84 岁),评估美国卫生与公众服务部定义的不活动频率。使用比值比(ORs)和归因分数(AFs)评估可改变的因素(体重状况、饮食中的脂肪、纤维、吸烟、抑郁症状、膝关节功能、膝关节疼痛和膝关节信心)与不活动之间的关系,控制描述性因素(年龄、性别、种族、教育程度、独居、就业、频繁的膝关节症状和合并症)。
近一半(48.9%)的膝骨关节炎患者不活动。超重(OR 1.8,95%置信区间[95%CI]1.2-2.5)或肥胖(OR 3.9,95%CI 2.6-5.7)、膳食纤维摄入不足(OR 1.6,95%CI 1.2-2.2)、严重膝关节功能障碍(OR 1.9,95%CI 1.3-2.8)和严重疼痛(OR 1.7,95%CI 1.1-2.5)与不活动显著相关,控制描述性因素。具有显著平均 AF 的可改变因素是超重或肥胖(AF 23.8%,95%CI 10.5-38.6%)和膳食纤维摄入不足(AF 12.1%,95%CI 0.1-24.5%),控制所有因素。
肥胖或超重、饮食质量、严重疼痛和严重功能障碍与膝骨关节炎成年人的身体活动不足显著相关。在设计针对活动水平较低的关节炎人群的身体活动干预措施时,应考虑所有这些因素。