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代谢危险因素(如超重、高血压、血脂异常和糖耐量受损)的积累会增加膝骨关节炎的发生和进展风险:ROAD 研究的 3 年随访结果。

Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidaemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: a 3-year follow-up of the ROAD study.

机构信息

Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

出版信息

Osteoarthritis Cartilage. 2012 Nov;20(11):1217-26. doi: 10.1016/j.joca.2012.06.006. Epub 2012 Jul 14.

Abstract

OBJECTIVE

To clarify the association between the occurrence and progression of knee osteoarthritis (KOA) with components of metabolic syndrome (MS), including overweight (OW), hypertension (HT), dyslipidaemia (DL), and impaired glucose tolerance (IGT), in a general population.

DESIGN

From the large-scale population-based cohort study entitled Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) initiated in 2005, 1,690 participants (596 men, 1,094 women) residing in mountainous and coastal areas were enrolled. Of these, 1,384 individuals (81.9%; 466 men, 918 women) completed the second survey, including knee radiography, 3 years later. KOA was defined as Kellgren-Lawrence (KL) grade ≥ 2 using paired X-ray films. Based on changes in KL grades between the baseline and second surveys, cumulative incidence and progression of KOA were determined. OW, HT, DL, and IGT at baseline were assessed using standard criteria.

RESULTS

The cumulative incidence of KOA among 1,384 completers over 3 years was 3.3%/year, and progression in KL grades for either knee, 8.0%/year. Logistic regression analyses after adjusting for potential risk factors revealed that the odds ratio (OR) for the occurrence of KOA significantly increased according to the number of MS components present (OR vs no component: one component, 2.33; two components, 2.82; ≥three components, 9.83). Similarly, progression of KOA significantly increased according to the number of MS components present (OR vs no component: one component, 1.38; two components, 2.29; ≥three components: 2.80).

CONCLUSION

Accumulation of MS components is significantly related to both occurrence and progression of KOA. MS prevention may be useful in reducing future KOA risk.

摘要

目的

阐明代谢综合征(MS)各组分(超重、高血压、血脂异常和糖耐量受损)与膝关节骨关节炎(KOA)的发生和进展之间的关系,该研究人群为一般人群。

设计

本研究来自于 2005 年开始的大型、基于人群的、题为“骨关节炎/骨质疏松症与残疾研究(ROAD)”的队列研究。共纳入居住在山区和沿海地区的 1690 名参与者(596 名男性,1094 名女性),其中 1384 名(81.9%,466 名男性,918 名女性)完成了第二次调查,包括 3 年后的膝关节 X 线摄影。KOA 采用配对 X 线片定义为 Kellgren-Lawrence(KL)分级≥2。根据基线和第二次调查之间 KL 分级的变化,确定 KOA 的累积发病率和进展。采用标准标准评估基线时的 OW、HT、DL 和 IGT。

结果

在 1384 名完成者中,3 年内 KOA 的累积发病率为 3.3%/年,KL 分级的进展为 8.0%/年。调整潜在危险因素后进行的 logistic 回归分析显示,KOA 发生的比值比(OR)随着 MS 组分数量的增加而显著增加(与无组分相比:一个组分,2.33;两个组分,2.82;≥三个组分,9.83)。同样,根据 MS 组分的数量,KOA 的进展显著增加(与无组分相比:一个组分,1.38;两个组分,2.29;≥三个组分:2.80)。

结论

MS 组分的累积与 KOA 的发生和进展显著相关。MS 的预防可能有助于降低未来 KOA 的风险。

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