跑步和步行对骨关节炎和髋关节置换风险的影响。
Effects of running and walking on osteoarthritis and hip replacement risk.
机构信息
Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
出版信息
Med Sci Sports Exerc. 2013 Jul;45(7):1292-7. doi: 10.1249/MSS.0b013e3182885f26.
PURPOSE
Running and other strenuous sports activities are purported to increase osteoarthritis (OA) risk, more so than walking and less-strenuous activities. Analyses were therefore performed to test whether running, walking, and other exercise affect OA and hip replacement risk and to assess the role of body mass index (BMI) in mediating these relationships.
METHODS
In this article, we studied the proportional hazards analyses of patients' report of having physician-diagnosed OA and hip replacement versus exercise energy expenditure (METs).
RESULTS
Of the 74,752 runners, 2004 reported OA and 259 reported hip replacements during the 7.1-yr follow-up; whereas of the 14,625 walkers, 696 reported OA and 114 reported hip replacements during the 5.7-yr follow-up. Compared with running <1.8 MET · h · d(-1), the risks for OA and hip replacement decreased as follows: 1) 18.1% (P = 0.01) and 35.1% (P = 0.03) for the 1.8- and 3.6-MET · h · d(-1) run, respectively; 2) 16.1% (P = 0.03) and 50.4% (P = 0.002) for the 3.6- and 5.4-MET · h · d(-1) run, respectively; and 3) 15.6% (P = 0.02) and 38.5% (P = 0.01) for the ≥ 5.4-MET · h · d(-1) run, suggesting that the risk reduction mostly occurred by 1.8 MET · h · d(-1). Baseline BMI was strongly associated with both OA (5.0% increase per kilogram per square meter, P = 2 × 10(-8)) and hip replacement risks (9.8% increase per kilogram per square meter, P = 4.8 × 10(-5)), and adjustment for BMI substantially diminished the risk reduction from running ≥ 1.8 MET · h · d(-1) for OA (from 16.5%, P = 0.01, to 8.6%, P = 0.21) and hip replacement (from 40.4%, P = 0.005, to 28.5%, P = 0.07). The reductions in OA and hip replacement risk by exceeding 1.8 MET · h · d(-1) did not differ significantly between runners and walkers. Other (nonrunning) exercise increased the risk of OA by 2.4% (P = 0.009) and hip replacement by 5.0% per MET · h · d(-1) (P = 0.02), independent of BMI.
CONCLUSIONS
Running significantly reduced OA and hip replacement risk due to, in part, running's association with lower BMI, whereas other exercise increased OA and hip replacement risk.
目的
据报道，跑步等剧烈运动比步行和低强度运动更能增加骨关节炎（OA）的风险。因此，进行了分析以测试跑步、步行和其他运动是否会影响 OA 和髋关节置换风险，并评估体重指数（BMI）在介导这些关系中的作用。
方法
在本文中，我们研究了患者报告的医生诊断为 OA 和髋关节置换与运动能量消耗（METs）的比例风险分析。
结果
在 74752 名跑步者中，有 2004 人在 7.1 年的随访中报告患有 OA，有 259 人报告患有髋关节置换；在 14625 名步行者中，有 696 人在 5.7 年的随访中报告患有 OA，有 114 人报告患有髋关节置换。与跑步<1.8 MET·h·d（-1）相比，OA 和髋关节置换的风险降低如下：1）18.1%（P=0.01）和 35.1%（P=0.03），分别为 1.8-和 3.6-MET·h·d（-1）跑；2）16.1%（P=0.03）和 50.4%（P=0.002），分别为 3.6-和 5.4-MET·h·d（-1）跑；3）15.6%（P=0.02）和 38.5%（P=0.01），分别为≥5.4-MET·h·d（-1）跑，表明风险降低主要发生在 1.8 MET·h·d（-1）跑。基线 BMI 与 OA（每千克每平方米增加 5.0%，P=2×10（-8））和髋关节置换风险（每千克每平方米增加 9.8%，P=4.8×10（-5））强烈相关，并且 BMI 的调整大大降低了跑步≥1.8 MET·h·d（-1）对 OA（从 16.5%，P=0.01，到 8.6%，P=0.21）和髋关节置换（从 40.4%，P=0.005，到 28.5%，P=0.07）的风险降低。跑步超过 1.8 MET·h·d（-1）对 OA 和髋关节置换风险的降低在跑步者和步行者之间没有显著差异。其他（非跑步）运动使 OA 风险增加 2.4%（P=0.009），髋关节置换风险增加 5.0%/MET·h·d（-1）（P=0.02），独立于 BMI。
结论
跑步显著降低了 OA 和髋关节置换的风险，部分原因是跑步与较低的 BMI 有关，而其他运动则增加了 OA 和髋关节置换的风险。
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