Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria 3004, Australia.
Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia; Cancer Epidemiology Centre, Cancer Council Victoria, Carlton, Victoria, Australia.
Semin Arthritis Rheum. 2014 Feb;43(4):429-36. doi: 10.1016/j.semarthrit.2013.07.013. Epub 2013 Sep 5.
To examine whether components of metabolic syndrome (MetS), either singly or additively, were associated with the incidence of severe knee and hip OA, and whether these associations were independent of obesity assessed by body mass index (BMI).
Twenty thousand, four hundred and thirty participants who had blood lipids, anthropometric and blood pressure measurements during 2003-2007 were selected from the Melbourne Collaborative Cohort Study. MetS was defined as central obesity assessed by waist circumference and any two of raised triglyceride level, reduced HDL cholesterol level, hypertension or impaired fasting glycaemia. The incidence of total knee and hip replacement was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry.
Six hundred and sixty participants had knee OA and 562 had hip OA. After adjustment for age, gender, country of birth, education, physical activity and BMI, central obesity [hazard ratio (HR) 1.59, 95% confidence interval (CI) 1.25-2.01] and hypertension (1.24, 1.05-1.48) were associated with increased risk of knee OA. The accumulation of MetS components was associated with knee OA risk, independent of BMI: one component, 2.12 (1.15-3.91); two components, 2.92 (1.60-5.33) and three or more components, 3.09 (1.68-5.69). No statistically significant associations were observed for hip OA.
Cumulative number of MetS components and central obesity and hypertension were associated with increased risk of severe knee OA, independent of BMI. No associations were observed with severe hip OA. These findings suggest that the pathogenesis of knee and hip OA differ and that targeting the management of MetS may reduce the risk of knee OA.
研究代谢综合征（MetS）各组分（单一存在或累加存在）是否与严重膝和髋骨关节炎的发病相关，以及这些相关性是否独立于 BMI 评估的肥胖。
选择 24300 名在 2003 年至 2007 年期间进行血脂、人体测量和血压测量的墨尔本合作队列研究参与者。MetS 通过腰围评估的中心性肥胖和甘油三酯水平升高、高密度脂蛋白胆固醇水平降低、高血压或空腹血糖受损中的任意两项来定义。通过将队列记录与澳大利亚矫形协会全国关节置换登记处联系，确定全膝关节和髋关节置换的发生率。
660 名参与者患有膝骨关节炎，562 名参与者患有髋骨关节炎。在校正年龄、性别、出生地、教育程度、身体活动和 BMI 后，中心性肥胖[风险比（HR）1.59，95%置信区间（CI）1.25-2.01]和高血压（1.24，1.05-1.48）与膝骨关节炎风险增加相关。MetS 组分的累积与膝骨关节炎风险相关，独立于 BMI：一个组分，2.12（1.15-3.91）；两个组分，2.92（1.60-5.33）和三个或更多组分，3.09（1.68-5.69）。髋骨关节炎未观察到统计学显著相关性。
MetS 组分的累积数量以及中心性肥胖和高血压与严重膝骨关节炎风险增加相关，独立于 BMI。髋骨关节炎与严重膝骨关节炎无关。这些发现表明膝和髋骨关节炎的发病机制不同，并且针对 MetS 的管理可能会降低膝骨关节炎的风险。
