Weiss Elizabeth
Department of Anthropology, San Jose State University, San Jose, CA, USA.
Rheumatology (Oxford). 2014 Nov;53(11):2095-9. doi: 10.1093/rheumatology/keu244. Epub 2014 Jun 17.
This study aimed to determine whether BMI increases knee pain as measured from self-reported surveys even when controlling for OA severity as measured by osteophytes and joint space narrowing visible on X-rays.
Data available through the Osteoarthritis Initiative (OAI) were analysed, which included a sample of 4769 individuals, to answer the above question regarding OA, excess weight and pain. OA severity was assessed through baseline X-rays on right knees that were scored on a composite quasi-Kellgren and Lawrence grade. Weight was assessed through BMI. Pain was assessed through self-reports of the WOMAC pain subset as well as a 30-day pain severity question based on a 0-10 scale. Data were analysed using SPSS and analyses of covariance (ANCOVAs) were run to examine models adjusted for age, smoking, prior injury, pain medication and Heberden's nodes. Critical alpha levels were set at 0.05.
The results reported here confirm that knee pain does increase with OA severity. However, ANCOVA multiple regressions with controls reveal that even when taking into account OA severity, individuals with higher BMIs experience greater pain than individuals with lower BMIs.
Weight loss may reduce knee OA pain even if the osteological symptoms are not treated.
本研究旨在确定即使在控制通过X射线可见的骨赘和关节间隙变窄所测量的骨关节炎（OA）严重程度时，体重指数（BMI）是否会如自我报告调查所测量的那样增加膝关节疼痛。
分析了通过骨关节炎倡议（OAI）获得的数据，其中包括4769名个体的样本，以回答上述有关OA、超重和疼痛的问题。通过对右膝的基线X射线进行评估来确定OA严重程度，采用综合的准凯尔格伦和劳伦斯分级进行评分。通过BMI评估体重。通过WOMAC疼痛子集中的自我报告以及基于0至10量表的30天疼痛严重程度问题来评估疼痛。使用SPSS进行数据分析，并进行协方差分析（ANCOVA）以检验针对年龄、吸烟、既往损伤、止痛药物和赫伯登结节进行调整的模型。临界α水平设定为0.05。
此处报告的结果证实膝关节疼痛确实会随着OA严重程度的增加而增加。然而，带有对照的ANCOVA多元回归显示，即使考虑到OA严重程度，BMI较高的个体比BMI较低的个体经历更严重的疼痛。
即使不治疗骨科症状，减肥也可能减轻膝关节OA疼痛。
