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两种不同骨关节炎亚群的 MRI 特征差异:来自骨关节炎倡议的数据。

Differences in MRI features between two different osteoarthritis subpopulations: data from the Osteoarthritis Initiative.

机构信息

Department of Orthopedics, Erasmus Medical Center, Rotterdam, The Netherlands.

Department of Orthopedics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

Osteoarthritis Cartilage. 2016 May;24(5):822-6. doi: 10.1016/j.joca.2015.12.006. Epub 2015 Dec 18.

Abstract

OBJECTIVE

To investigate differences in MRI features between two etiologically distinct subtypes of knee osteoarthritis (OA): one group with metabolic syndrome and one lean group with frequent physical activity.

METHODS

We included two groups of 50 subjects of the Osteoarthritis Initiative (OAI) incidence subcohort, with KL ≥ 2 in at least one knee at 48 months follow-up. Inclusion criteria for the metabolic syndrome group were a body mass index (BMI) ≥ 30 kg/m(2) and two out of three of the following criteria: hypertension (RR > 130/85 mm Hg or hypertension medication), insulin resistance (high blood sugar or diabetic medication) or dyslipidemia (lipid lowering medication). Inclusion criteria for the active lean group were a BMI < 25 kg/m(2) and a Physical Activity Scale for the Elderly (PASE) score ≥ 2. MRI scans were scored using MR Imaging Osteoarthritis Knee Score (MOAKS). Differences in MOAKS items between groups were tested using generalized linear models adjusted for sex and age.

RESULTS

Scores for cartilage damage were significantly higher in the patella, trochlea and lateral femur in the metabolic syndrome group. Osteophyte scores were higher for all compartments in the metabolic syndrome group, though only significant for the patella, trochlea and medial tibia. Hoffa synovitis was significantly more prevalent in the active lean group while prepatellar bursa signal was more prevalent in the metabolic syndrome group.

CONCLUSION

Metabolic OA and OA related to physical activity showed differences in MRI features, depending on knee compartment. These results show that different etiological processes in knee OA can lead to differences in structural degradation.

摘要

目的

研究两种不同病因的膝骨关节炎(OA)的 MRI 特征差异:一组为代谢综合征,一组为频繁体力活动的瘦体型。

方法

我们纳入了 Osteoarthritis Initiative(OAI)发病亚队列的两组 50 名受试者,其中至少有一只膝关节在 48 个月随访时 KL≥2。代谢综合征组的纳入标准为 BMI≥30kg/m(2)和以下三项标准中的两项:高血压(RR>130/85mmHg 或高血压药物治疗)、胰岛素抵抗(高血糖或糖尿病药物治疗)或血脂异常(降脂药物治疗)。瘦体型活跃组的纳入标准为 BMI<25kg/m(2)和老年人身体活动量表(PASE)评分≥2。使用磁共振成像骨关节炎膝关节评分(MOAKS)对 MRI 扫描进行评分。使用广义线性模型,根据性别和年龄调整,检验两组之间 MOAKS 项目的差异。

结果

代谢综合征组髌骨、滑车和外侧股骨的软骨损伤评分显著较高。代谢综合征组所有部位的骨赘评分均较高,但仅髌骨、滑车和内侧胫骨有统计学意义。活跃瘦体型组 Hoffa 滑膜炎更为常见,而代谢综合征组髌前滑囊炎信号更为常见。

结论

代谢性 OA 和与体力活动相关的 OA 在 MRI 特征上存在差异,这取决于膝关节的部位。这些结果表明,膝骨关节炎的不同病因过程可导致结构降解的差异。

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