Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States.
Department of Epidemiology and Biostatistics, University of California, San Francisco, United States.
Osteoarthritis Cartilage. 2016 Jul;24(7):1126-34. doi: 10.1016/j.joca.2016.01.984. Epub 2016 Jan 30.
To investigate compositional cartilage changes measured with 3T MRI-based T2 values over 48 months in overweight and obese individuals with different degrees of weight loss (WL) and to study whether WL slows knee cartilage degeneration and symptom worsening.
We studied participants from the Osteoarthritis Initiative with risk factors or radiographic evidence of mild to moderate knee osteoarthritis with a baseline BMI ≥25 kg/m(2). We selected subjects who over 48 months lost a, moderate (BMI change, 5-10%WL, n = 180) or large amount of weight (≥10%WL, n = 78) and frequency-matched these to individuals with stable weight (<3%, n = 258). Right knee cartilage T2 maps of all compartments and grey-level co-occurrence matrix (GLCM) texture analyses were evaluated and associations with WL and clinical symptoms (WOMAC subscales for pain, stiffness and disability) were assessed using multivariable regression models.
The amount of weight change was significantly associated with change in cartilage T2 of the medial tibia (β 0.9 ms, 95% CI 0.4 to 1.1, P = 0.001). Increase of T2 in the medial tibia was significantly associated with increase in WOMAC pain (β 0.5 ms, 95% CI 0.2 to 0.6, P = 0.02) and disability (β 0.03 ms, 95% CI 0.003 to 0.05, P = 0.03). GLCM contrast and variance over all compartments showed significantly less progression in the >10%WL group compared to the stable weight group (both comparisons, P = 0.04).
WL over 48 months is associated with slowed knee cartilage degeneration and improved knee symptoms.
通过 3T MRI 基于 T2 值的研究，探究超重和肥胖个体在 48 个月内体重减轻（weight loss，WL）程度不同时的软骨成分变化，并研究 WL 是否会减缓膝关节软骨退变和症状恶化。
我们研究了来自骨关节炎倡议（Osteoarthritis Initiative）的参与者，这些参与者有导致轻度至中度膝关节骨关节炎的危险因素或放射学证据，且基线 BMI≥25kg/m2。我们选择了在 48 个月内体重减轻一定量（体重减轻量 5-10%，n=180）或大量（体重减轻≥10%，n=78）的参与者，并将这些参与者与体重稳定（<3%，n=258）的参与者进行频率匹配。对所有膝关节软骨的 T2 图和灰度共生矩阵（grey-level co-occurrence matrix，GLCM）纹理分析进行评估，并使用多变量回归模型评估与 WL 和临床症状（WOMAC 疼痛、僵硬和残疾子量表）的相关性。
体重变化量与内侧胫骨软骨 T2 的变化显著相关（β0.9ms，95%置信区间 0.4 至 1.1，P=0.001）。内侧胫骨 T2 的增加与 WOMAC 疼痛（β0.5ms，95%置信区间 0.2 至 0.6，P=0.02）和残疾（β0.03ms，95%置信区间 0.003 至 0.05，P=0.03）的增加显著相关。所有膝关节软骨中 GLCM 对比度和方差的变化在体重减轻>10%的组中与体重稳定的组相比明显减缓（两种比较，P=0.04）。
48 个月内 WL 与膝关节软骨退变减缓及膝关节症状改善相关。
