INSERM, CIC-EC 1433, 54000 Nancy, France; Université de Lorraine, Paris Descartes University, EA 4360 Apemac, 54500 Nancy, France.
Université de Lorraine, Paris Descartes University, EA 4360 Apemac, 54500 Nancy, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, Department of internal medicine, 75015 Paris, France.
Joint Bone Spine. 2018 Mar;85(2):233-238. doi: 10.1016/j.jbspin.2017.02.006. Epub 2017 Feb 24.
In people with hip osteoarthritis (OA), the impact of obesity on health-related quality of life (HRQoL) remains unknown. Also whether cardiovascular conditions can modify the obesity-HRQoL relation has not been explored. We aimed to (1) study the cross-sectional relationship between body mass index (BMI) and HRQoL in symptomatic hip OA patients and determine whether cardiovascular comorbidity modifies this relationship and (2) examine the impact of BMI on the course of HRQoL over time.
We used data from the first 3 years of follow-up from the KHOALA study, which recruited patients from 2007 to 2009. HRQoL was assessed by the SF-36 and OAKHQOL questionnaires at baseline and during follow-up. We determined BMI and presence of cardiovascular disease by the Groll score. Associated factors at baseline and predictors of HRQoL over time were evaluated by multiple linear regression.
For 222 hip OA patients included, mean (SD) BMI was 26.9 (4.4) kg/m; 37 (17.1%) had at least one cardiovascular comorbidity. Increased BMI but not presence of cardiovascular comorbidity was associated with poor HRQoL. Increased BMI affected mainly physical and social HRQoL dimensions (up to -1.0 points, 95% CI [-1.6;-0.4]; P=0.002). The BMI-HRQoL relationship was not modified by the presence of cardiovascular disease. BMI was not associated with the course of HRQoL.
In patients with hip OA, BMI had an independent weak negative impact on HRQoL that was not modified by cardiovascular comorbidities. Neither of these factors affected HRQoL change during a 3-year follow-up.
在患有髋部骨关节炎（OA）的人群中，肥胖对健康相关生活质量（HRQoL）的影响尚不清楚。此外，心血管疾病是否可以改变肥胖与 HRQoL 之间的关系也尚未得到探索。我们的目的是：（1）研究有症状的髋部 OA 患者的 BMI 与 HRQoL 之间的横断面关系，并确定心血管合并症是否会改变这种关系；（2）检查 BMI 对 HRQoL 随时间变化的影响。
我们使用了 KHOALA 研究前 3 年的随访数据，该研究于 2007 年至 2009 年招募了患者。在基线和随访期间，使用 SF-36 和 OAKHQOL 问卷评估 HRQoL。我们通过 Groll 评分确定 BMI 和心血管疾病的存在。通过多元线性回归评估基线时的相关因素和 HRQoL 随时间的预测因素。
共纳入 222 例髋部 OA 患者，平均（SD）BMI 为 26.9（4.4）kg/m²；37 例（17.1%）至少有一种心血管合并症。较高的 BMI 但没有心血管合并症与较差的 HRQoL 相关。较高的 BMI 主要影响身体和社会 HRQoL 维度（最高降低 1.0 分，95%CI [-1.6；-0.4]；P=0.002）。心血管疾病的存在并未改变 BMI 与 HRQoL 的关系。BMI 与 HRQoL 的变化无关。
在髋部 OA 患者中，BMI 对 HRQoL 有独立的微弱负面影响，而心血管合并症并未改变这种影响。在 3 年的随访期间，这两个因素都没有影响 HRQoL 的变化。
