Boston University School of Medicine, Boston, Massachusetts.
Brigham and Women's Hospital, Boston, Massachusetts.
Arthritis Rheumatol. 2017 Jun;69(6):1194-1203. doi: 10.1002/art.40087. Epub 2017 May 8.
Previous studies have suggested that metabolic syndrome is associated with osteoarthritis (OA). However, analyses have often not included adjustment for body mass index (BMI) and have not addressed whether levels of individual metabolic syndrome components are related to OA. This study was undertaken to examine the relationship of metabolic syndrome and its components with radiographic and symptomatic knee OA.
Framingham Study subjects were assessed for OA in 1992-1995 and again in 2002-2005. Near the baseline visit, subjects had components of metabolic syndrome assessed. We defined incident radiographic OA as present when a knee without radiographic OA at baseline had a Kellgren/Lawrence grade of ≥2 at follow-up, and defined incident symptomatic OA as present when a knee developed the new combination of radiographic OA and knee pain. After excluding knees with prevalent OA at baseline, we tested the relationship of metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria and its components with the risk of incident radiographic OA and symptomatic OA before and after adjusting for BMI using the risk ratio from a binary regression with generalized estimating equations.
A total of 991 subjects (55.1% women) with a mean age of 54.2 years were studied, and 26.7% of men and 22.9% of women had metabolic syndrome. Metabolic syndrome and many of its components were associated with both incident radiographic OA and symptomatic OA, but after adjustment for BMI, almost all of these associations became weak and nonsignificant. An association of high blood pressure, especially diastolic pressure, with OA outcomes persisted in both men and women.
After adjustment for BMI, neither metabolic syndrome nor its components were associated with incident OA. There may be an association between OA and high blood pressure that needs further study.
先前的研究表明，代谢综合征与骨关节炎（OA）有关。然而，分析往往没有调整体重指数（BMI），也没有解决个体代谢综合征成分水平与 OA 的关系。本研究旨在探讨代谢综合征及其成分与放射学和症状性膝关节 OA 的关系。
弗雷明汉研究对象在 1992-1995 年和 2002-2005 年进行了 OA 评估。在基线检查时，对受试者进行了代谢综合征成分的评估。我们将放射学 OA 的新发定义为基线时无放射学 OA 的膝关节在随访时出现 Kellgren/Lawrence 分级≥2，将症状性 OA 的新发定义为膝关节出现新的放射学 OA 和膝关节疼痛组合。在排除基线时存在的膝关节 OA 后，我们使用广义估计方程的二元回归风险比，在调整 BMI 后，测试了根据国家胆固醇教育计划成人治疗专家组 III 标准定义的代谢综合征及其成分与新发放射学 OA 和症状性 OA 风险的关系。
共有 991 名（55.1%为女性）平均年龄为 54.2 岁的受试者进行了研究，26.7%的男性和 22.9%的女性患有代谢综合征。代谢综合征及其许多成分与新发放射学 OA 和症状性 OA 均相关，但在调整 BMI 后，几乎所有这些关联均变得较弱且无统计学意义。男性和女性的高血压，尤其是舒张压，与 OA 结果之间存在关联。
在调整 BMI 后，代谢综合征及其成分与新发 OA 均无相关性。OA 与高血压之间可能存在关联，需要进一步研究。
