Department of Medicine, Boston University School of Medicine, Clinical Epidemiology Research and Training Unit, Boston, Massachusetts, USA.
Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.
Ann Rheum Dis. 2017 Aug;76(8):1411-1419. doi: 10.1136/annrheumdis-2016-210810. Epub 2017 May 23.
Dietary fibre reduces body weight and inflammation both of which are linked with knee osteoarthritis (OA). We examined the association between fibre intake and risk of knee OA.
We used data from the Osteoarthritis Initiative (OAI) of 4796 participants and Framingham Offspring Osteoarthritis Study (Framingham) of 1268 persons. Dietary intake of fibre was estimated at baseline, and incident radiographic OA (ROA) and symptomatic OA (SxOA) were followed annually until 48 months in OAI and assessed 9 years later in Framingham. Knee pain worsening was also examined in OAI. Generalised estimating equations were applied in multivariable regression models.
In OAI, we identified 869 knees with SxOA, 152 knees with ROA and 1964 knees with pain worsening among 4051 subjects with valid dietary intake (baseline mean age: 61.2 years; mean body mass index (BMI): 28.6). In Framingham, 143 knees with SxOA and 176 knees with ROA among 971 such subjects (baseline mean age: 53.9 years; mean BMI: 27.0) were identified. In both cohorts, dietary total fibre was inversely associated with risk of SxOA (p trend <0.03) with significantly lower risk at the highest versus lowest quartile (OR (95% CI): 0.70 (0.52, 0.94) for OAI and 0.39 (0.17, 0.88) for Framingham). Furthermore, dietary total and cereal fibre were significantly inversely associated with knee pain worsening in OAI (p trend <0.02). No apparent association was found with ROA.
Findings from two longitudinal studies consistently showed that higher total fibre intake was related to a lower risk of SxOA, while the relation to ROA was unclear.
膳食纤维既能减轻体重又能减轻炎症，而这两者均与膝关节骨关节炎（OA）有关。我们研究了膳食纤维摄入量与膝关节 OA 风险之间的关系。
我们使用了来自 Osteoarthritis Initiative（OAI）的 4796 名参与者和来自 Framingham Offspring Osteoarthritis Study（Framingham）的 1268 名参与者的数据。在基线时估计膳食纤维的摄入量，并在 OAI 中每年随访一次，直至 48 个月，在 Framingham 中随访 9 年，评估放射学膝关节 OA（ROA）和症状性 OA（SxOA）的发生情况。还在 OAI 中检查了膝关节疼痛加重的情况。使用广义估计方程进行多变量回归模型分析。
在 OAI 中，我们在 4051 名具有有效饮食摄入数据的受试者中发现了 869 个膝关节 SxOA、152 个膝关节 ROA 和 1964 个膝关节疼痛加重（基线平均年龄：61.2 岁；平均体重指数（BMI）：28.6）。在 Framingham 中，在 971 名具有这种数据的受试者中发现了 143 个膝关节 SxOA 和 176 个膝关节 ROA（基线平均年龄：53.9 岁；平均 BMI：27.0）。在这两个队列中，膳食纤维总量与 SxOA 风险呈负相关（p 趋势 <0.03），与最低和最高四分位相比，风险显著降低（OAI 的 OR（95%置信区间）：0.70（0.52，0.94）和 Framingham 的 0.39（0.17，0.88））。此外，膳食纤维总量和谷物纤维与 OAI 中膝关节疼痛加重呈显著负相关（p 趋势 <0.02）。与 ROA 之间未见明显关联。
两项纵向研究的结果一致表明，较高的膳食纤维总摄入量与较低的 SxOA 风险相关，而与 ROA 的关系尚不清楚。
