Department of Medicine, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria.
Clin Rheumatol. 2017 Nov;36(11):2541-2548. doi: 10.1007/s10067-017-3816-1. Epub 2017 Sep 13.
Osteoarthritis (OA) of the knee is the most common type of arthritis all over the world. Obesity is the strongest modifiable risk factor and causes OA through a combination metabolic factors and mechanical loading. This study aimed to determine the frequency of metabolic syndrome (Mets) among patients with knee OA and its relationship with pain and functional status. This was a descriptive hospital-based cross-sectional study involving patients with knee OA. Pain was measured using a 0-10 numeric rating visual analog scale (VAS). Functional status was assessed using Steinbrocker's functional classification. Metabolic syndrome was diagnosed using the International Diabetic Federation criteria. Radiographs of both knees were taken and graded using Kellgren and Lawrence scale. Relationship of pain and functional status with obesity and Mets was assessed using Pearson's correlation. A p value of < 0.05 was considered significant. Two hundred and forty-four patients with knee OA comprising 63 (25.8%) males and 181 (74.2%) females were recruited. The median age was 50 years (range 18-73 years). Mets was diagnosed in 146 (59.8%). Obesity, diabetes, and hypertension were present in 154 (63.1%), 40 (16%), and 144 (59%) patients, respectively. Severe pain at first visit was present in 216 (88.5%) patients of which 128 (52.4%) had Mets compared to 85 (36.1%) without Mets (χ = 2.40, p = 0.361). Two hundred and four (83.6%) had Steinbrocker's functional classes II and III. Waist circumference was higher in patients with Mets (p = 0.025) but age (p = 0.092), BMI (p = 0.831), VAS (p = 0.361), and functional class (p = 0.401) were similar in those with and without Mets. Body mass index showed significant association with severity of pain (p = 0.017) but not with functional class (p = 0.138). Kellgren and Lawrence radiographic grades III and IV were documented in 288 (48.5%) and 136 (27.2%) knees, respectively. A higher BMI correlated with more severe radiographic grading for the right (p = 0.043) and left (p < 0.001) knees, respectively. Mets is prevalent (59.8%) among Nigerians with knee OA, and those with Mets have higher waist circumference. Significant association was observed between BMI with pain and Kellgren-Lawrence (KL) grade. Mets was not associated with pain, function, or KL grade.
膝关节骨关节炎（OA）是全世界最常见的关节炎类型。肥胖是最强的可改变的危险因素，它通过代谢因素和机械负荷的共同作用导致 OA。本研究旨在确定膝关节 OA 患者中代谢综合征（Mets）的频率及其与疼痛和功能状态的关系。这是一项基于医院的描述性横断面研究，涉及膝关节 OA 患者。疼痛采用 0-10 数字评分视觉模拟量表（VAS）进行测量。功能状态采用 Steinbrocker 功能分类进行评估。代谢综合征采用国际糖尿病联合会标准进行诊断。对双侧膝关节进行 X 线摄影，并采用 Kellgren 和 Lawrence 量表进行分级。采用 Pearson 相关分析评估疼痛和功能状态与肥胖和 Mets 的关系。p 值<0.05 被认为具有统计学意义。共招募了 244 例膝关节 OA 患者，其中男性 63 例（25.8%），女性 181 例（74.2%）。中位年龄为 50 岁（范围 18-73 岁）。诊断出 Mets 146 例（59.8%）。肥胖、糖尿病和高血压分别见于 154 例（63.1%）、40 例（16%）和 144 例（59%）患者。216 例（88.5%）患者首次就诊时疼痛剧烈，其中 128 例（52.4%）有 Mets，而 85 例（36.1%）无 Mets（χ²=2.40，p=0.361）。204 例（83.6%）患者 Steinbrocker 功能分级为 II 级和 III 级。Mets 患者的腰围较高（p=0.025），但年龄（p=0.092）、BMI（p=0.831）、VAS（p=0.361）和功能分级（p=0.401）在 Mets 患者和无 Mets 患者之间相似。BMI 与疼痛严重程度呈显著相关（p=0.017），但与功能分级无显著相关（p=0.138）。Kellgren 和 Lawrence 放射学分级 III 和 IV 分别见于 288 例（48.5%）和 136 例（27.2%）膝关节。较高的 BMI 与右侧（p=0.043）和左侧（p<0.001）膝关节的放射学分级更严重相关。代谢综合征（Mets）在尼日利亚膝关节 OA 患者中较为常见（59.8%），且 Mets 患者的腰围更高。BMI 与疼痛和 Kellgren-Lawrence（KL）分级之间存在显著相关性。Mets 与疼痛、功能或 KL 分级无显著相关性。
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