Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Victoria, Australia.
Osteoarthritis Cartilage. 2018 May;26(5):671-679. doi: 10.1016/j.joca.2018.02.895. Epub 2018 Feb 21.
To examine the association between ambulatory activity (AA), body composition measures and hip or knee joint replacement (JR) due to osteoarthritis.
At baseline, 1082 community-dwelling older-adults aged 50-80 years were studied. AA was measured objectively using pedometer and body composition by dual-energy X-ray absorptiometry. The incidence of primary (first-time) JR was determined by data linkage to the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Log binomial regression with generalized estimating equations were used to estimate the risk of JR associated with baseline AA and body composition measures, adjusting for age, sex, X-ray disease severity, and pain.
Over 13 years of follow-up, 74 (6.8%) participants had a knee replacement (KR) and 50 (4.7%) a hip replacement (HR). AA was associated with a higher risk of KR (RR 1.09/1000 steps/day, 95% CI 1.01, 1.16) and a lower risk of HR (RR 0.90/1000 steps/day, 95% CI 0.81, 0.99). Body mass index (BMI) (RR 1.07/kg/m, 95% CI 1.03, 1.12), total fat mass (RR 1.03/kg, 95% CI 1.01, 1.06), trunk fat mass (RR 1.05/kg, 95% CI 1.00, 1.09), and waist circumference (RR 1.02/cm, 95% CI 1.00, 1.04) were associated with a higher risk of KR. Body composition measures were not associated with HR.
An objective measure of AA was associated with a small increased risk of KR and a small reduced risk of HR. Worse body composition profiles were associated with KR, but not HR. Altogether this may suggest different causal pathways for each site with regard to habitual activity and obesity.
研究动态活动（AA）、身体成分测量与髋或膝关节骨关节炎置换（JR）的关系。
在基线时，研究了 1082 名年龄在 50-80 岁的社区居住的老年人。使用计步器客观测量 AA，使用双能 X 射线吸收法测量身体成分。通过与澳大利亚矫形协会国家关节置换登记处（AOANJRR）的数据链接，确定原发性（首次）JR 的发生率。使用广义估计方程的对数二项式回归来估计与基线 AA 和身体成分测量相关的 JR 风险，调整年龄、性别、X 射线疾病严重程度和疼痛。
在 13 年的随访中，74 名（6.8%）参与者接受了膝关节置换（KR），50 名（4.7%）接受了髋关节置换（HR）。AA 与 KR 风险增加相关（RR 1.09/1000 步/天，95%CI 1.01，1.16），与 HR 风险降低相关（RR 0.90/1000 步/天，95%CI 0.81，0.99）。体重指数（BMI）（RR 1.07/kg/m，95%CI 1.03，1.12）、总脂肪量（RR 1.03/kg，95%CI 1.01，1.06）、躯干脂肪量（RR 1.05/kg，95%CI 1.00，1.09）和腰围（RR 1.02/cm，95%CI 1.00，1.04）与 KR 风险增加相关。身体成分测量与 HR 无关。
AA 的客观测量与 KR 的风险略有增加和 HR 的风险略有降低相关。更差的身体成分与 KR 相关，但与 HR 无关。总的来说，这可能表明习惯性活动和肥胖对每个部位的因果途径不同。
