肥胖和超重个体的减肥方案与减少软骨退化有关：来自 Osteoarthritis Initiative 的 96 个月数据。
Weight loss regimen in obese and overweight individuals is associated with reduced cartilage degeneration: 96-month data from the Osteoarthritis Initiative.
机构信息
Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA; Department of Radiology, Technical University of Munich, Munich, Germany.
Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
出版信息
Osteoarthritis Cartilage. 2019 Jun;27(6):863-870. doi: 10.1016/j.joca.2019.01.018. Epub 2019 Feb 28.
PURPOSE
To investigate change in knee cartilage composition over 96 months in overweight and obese participants with constant weight compared to those with weight loss (WL), and to assess how different WL regimens are associated with these changes.
METHODS
We studied right knees of 760 participants (age 62.6 ± 9.0y; 465 females) with a baseline body mass index (BMI) >25 kg/m2 from the Osteoarthritis Initiative with mild to moderate or with risk factors for knee osteoarthritis. Participants losing weight (>5% of baseline BMI over 72 months; N = 380) were compared to controls with stable weight (SW, N = 380). Participants losing weight were categorized based on WL method (diet and exercise, diet only, exercise only) and compared to those with stable weight. Magnetic resonance imaging (MRI) at 3T was performed at baseline, 48- and 96-months. The association of WL and WL method with change in cartilage composition, measured with T2 mapping, was analyzed using mixed random effects models.
RESULTS
Compared to SW, WL was associated with a significantly slower increase in global (averaged over all compartments) cartilage T2 (adjusted mean difference of change in T2 ms/year [95% CI] between the groups: 0.24 [0.20, 0.41] ms/year; P < 0.001) and global deep layer cartilage T2 0.35 [0.20, 0.42] ms/year; P < 0.001), suggesting slower cartilage deterioration. Compared to the SW group, slower increases in global T2 were observed in the diet and diet and exercise groups, but not in the exercise only group (P = 0.042, P = 0.003 and P = 0.85, respectively).
CONCLUSION
Our results suggest that WL may slow knee cartilage degeneration over 96 months, and that these potential benefits may differ by method of WL.
目的
研究超重和肥胖参与者体重保持不变与体重减轻（WL）相比，96 个月内膝关节软骨成分的变化，并评估不同的 WL 方案与这些变化的相关性。
方法
我们研究了来自 Osteoarthritis Initiative 的 760 名参与者（年龄 62.6±9.0 岁；465 名女性）右膝，这些参与者基线时的体重指数（BMI）>25kg/m2，存在轻度至中度膝关节骨关节炎或膝关节骨关节炎的危险因素。与体重稳定（SW，N=380）的对照组相比，体重减轻（>基线 BMI 的 5%，持续 72 个月；N=380）的参与者被纳入研究。根据 WL 方法（饮食和运动、仅饮食、仅运动）对体重减轻的参与者进行分类，并与体重稳定的参与者进行比较。在基线、48 个月和 96 个月时使用 3T 磁共振成像（MRI）进行检测。使用混合随机效应模型分析 WL 和 WL 方法与 T2 图谱测量的软骨成分变化的相关性。
结果
与 SW 相比，WL 与全膝关节（所有节段平均值）软骨 T2 增加速度明显减慢有关（两组间 T2 变化的调整平均差异[95%CI]：0.24[0.20，0.41]ms/年；P<0.001）和全膝关节深层软骨 T2 增加速度减慢（0.35[0.20，0.42]ms/年；P<0.001），提示软骨恶化速度较慢。与 SW 组相比，饮食和饮食与运动组的全膝关节 T2 增加速度较慢，但运动组无此现象（P=0.042，P=0.003 和 P=0.85）。
结论
我们的研究结果表明，96 个月内 WL 可能会减缓膝关节软骨退变，并且这些潜在益处可能因 WL 方法而异。
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