Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Victoria, Australia.
Rheumatology (Oxford). 2020 Jan 1;59(1):185-193. doi: 10.1093/rheumatology/kez266.
To examine the association of metabolic syndrome (MetS) and its components with knee cartilage volume loss and bone marrow lesion (BML) change.
Longitudinal data on 435 participants from a population-based cohort study were analysed. Blood pressure, glucose, triglycerides and high-density lipoprotein (HDL) were collected. MetS was defined based on the National Cholesterol Education Program-Adult Treatment Panel III criteria. MRI of the right knee was performed to measure cartilage volume and BML. Radiographic knee OA was assessed by X-ray and graded using the Altman atlas for osteophytes and joint space narrowing.
Thirty-two percent of participants had MetS and 60% had radiographic knee OA. In multivariable analysis, the following were independently associated with medial tibial cartilage volume loss: MetS, β = -0.30%; central obesity, β = -0.26%; and low HDL, β = -0.25% per annum. MetS, hypertriglyceridaemia and low HDL were also associated with higher risk of BML size increase in the medial compartment (MetS: relative risk 1.72, 95% CI 1.22, 2.43; hypertriglyceridaemia: relative risk 1.43, 95% CI 1.01, 2.02; low HDL: relative risk 1.67, 95% CI 1.18, 2.36). After further adjustment for central obesity or BMI, MetS and low HDL remained statistically significant for medial tibial cartilage volume loss and BML size increase. The number of components of MetS correlated with greater cartilage volume loss and BML size increase (both P for trend <0.05). There were no statistically significant associations in the lateral compartment.
MetS and low HDL are associated with medial compartment cartilage volume loss and BML size increase, suggesting that targeting these factors has the potential to prevent or slow knee structural change.
探讨代谢综合征（MetS）及其组分与膝关节软骨体积丢失和骨髓病变（BML）变化的关系。
对一项基于人群的队列研究中的 435 名参与者的纵向数据进行了分析。采集血压、血糖、甘油三酯和高密度脂蛋白（HDL）数据。MetS 根据国家胆固醇教育计划-成人治疗小组 III 标准定义。对右膝关节进行 MRI 检查以测量软骨体积和 BML。X 射线评估放射学膝关节骨关节炎，并使用 Altman 骨赘和关节间隙狭窄图谱进行分级。
32%的参与者患有 MetS，60%的参与者患有放射学膝关节骨关节炎。在多变量分析中，以下因素与内侧胫骨软骨体积丢失独立相关：MetS，β=-0.30%；中心性肥胖，β=-0.26%；以及低 HDL，β=-0.25%/年。MetS、高甘油三酯血症和低 HDL 也与内侧胫骨 BML 大小增加的风险增加相关（MetS：相对风险 1.72，95%CI 1.22，2.43；高甘油三酯血症：相对风险 1.43，95%CI 1.01，2.02；低 HDL：相对风险 1.67，95%CI 1.18，2.36）。在进一步调整中心性肥胖或 BMI 后，MetS 和低 HDL 与内侧胫骨软骨体积丢失和 BML 大小增加仍具有统计学意义。MetS 的组分数量与更大的软骨体积丢失和 BML 大小增加相关（趋势 P 值均<0.05）。在外侧胫骨中未观察到统计学显著的相关性。
MetS 和低 HDL 与内侧胫骨软骨体积丢失和 BML 大小增加相关，表明针对这些因素有可能预防或减缓膝关节结构变化。
