Brigham and Women's Hospital, Harvard Medical School and Boston University School of Public Health, Boston, Massachusetts.
Brigham and Women's Hospital, Boston, Massachusetts.
Arthritis Care Res (Hoboken). 2020 Oct;72(10):1349-1357. doi: 10.1002/acr.24035.
One-half of the 14 million persons in the US with knee osteoarthritis (OA) are not physically active, despite evidence that physical activity (PA) is associated with improved health. We undertook this study to estimate both the quality-adjusted life-year (QALY) losses in a US population with knee OA due to physical inactivity and the health benefits associated with higher PA levels.
We used data from the Osteoarthritis Initiative and the Centers for Disease Control and Prevention to estimate the proportions of a US population with knee OA ages ≥45 years that are inactive, insufficiently active, and active, and the likelihood of a shift in their PA level. We used the OA Policy Model, a computer simulation of knee OA, to determine QALYs lost due to inactivity and to measure potential benefits of increased PA (comorbidities averted and QALYs saved).
Among 13.7 million persons with knee OA, a total of 7.5 million QALYs, or 0.55 QALYs per person, were lost due to inactivity or insufficient PA relative to activity over their remaining lifetimes. Black Hispanic women experienced the highest losses, at 0.76 QALYs per person. Women of all races/ethnicities had ~20% higher loss burdens than men. According to our model, if 20% of the inactive population were instead active, 95,920 cases of cancer, 222,413 of cardiovascular disease, and 214,725 of diabetes mellitus would potentially be averted, and 871,541 potential QALYs would be saved.
Physical inactivity leads to substantial QALY losses in a US population with knee OA. Increases in the activity levels in even a fraction of this population may have considerable collateral health benefits, potentially averting cases of cancer, cardiovascular disease, and diabetes mellitus.
在美国，有 1400 万人患有膝关节骨关节炎（OA），其中有一半人不进行身体活动，尽管有证据表明身体活动（PA）与改善健康有关。我们进行这项研究是为了估计由于身体不活动而导致的美国膝关节 OA 人群的质量调整生命年（QALY）损失，以及与更高水平的 PA 相关的健康益处。
我们使用来自骨关节炎倡议和疾病控制与预防中心的数据来估计年龄≥45 岁的美国膝关节 OA 人群中不活动、活动不足和活动的比例，以及他们的活动水平变化的可能性。我们使用 OA 政策模型，这是一个膝关节 OA 的计算机模拟，来确定由于不活动而导致的 QALY 损失，并衡量增加 PA 的潜在益处（避免的合并症和节省的 QALY）。
在 1370 万患有膝关节 OA 的人群中，由于不活动或活动不足与活动相比，在他们的剩余寿命中总共损失了 750 万个 QALY，或每人 0.55 个 QALY。黑西班牙裔女性的损失最高，每人 0.76 个 QALY。所有种族/族裔的女性比男性的损失负担高约 20%。根据我们的模型，如果有 20%的不活跃人群改为活跃，那么可能会预防 95920 例癌症、222413 例心血管疾病和 214725 例糖尿病，并且可能会节省 871541 个潜在的 QALY。
身体不活动导致美国膝关节 OA 人群的大量 QALY 损失。即使在这部分人群中增加活动水平的一小部分，也可能带来相当大的健康益处，可能预防癌症、心血管疾病和糖尿病的发生。
