Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands.
Department of Internal Medicine, Medisch Spectrum Twente, the Netherlands.
Osteoarthritis Cartilage. 2019 Dec;27(12):1761-1767. doi: 10.1016/j.joca.2019.08.003. Epub 2019 Aug 23.
To investigate associations of leptin and adiponectin levels with knee and hand osteoarthritis, and explore whether these mediate the association between adiposity and osteoarthritis.
This is a cross-sectional analysis of baseline data from the population-based Netherlands Epidemiology of Obesity study. Adiposity was assessed with body mass index (BMI) and percentage total body fat (%TBF). Osteoarthritis, defined as hand or knee osteoarthritis, was determined using American College of Rheumatology criteria. Fasting serum adipokine levels were measured using immunoassays. Associations between adiposity and osteoarthritis were examined with logistic regression, adjusted for age, sex, ethnicity and education, and additionally for leptin and adiponectin as potential mediators.
In 6408 participants (56% women, median age 56 years), prevalence of osteoarthritis was 22% (10% isolated knee and 8% isolated hand osteoarthritis). Leptin levels were positively associated with osteoarthritis, while adiponectin levels were not. Leptin partially mediated the association of adiposity with osteoarthritis (OR 1.40 (95%CI 1.30; 1.52) attenuated to 1.38 (1.24; 1.54) per 5 units BMI and OR 1.25 (1.17; 1.35) to 1.20 (1.10; 1.32) per 5 units %TBF, representing 4% and 17% mediation, respectively). Larger proportion mediation by leptin was found in knee (13%/27%) than in hand osteoarthritis (9%/18%). Sex-stratified analyses generally showed stronger associations between adiposity, leptin and osteoarthritis in women than in men.
Serum leptin levels were associated with osteoarthritis, and partially mediated the association between adiposity and osteoarthritis, while adiponectin levels were not associated with osteoarthritis. These findings provide evidence for systemic effects of adipose tissue in osteoarthritis.
探讨瘦素和脂联素水平与膝和手骨关节炎的关系，并探讨这些因子是否介导肥胖与骨关节炎之间的关联。
这是一项基于人群的荷兰肥胖症流行病学研究的基线数据的横断面分析。采用体重指数（BMI）和体脂肪百分比（%TBF）评估肥胖程度。骨关节炎的定义为手或膝骨关节炎，采用美国风湿病学会标准确定。采用免疫分析法测定空腹血清脂联素水平。采用逻辑回归法，在调整年龄、性别、种族和教育程度的基础上，进一步调整瘦素和脂联素作为潜在的中介因素，分析肥胖程度与骨关节炎之间的关系。
在 6408 名参与者（56%为女性，中位年龄 56 岁）中，骨关节炎的患病率为 22%（10%为孤立性膝骨关节炎，8%为孤立性手骨关节炎）。瘦素水平与骨关节炎呈正相关，而脂联素水平则无相关性。瘦素部分介导了肥胖与骨关节炎之间的关联（OR 1.40（95%CI 1.30；1.52）减弱至 5 个 BMI 单位的 1.38（1.24；1.54）和 5 个 %TBF 单位的 1.25（1.17；1.35），分别代表 4%和 17%的中介作用）。瘦素介导的比例在膝骨关节炎（13%/27%）中高于手骨关节炎（9%/18%）。性别分层分析结果表明，肥胖、瘦素与骨关节炎之间的关联在女性中比男性中更强。
血清瘦素水平与骨关节炎相关，部分介导了肥胖与骨关节炎之间的关联，而脂联素水平与骨关节炎无关。这些发现为脂肪组织在骨关节炎中的全身作用提供了证据。
