Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Osteoarthritis Cartilage. 2020 Apr;28(4):410-417. doi: 10.1016/j.joca.2020.01.006. Epub 2020 Jan 31.
Weight loss has beneficial effects on clinical outcomes in knee osteoarthritis (OA), but the mechanism is still unclear. Since meniscus extrusion is associated with knee pain, this study assessed whether weight loss by diet and/or exercise is associated with less progression in meniscus extrusion measures over time.
The Intensive Diet and Exercise for Arthritis trial (IDEA) was a prospective, single-blind, randomized-controlled trial including overweight and obese older adults with knee pain and radiographic OA. Participants were randomized to 18-month interventions: exercise only, diet only or diet + exercise. In a random subsample of 105 participants, MRIs were obtained at baseline and follow-up. The medial and lateral menisci were segmented and quantitative position and size measures were obtained, along with semiquantitative extrusion measures. Linear and log-binomial regression were used to examine the association between change in weight and change in meniscus measures. Between-group differences were analyzed using an analysis of covariance.
Weight loss was associated with less progression over time of medial meniscus extrusion as measured by the maximum (β: -24.59 μm, 95%CI: -41.86, -7.33) and mean (β: -19.08 μm, 95%CI: -36.47, -1.70) extrusion distances. No relationships with weight loss were observed for lateral meniscus position, medial or lateral meniscus size or semiquantitative measures. Change in meniscus position and size did not differ significantly between groups.
Weight loss was associated with beneficial modifications of medial meniscus extrusion over 18 months. This may be one of the mechanisms by which weight loss translates into a clinical benefit.
NCT00381290.
体重减轻对膝骨关节炎（OA）的临床结局有有益影响，但机制尚不清楚。由于半月板挤出与膝关节疼痛有关，本研究评估了通过饮食和/或运动减轻体重是否与半月板挤出测量值随时间的进展程度降低相关。
关节炎强化饮食和运动试验（IDEA）是一项前瞻性、单盲、随机对照试验，纳入了超重和肥胖、膝关节疼痛和放射学 OA 的老年患者。参与者被随机分配到 18 个月的干预措施：仅运动、仅饮食或饮食+运动。在 105 名随机亚组参与者中，在基线和随访时获得了 MRI。对内侧和外侧半月板进行分割，并获得了定量位置和大小测量值，以及半定量挤出测量值。线性和对数二项式回归用于检查体重变化与半月板测量值变化之间的关系。使用协方差分析分析组间差异。
体重减轻与内侧半月板挤出的最大（β：-24.59μm，95%CI：-41.86，-7.33）和平均（β：-19.08μm，95%CI：-36.47，-1.70）挤出距离随时间的进展呈负相关。体重减轻与外侧半月板位置、内侧或外侧半月板大小或半定量测量值之间无相关性。半月板位置和大小的变化在组间无显著差异。
体重减轻与 18 个月内侧半月板挤出的有益改变有关。这可能是体重减轻转化为临床益处的机制之一。
NCT00381290。
