Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, unité de nutrition humaine, INRA, Université Clermont Auvergne, F-63003, Clermont-Ferrand, France.
Service de santé publique, CHU Clermont-Ferrand, F-63003, Clermont-Ferrand, France.
Sci Rep. 2020 Feb 27;10(1):3601. doi: 10.1038/s41598-020-60587-1.
Obesity is one of the most important risk factors of knee osteoarthritis (KOA), but its impact on clinical and functional consequences is less clear. The main objective of this cross-sectional study was to describe the relation between body mass index (BMI) and clinical expression of KOA. Participants with BMI ≥ 25 kg/m and KOA completed anonymous self-administered questionnaires. They were classified according to BMI in three groups: overweight (BMI 25-30 kg/m), stage I obesity (BMI 30-35 kg/m) and stage II/III obesity (BMI ≥ 35 kg/m). The groups were compared in terms of pain, physical disability, level of physical activity (PA) and fears and beliefs concerning KOA. Among the 391 individuals included, 57.0% were overweight, 28.4% had stage I obesity and 14.6% had stage II/III obesity. Mean pain score on a 10-point visual analog scale was 4.3 (SD 2.4), 5.0 (SD 2.6) and 5.2 (SD 2.3) with overweight, stage I and stage II/III obesity, respectively (p = 0.0367). The mean WOMAC function score (out of 100) was 36.2 (SD 20.1), 39.5 (SD 21.4) and 45.6 (SD 18.4), respectively (p = 0.0409). The Knee Osteoarthritis Fears and Beliefs Questionnaire total score (KOFBEQ), daily activity score and physician score significantly differed among BMI groups (p = 0.0204, p = 0.0389 and p = 0.0413, respectively), and the PA level significantly differed (p = 0.0219). We found a dose-response relation between BMI and the clinical consequences of KOA. Strategies to treat KOA should differ by obesity severity. High PA level was associated with low BMI and contributes to preventing the clinical consequences of KOA.
肥胖是膝骨关节炎（KOA）最重要的危险因素之一，但它对临床和功能后果的影响尚不清楚。本横断面研究的主要目的是描述体重指数（BMI）与 KOA 临床表现之间的关系。BMI≥25kg/m 且患有 KOA 的参与者完成了匿名自我管理问卷。他们根据 BMI 分为三组：超重（BMI 25-30kg/m）、I 期肥胖（BMI 30-35kg/m）和 II/III 期肥胖（BMI≥35kg/m）。比较了三组的疼痛、身体残疾、身体活动（PA）水平以及对 KOA 的恐惧和信念。在纳入的 391 名个体中，57.0%超重，28.4%I 期肥胖，14.6%II/III 期肥胖。10 分视觉模拟量表上的平均疼痛评分分别为超重组 4.3（SD 2.4）、I 期肥胖组 5.0（SD 2.6）和 II/III 期肥胖组 5.2（SD 2.3）（p=0.0367）。WOMAC 功能评分（满分 100）的平均值分别为超重组 36.2（SD 20.1）、I 期肥胖组 39.5（SD 21.4）和 II/III 期肥胖组 45.6（SD 18.4）（p=0.0409）。Knee Osteoarthritis Fears and Beliefs Questionnaire 总评分（KOFBEQ）、日常活动评分和医生评分在 BMI 组之间存在显著差异（p=0.0204、p=0.0389 和 p=0.0413），PA 水平也存在显著差异（p=0.0219）。我们发现 BMI 与 KOA 临床后果之间存在剂量反应关系。治疗 KOA 的策略应根据肥胖程度的不同而有所区别。高 PA 水平与低 BMI 相关，有助于预防 KOA 的临床后果。
