University of Minnesota School of Public Health, Minneapolis.
Boston University School of Medicine and School of Public Health, Boston, Massachusetts.
Arthritis Care Res (Hoboken). 2021 Mar;73(3):318-327. doi: 10.1002/acr.24252.
To examine the association between weight change from young adulthood to midlife and the risk of incident arthritis.
Using data from the National Health and Nutrition Examination Survey, we categorized participants into weight-change categories based on their recalled weight during young adulthood and midlife. We estimated the association of weight change and developing an arthritis condition over 10 years using adjusted Cox models. Findings were extrapolated to the US population to determine the proportion of incident arthritis cases that could be averted if the entire population maintained a normal body mass index (BMI) in young adulthood and midlife.
Among our sample of adults who were ages 40-69 years at their midlife weight measure (n = 13,669), 3,603 developed an arthritis condition. Compared with adults who maintained a normal-normal BMI, the normal-overweight, normal-obese, overweight-obese, and obese-obese groups had a significantly elevated risk of incident arthritis conditions. The obese-overweight group had a lower risk of incident arthritis conditions compared with the obese-obese group and a comparable risk to the overweight-overweight group. Nearly one-fourth of incident arthritis cases, corresponding to 2.7 million individuals, would have been averted under the hypothetical scenario where all individuals maintained normal weight from young adulthood to midlife.
Weight loss from young adulthood to midlife was associated with a substantially reduced risk of developing an arthritis condition. We found no evidence of residual risk from having been heavier earlier in life. Our findings highlight the critical need to expand obesity treatment and prevention to achieve meaningful reductions in the burden of arthritis.
探讨从青年期到中年期体重变化与关节炎发病风险的关系。
利用国家健康和营养调查的数据，我们根据参与者在青年期和中年期回忆的体重，将其分为体重变化类别。我们使用调整后的 Cox 模型估计体重变化与 10 年内关节炎发病的相关性。将研究结果外推至美国人群，以确定如果整个人群在青年期和中年期保持正常体重指数（BMI），可以预防多少例新发关节炎病例。
在我们的中年体重测量（n=13669）年龄在 40-69 岁的成年人样本中，有 3603 人患有关节炎。与保持正常-正常 BMI 的成年人相比，正常-超重、正常-肥胖、超重-肥胖和肥胖-肥胖组发生关节炎的风险显著升高。与肥胖-肥胖组相比，肥胖-超重组发生关节炎的风险较低，与超重-超重组的风险相当。在假设所有个体从青年期到中年期都保持正常体重的情况下，近四分之一（270 万人）的新发关节炎病例可以预防。
从青年期到中年期的体重减轻与关节炎发病风险显著降低相关。我们没有发现早期体重较重会残留风险的证据。我们的研究结果强调了扩大肥胖治疗和预防的必要性，以实现关节炎负担的显著减轻。
