骨密度与男性和女性膝关节骨关节炎发展的关系：使用第四次和第五次韩国国家健康和营养检查调查的横断面研究。

Association of bone mineral density with the development of knee osteoarthritis in men and women: a cross-sectional study using the fourth and fifth Korea National Health and Nutrition Examination Surveys.

机构信息

Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.

Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, South Korea.

出版信息

Arch Osteoporos. 2020 Jul 27;15(1):117. doi: 10.1007/s11657-020-00793-6.

DOI:10.1007/s11657-020-00793-6

PMID:32720172

Abstract

UNLABELLED

Bone mineral density (BMD) and osteoarthritis (OA) were correlated but the relationship was varied according to sex. An association between lumbar spine and femur neck BMDs and OA showed a positive relation in women, while lumbar spine and pelvis BMDs in men were associated with OA with a negative relation.

PURPOSE

The purpose of this study was to evaluate the association of BMD in various body parts in conjunction with the presence or severity of radiographic knee osteoarthritis (KOA) in relation to sex.

METHODS

This study was a cross-sectional analysis using Korea National Health and Nutrition Examination Surveys. KOA was graded using the Kellgren-Lawrence (KL) grading system. Radiographic KOA was defined as a KL grade 2 or higher. The associations between KOA and BMD in certain body parts (femur, pelvis, lumbar, lower leg, and whole-body) were assessed. BMD was measured using dual-energy X-ray absorptiometry. The BMD of each body part was divided into quartiles and the relationship between KOA and BMD was examined according to sex.

RESULTS

BMD did not show a significant tendency according to KL grade in either sex. In men, the severity of KL grade have a statistically significant relationship with total femur (R = 0.303, p < 0.05), femur neck (R = 0.257, p < 0.05), lumbar (R = 0.137, p < 0.05), and pelvis BMD (R = 0.185, p < 0.05). In women, total femur (R = 0.466, p < 0.05), lumbar (R = 0.316, p < 0.05), pelvis (R = 0.343, p < 0.05), and lower leg BMD (R = 0.133, p < 0.05) were associated with the severity of KL grade. When the BMD was divided into quartiles, lumbar (p < 0.05) and pelvis BMD (p < 0.05) in men had statistically significant association with knee OA as BMD decreased. In women, femur neck (p < 0.05) and lumbar BMD (p < 0.05) were significantly associated with knee OA as BMD increased.

CONCLUSION

The relationship between BMD and OA severity varied according to sex. In women, there was a positive association between femur neck and lumbar BMD and OA, while BMD of the lumbar and pelvis in men was negatively correlated with OA.

LEVEL OF EVIDENCE

Cohort study, III.

摘要

目的

本研究旨在评估不同身体部位的骨密度（BMD）与放射学膝关节骨关节炎（KOA）的存在或严重程度与性别之间的关联。

方法

本研究为使用韩国国家健康和营养检查调查进行的横断面分析。使用 Kellgren-Lawrence（KL）分级系统对 KOA 进行分级。放射学 KOA 定义为 KL 分级 2 或更高。评估 KOA 与特定身体部位（股骨、骨盆、腰椎、小腿和全身）的 BMD 之间的关联。使用双能 X 射线吸收法测量 BMD。将每个身体部位的 BMD 分为四分之一，并根据性别检查 KOA 与 BMD 的关系。

结果

在两性中，BMD 均未表现出与 KL 分级相关的显著趋势。在男性中，KL 分级的严重程度与全股骨（R=0.303，p<0.05）、股骨颈（R=0.257，p<0.05）、腰椎（R=0.137，p<0.05）和骨盆 BMD（R=0.185，p<0.05）有统计学显著关系。在女性中，全股骨（R=0.466，p<0.05）、腰椎（R=0.316，p<0.05）、骨盆（R=0.343，p<0.05）和小腿 BMD（R=0.133，p<0.05）与 KL 分级的严重程度相关。当 BMD 分为四分之一时，男性的腰椎（p<0.05）和骨盆 BMD（p<0.05）与随着 BMD 降低，膝关节 OA 有统计学显著关联。在女性中，股骨颈（p<0.05）和腰椎 BMD（p<0.05）与随着 BMD 增加，膝关节 OA 有显著关联。