Boston University, Boston, Massachusetts.
University of California, San Francisco.
Arthritis Care Res (Hoboken). 2022 Feb;74(2):274-280. doi: 10.1002/acr.24455. Epub 2022 Jan 8.
Studies suggest an association between elevated total serum cholesterol, particularly low-density lipoprotein (LDL), and osteoarthritis (OA). The present study was undertaken to evaluate the association between total cholesterol, LDL, and high-density lipoprotein (HDL) and risk of knee OA.
We studied participants from the Multicenter Osteoarthritis study (MOST) cohort at risk of developing knee OA. From baseline through 7 years, repeated knee radiographs and magnetic resonance images (MRIs) were obtained, and knee symptoms were queried. From baseline fasting blood samples, lipids and lipoproteins were analyzed using standard assays. After excluding participants with baseline OA, we defined 2 sets of patients: those developing radiographic OA, and those developing symptomatic OA (knee pain and radiographic OA). Controls did not develop these outcomes. Additionally, we examined worsening of cartilage loss and synovitis on MRI and of knee pain using the Western Ontario and McMaster Universities Osteoarthritis Index scale. We carried out logistic regression adjusting for age, sex, body mass index, education, baseline pain, and depressive symptoms, testing total cholesterol and lipoproteins as continuous measures, and we performed sensitivity analyses examining whether commonly used thresholds for high cholesterol, LDL, or low HDL increased risk.
We studied 337 patients with incident symptomatic OA and 283 patients with incident radiographic OA. The mean age at baseline was 62 years (55% women). Neither total cholesterol, LDL, nor HDL showed a significant association with radiographic or symptomatic OA. Additionally, we found no association of these lipid measures with cartilage loss, worsening synovitis, or worsening knee pain.
Our data do not support an association between total cholesterol, LDL, or HDL with OA outcomes.
研究表明，总血清胆固醇升高，尤其是低密度脂蛋白（LDL），与骨关节炎（OA）有关。本研究旨在评估总胆固醇、LDL 和高密度脂蛋白（HDL）与膝关节 OA 风险之间的关系。
我们研究了多中心骨关节炎研究（MOST）队列中处于膝关节 OA 发病风险的参与者。从基线到 7 年，重复进行膝关节 X 射线和磁共振成像（MRI）检查，并询问膝关节症状。从基线空腹血样中，使用标准检测方法分析血脂和脂蛋白。在排除基线 OA 患者后，我们定义了两组患者：出现放射学 OA 的患者和出现症状性 OA（膝关节疼痛和放射学 OA）的患者。对照组未出现这些结局。此外，我们还检查了 MRI 上软骨丢失和滑膜炎的恶化以及使用西安大略和麦克马斯特大学骨关节炎指数量表的膝关节疼痛恶化情况。我们进行了逻辑回归分析，调整了年龄、性别、体重指数、教育程度、基线疼痛和抑郁症状，以连续测量的方式检验总胆固醇和脂蛋白，并进行了敏感性分析，以检验常用的高胆固醇、LDL 或低 HDL 阈值是否会增加风险。
我们研究了 337 例新发症状性 OA 患者和 283 例新发放射学 OA 患者。基线时的平均年龄为 62 岁（55%为女性）。总胆固醇、LDL 或 HDL 均与放射学或症状性 OA 无显著相关性。此外，我们还发现这些血脂指标与软骨丢失、滑膜炎恶化或膝关节疼痛恶化均无关联。
我们的数据不支持总胆固醇、LDL 或 HDL 与 OA 结局之间存在关联。
