Wada Osamu, Yamada Minoru, Kamitani Tsukasa, Mizuno Kiyonori, Kurita Noriaki
Anshin Hospital, Kobe, Japan.
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.
Clin Rheumatol. 2021 Apr;40(4):1539-1546. doi: 10.1007/s10067-020-05419-3. Epub 2020 Sep 29.
INTRODUCTION/OBJECTIVES: This study examined whether phase angle (PhA) is associated with hip osteoarthritis (HOA) severity and quadriceps strength in patients with HOA.
A series of 549 patients with HOA, obtained from the Screening for People Suffering Sarcopenia in the Orthopedic cohort of Kobe study, were analyzed. PhA and quadriceps strength were measured using bioelectrical impedance analysis and a handheld dynamometer, respectively. The HOA severity was graded using the Kellgren-Lawrence radiographic scale. We estimated (1) mean differences in PhA by differences in HOA severity and (2) mean differences in quadriceps strength by differences in PhA using general linear models.
The patients' mean age was 64.9 years, and 85% were women. A decreasing trend of PhA associated with increasing HOA severity was observed (P for trend < 0.001). PhA was statistically associated with a decrease in HOA grade 4 compared with that associated with HOA grade 1 (mean difference, - 0.40°; 95% confidence interval (CI), - 0.51° to - 0.30°). PhA per leg was associated with greater quadriceps strength per leg independent of age, sex, leg muscle mass, and HOA severity (mean difference per 1° increase, 3.80 Nm; 95% CI, 0.93 to 6.66). There was insufficient evidence of any difference in the association between PhA and quadriceps strength by HOA severity and sex (P for interaction = 0.07 and 0.06, respectively).
PhA gradually decreased with increasing HOA severity, especially in patients with end-stage HOA. Paying close attention to PhA might provide a key to increasing quadriceps strength, regardless of HOA severity. Key Points • PhA gradually decreased with progression of HOA, particularly in patients with end-stage HOA. • PhA was positively associated with quadriceps strength, regardless of HOA severity. • PhA could be one of the indicators of quadriceps strength in patients with HOA.
引言/目的：本研究探讨了相位角（PhA）是否与髋骨关节炎（HOA）患者的HOA严重程度及股四头肌力量相关。
对从神户研究骨科队列中筛选出的549例HOA患者进行分析。分别使用生物电阻抗分析和手持测力计测量PhA和股四头肌力量。采用Kellgren-Lawrence放射学量表对HOA严重程度进行分级。我们使用一般线性模型估计（1）HOA严重程度差异导致的PhA平均差异，以及（2）PhA差异导致的股四头肌力量平均差异。
患者的平均年龄为64.9岁，85%为女性。观察到PhA随HOA严重程度增加而呈下降趋势（趋势P<0.001）。与HOA 1级相比，PhA与HOA 4级的降低在统计学上相关（平均差异，-0.40°；95%置信区间（CI），-0.51°至-0.30°）。每条腿的PhA与每条腿更大的股四头肌力量相关，独立于年龄、性别、腿部肌肉质量和HOA严重程度（每增加1°的平均差异，3.80 Nm；95%CI，0.93至6.66）。没有足够证据表明HOA严重程度和性别在PhA与股四头肌力量之间的关联存在差异（交互作用P分别为0.07和0.06）。
PhA随HOA严重程度增加而逐渐降低，尤其是在终末期HOA患者中。密切关注PhA可能为增加股四头肌力量提供关键，无论HOA严重程度如何。要点 • PhA随HOA进展逐渐降低，尤其是在终末期HOA患者中。• 无论HOA严重程度如何，PhA与股四头肌力量呈正相关。• PhA可能是HOA患者股四头肌力量的指标之一。
