Department of Rheumatology.
Department of Radiology.
Rheumatology (Oxford). 2021 Jul 1;60(7):3268-3277. doi: 10.1093/rheumatology/keaa778.
We investigated the role of blood pressure, vessel wall stiffness [pulse wave velocity (PWV)] and subclinical atherosclerosis markers [carotid intima-media thickness (cIMT), popliteal vessel wall thickness (pVWT)] as mediators of the association of obesity with OA.
We used cross-sectional data from a subset of the population-based NEO study (n = 6334). We classified clinical hand and knee OA by the ACR criteria, and structural knee OA, effusion and bone marrow lesions on MRI (n = 1285). cIMT was assessed with ultrasonography. pVWT was estimated on knee MRI (n = 1285), and PWV by abdominal velocity-encoded MRIs (n = 2580), in subpopulations. Associations between BMI and OA were assessed with logistic regression analyses, adjusted for age, sex and education. Blood pressure, cIMT, pVWT and PWV were added to the model to estimate mediation.
The population consisted of 55% women, with a mean (s.d.) age of 56(6) years. Clinical hand OA was present in 8%, clinical knee OA in 10%, and structural knee OA in 12% of participants. BMI was positively associated with all OA outcomes. cIMT partially mediated the association of BMI with clinical hand OA [10.6 (6.2; 30.5)%], structural knee OA [3.1 (1.9; 7.3)%] and effusion [10.8 (6.0; 37.6)%]. Diastolic blood pressure [2.1 (1.6; 3.0)%] minimally mediated the association between BMI and clinical knee OA. PWV and pVWT did not mediate the association between BMI and OA.
cIMT and diastolic blood pressure minimally mediated the association of BMI with OA. This suggests that such mediation is trivial in the middle-aged population.
我们研究了血压、血管壁僵硬（脉搏波速度[PWV]）和亚临床动脉粥样硬化标志物（颈动脉内膜中层厚度[cIMT]、腘血管壁厚度[pVWT]）作为肥胖与 OA 相关性的中介因素的作用。
我们使用基于人群的 NEO 研究的亚组人群的横断面数据。我们根据 ACR 标准对临床手部和膝关节 OA 进行分类，并对膝关节 MRI 上的结构性膝关节 OA、积液和骨髓病变进行分类（n=1285）。使用超声评估 cIMT。在亚人群中，通过膝关节 MRI 估计 pVWT（n=1285），通过腹部速度编码 MRI 测量 PWV（n=2580）。使用逻辑回归分析评估 BMI 与 OA 之间的关联，调整年龄、性别和教育。将血压、cIMT、pVWT 和 PWV 添加到模型中以估计中介作用。
该人群由 55%的女性组成，平均（标准差）年龄为 56（6）岁。手部临床 OA 患病率为 8%，膝关节临床 OA 为 10%，结构性膝关节 OA 为 12%。BMI 与所有 OA 结局呈正相关。cIMT 部分中介了 BMI 与手部临床 OA [10.6（6.2；30.5）%]、结构性膝关节 OA [3.1（1.9；7.3）%]和积液 [10.8（6.0；37.6）%]之间的关联。舒张压[2.1（1.6；3.0）%]轻度中介了 BMI 与膝关节临床 OA 之间的关联。PWV 和 pVWT 并未介导 BMI 与 OA 之间的关联。
cIMT 和舒张压轻度中介了 BMI 与 OA 的关联。这表明在中年人群中这种中介作用微不足道。
