Davis M A, Ettinger W H, Neuhaus J M, Hauck W W
Department of Epidemiology and International Health, School of Medicine, University of California, San Francisco 94143-0560.
Am J Epidemiol. 1988 May;127(5):1019-30. doi: 10.1093/oxfordjournals.aje.a114878.
This study investigated the role of obesity (body mass index, total body weight, triceps skinfold, subscapular skinfold) compared with other anthropometric variables (body fat distribution, muscularity, elbow breadth, bitrochanteric breadth) in order to explain previously noted sex differences in osteoarthritis of the knee. Anthropometric measures, self-reported symptoms, and knee x-ray data were analyzed for 3,905 adults aged 45-74 years with valid x-ray data from the First National Health and Nutrition Examination Survey, 1971-1975. Prevalence of knee osteoarthritis was 4.9% in women and 2.6% in men. The relative risk for women compared with men increased from 1.57 at 45-54 years to 2.14 at 65-74 years. Adjusting for body mass index and subscapular and triceps skinfolds reduced the sex difference, whereas adjusting for total body weight, body fat distribution, muscularity, and skeletal size increased the sex difference. Body mass index was the variable that best reduced the sex difference when the other variables were included in the analysis; it did not, however, eliminate the sex difference. No sex differences were found in the strength of the association between anthropometric variables and osteoarthritis, nor was there evidence to suggest that obesity is a consequence of knee osteoarthritis rather than a risk factor.
本研究调查了肥胖（体重指数、总体重、肱三头肌皮褶厚度、肩胛下皮褶厚度）与其他人体测量学变量（体脂分布、肌肉量、肘宽、大转子间宽）相比在解释先前已注意到的膝关节骨关节炎性别差异方面的作用。对来自1971 - 1975年第一次全国健康和营养检查调查的3905名45 - 74岁有有效X线数据的成年人的人体测量指标、自我报告症状和膝关节X线数据进行了分析。膝关节骨关节炎的患病率在女性中为4.9%，在男性中为2.6%。女性与男性相比的相对风险从45 - 54岁时的1.57增加到65 - 74岁时的2.14。对体重指数、肩胛下和肱三头肌皮褶厚度进行调整可减小性别差异，而对总体重、体脂分布、肌肉量和骨骼大小进行调整则会增大性别差异。当分析中纳入其他变量时，体重指数是最能减小性别差异的变量；然而，它并未消除性别差异。在人体测量学变量与骨关节炎之间的关联强度方面未发现性别差异，也没有证据表明肥胖是膝关节骨关节炎的结果而非风险因素。
