Department of Orthopaedic Surgery, Chungnam National University Hospital, Daejeon, Korea.
Department of Orthopaedic Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Clin Orthop Surg. 2021 Mar;13(1):60-66. doi: 10.4055/cios20111. Epub 2021 Feb 15.
Osteoarthritis (OA) and osteoporosis (OP) are the 2 most common bone disorders associated with aging. We can simply assume that older patients have a higher incidence of OA and OP with more severity. Although several papers have conducted studies on the relationship between OA and OP, none of them has demonstrated a conclusive link. In this study, we used radiological knee OA and bone mineral density (BMD; T-score of the total hip and lumbar spine) to analyze the incidence of OA and OP in a large population. We aimed to determine the relationship between OA and OP and investigate the associated risk factors.
This cross-sectional study used data extracted from the 2010-2012 Korea National Health and Nutrition Examination Survey. We evaluated a total of 4,250 participants aged ≥ 50 years who underwent knee radiography and dual-energy X-ray absorptiometry and their laboratory results. The relationship between radiological knee OA and BMD was assessed. The generalized linear model was used to evaluate the relationship between BMD and Kellgren-Lawrence (KL) grade.
The higher KL grade was associated with older age, higher body mass index (BMI), female sex, and lower hemoglobin level ( < 0.001). No significant association was found between OA and the following variables: white blood cell, platelet, total cholesterol, vitamin D, alkaline phosphatase, parathyroid hormone, hypertension, diabetes, asthma, dyslipidemia, smoking status, alcohol consumption, and regular exercise ( > 0.05). After adjusting for confounding factors (age, BMI, diabetes, hypertension, smoking, and alcohol consumption), the average T-scores of total hip and lumbar spine were the highest in the mild OA group with KL grade 2 (-0.22 ± 1.08 and -0.89 ± 1.46, respectively, < 0.001). The average T-scores of the total hip and lumbar spine significantly decreased as OA progressed from moderate (KL grade 3; -0.49 ± 1.05 and -1.33 ± 1.38, respectively, < 0.001) to severe (KL grade 4; -0.73 ± 1.13 and -1.74 ± 1.75, respectively, < 0.001). T-scores of the moderate-to-severe OA group were significantly lower than those of the non-OA group (KL grades 0 and 1, < 0.001).
Compared with the non-OA group, BMD (T-scores of the total hip and lumbar spine) was higher in the mild OA group and lower in the moderate-to-severe OA group.
骨关节炎（OA）和骨质疏松症（OP）是与衰老相关的两种最常见的骨骼疾病。我们可以简单地假设，年龄较大的患者 OA 和 OP 的发病率更高，且病情更严重。尽管有几篇论文对 OA 和 OP 之间的关系进行了研究，但没有一篇论文证明两者之间存在明确的联系。在这项研究中，我们使用放射学膝关节 OA 和骨密度（BMD；总髋部和腰椎的 T 评分）来分析大量人群中 OA 和 OP 的发病率。我们旨在确定 OA 和 OP 之间的关系，并研究相关的危险因素。
本横断面研究使用了 2010-2012 年韩国国家健康和营养检查调查中提取的数据。我们评估了总共 4250 名年龄≥50 岁的参与者，他们接受了膝关节放射摄影和双能 X 射线吸收法检查，并进行了实验室检查。评估了放射学膝关节 OA 与 BMD 之间的关系。使用广义线性模型评估了 BMD 与 Kellgren-Lawrence（KL）分级之间的关系。
较高的 KL 分级与年龄较大、体重指数（BMI）较高、女性和较低的血红蛋白水平有关（<0.001）。OA 与以下变量之间无显著相关性：白细胞、血小板、总胆固醇、维生素 D、碱性磷酸酶、甲状旁腺激素、高血压、糖尿病、哮喘、血脂异常、吸烟状况、饮酒和定期运动（>0.05）。在调整混杂因素（年龄、BMI、糖尿病、高血压、吸烟和饮酒）后，KL 分级 2 级（轻度 OA）的总髋部和腰椎 T 评分最高（分别为-0.22±1.08 和-0.89±1.46，均<0.001）。随着 OA 从中度（KL 分级 3）进展到重度（KL 分级 4），总髋部和腰椎的 T 评分均显著降低（分别为-0.49±1.05 和-1.33±1.38，均<0.001）。中重度 OA 组的 T 评分明显低于非 OA 组（KL 分级 0 和 1，均<0.001）。
与非 OA 组相比，轻度 OA 组的 BMD（总髋部和腰椎 T 评分）较高，而中重度 OA 组的 BMD 较低。
