Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea.
Int J Rheum Dis. 2022 Feb;25(2):192-200. doi: 10.1111/1756-185X.14255. Epub 2021 Dec 7.
Metabolic syndrome is a major health problem worldwide associated with obesity, thus drawing attention to its relation to osteoarthritis (OA). However, it is still uncertain whether metabolic syndrome or body fat distribution is associated with knee OA. The aim of this longitudinal study was to elucidate the association between metabolic obesity and adverse structural changes of knee OA assessed by magnetic resonance imaging (MRI).
Participants were recruited from the Hallym Aging Study cohort in Korea. Knee MRI scans, along with dual-energy X-ray absorptiometry, were assessed in 226 participants at baseline and after 3 years. The structural progression in the tibiofemoral joint was evaluated using the semi-quantitative Whole-Organ MRI Score (WORMS) for cartilage morphology and bone marrow lesions (BML). Logistic regression with generalized estimating equation was performed for associations of metabolic risk factors with worsening of WORMS scores at the subregional level.
In the medial compartment, fat mass in women was associated with cartilage loss, but the statistical significance disappeared after adjusting for body mass index. Metabolic syndrome and each of its components were not associated with cartilage loss or increase of BML. On the other hand, the interaction effects of metabolic syndrome on the association between obesity and knee OA progression were not significant.
In this cohort, metabolic effects of obesity on knee cartilage damage and BML were not demonstrated. Further large-scale studies are required to prove the causal relationship between metabolic obesity and knee OA.
代谢综合征是一个全球性的重大健康问题，与肥胖有关，因此引起了人们对其与骨关节炎（OA）关系的关注。然而，代谢综合征或体脂分布与膝骨关节炎之间的关系仍不确定。本纵向研究的目的是阐明代谢性肥胖与磁共振成像（MRI）评估的膝骨关节炎不良结构变化之间的关系。
参与者来自韩国 Hallym 衰老研究队列。在基线和 3 年后，对 226 名参与者进行了膝关节 MRI 扫描和双能 X 射线吸收法检查。使用全关节 MRI 评分（WORMS）对软骨形态和骨髓病变（BML）进行半定量评估，以评估胫股关节的结构进展。采用广义估计方程的逻辑回归分析代谢危险因素与 WORMS 评分亚区水平恶化的相关性。
在女性的内侧关节中，脂肪量与软骨丢失有关，但在调整体重指数后，统计学意义消失。代谢综合征及其各组成部分与软骨丢失或 BML 增加无关。另一方面，代谢综合征对肥胖与膝骨关节炎进展之间关联的交互作用不显著。
在本队列中，肥胖对膝关节软骨损伤和 BML 的代谢影响未得到证实。需要进一步的大规模研究来证明代谢性肥胖与膝骨关节炎之间的因果关系。
