Samaan Sara F, Taha Sara I
Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Clin Med Insights Arthritis Musculoskelet Disord. 2022 May 24;15:11795441221097361. doi: 10.1177/11795441221097361. eCollection 2022.
Several studies have linked metabolic syndrome (MetS) to osteoarthritis (OA), but they have not looked into how MetS can affect the health-related quality of life (HRQOL) of OA individuals.
We aimed to assess the association of MetS and its components, including obesity, hypertension, hyperglycemia, and dyslipidemia, with HRQOL among Egyptians with knee OA.
This cross-sectional study comprised 116 adult Egyptian participants with knee OA. They were divided into 2 groups based on whether or not they had the MetS. All participants were subjected to a thorough medical history taking and a detailed medical examination. The Kellgren and Lawrence (K/L) scale evaluated OA in all individuals using anteroposterior knee radiographs. The Health Assessment Questionnaire-Disability Index (HAQ-DI) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess participants' HRQOL; their higher scores indicate more disability. Spearman rank and Pearson's correlation analyses were used to assess the association between variables.
Diabetes, hypertension, dyslipidemia, and obesity were significantly associated with the OA + MetS group with a prevalence of 77.6%, 82.8%, 77.6%, and 50.0%, respectively. According to the K/L scale, 70.7% of the OA + MetS group had grade IV knee affection. The HAQ-DI and WOMAC scores were significantly ( < .001) higher among the OA + MetS individuals compared with the OA individuals. Interleukin (IL)-6 serum levels were also significantly higher in the OA + MetS group ( = .036) and increased significantly with the more serious radiological damage and functional disability. We found significant positive correlations between HAQ-DI and WOMAC with waist circumference ( = .004, .001), as well as triglycerides ( = .006, .008), cholesterol ( = .041, .048), fasting blood sugar ( < .001, < .001) and significant negative correlations with high-density lipoprotein levels ( = .628, .002).
Individuals with knee OA with MetS showed more significant radiological damage, severe functional disability, and poor HRQOL. They also had higher levels of IL-6, which correlated significantly with the degree of disability, promoting it as a significant therapeutic target.
多项研究已将代谢综合征（MetS）与骨关节炎（OA）联系起来，但尚未研究MetS如何影响OA患者的健康相关生活质量（HRQOL）。
我们旨在评估MetS及其组成部分，包括肥胖、高血压、高血糖和血脂异常，与埃及膝关节OA患者HRQOL之间的关联。
这项横断面研究纳入了116名成年埃及膝关节OA患者。根据是否患有MetS将他们分为两组。所有参与者都接受了全面的病史采集和详细的体格检查。使用前后位膝关节X线片，通过凯尔格伦和劳伦斯（K/L）量表对所有个体的OA进行评估。采用健康评估问卷残疾指数（HAQ-DI）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）来评估参与者的HRQOL；分数越高表明残疾越严重。采用Spearman秩相关分析和Pearson相关分析来评估变量之间的关联。
糖尿病、高血压、血脂异常和肥胖与OA + MetS组显著相关，患病率分别为77.6%、82.8%、77.6%和50.0%。根据K/L量表，OA + MetS组中70.7%的患者膝关节病变为IV级。与OA患者相比，OA + MetS个体的HAQ-DI和WOMAC评分显著更高（<0.001）。OA + MetS组的白细胞介素（IL）-6血清水平也显著更高（=0.036），并且随着放射学损伤和功能残疾的加重而显著升高。我们发现HAQ-DI和WOMAC与腰围（=0.004，0.001）、甘油三酯（=0.006，0.008）、胆固醇（=0.041，0.048）、空腹血糖（<0.001，<0.001）之间存在显著正相关，与高密度脂蛋白水平存在显著负相关（=0.628，0.002）。
患有MetS的膝关节OA患者表现出更显著的放射学损伤、严重的功能残疾和较差的HRQOL。他们的IL-6水平也更高，且与残疾程度显著相关，这促使其成为一个重要的治疗靶点。
