Department of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden
Spenshult Research and Development Centre, Halmstad, Sweden.
BMJ Open. 2022 Jul 14;12(7):e057086. doi: 10.1136/bmjopen-2021-057086.
The overall objective in this study is to investigate the early development of radiographic knee osteoarthritis (OA) and its association with hand or/and knee OA, metabolic diseases, biomarkers, chronic pain, physical function and daily physical activity types.
The Halland osteoarthritis (HALLOA) cohort is a longitudinal cohort study that includes individuals with knee pain in the southwest of Sweden. Enrolment took place from 2017 to 2019. The inclusion criteria were current knee pain, with no former known radiographic knee OA and no cruciate ligament rupture or rheumatological disorder. The participants were recruited: (1) when seeking care for knee pain in primary healthcare or (2) by advertisements in local newspapers. There are 306 individuals included in the study, mean age (SD) 51.7 (8.7) years and 69% are women. The baseline and follow-ups include clinical tests, radiographical examinations, blood samples, metabolic measures, pain pressure thresholds, tests of physical functions, daily physical activity types and patient-reported outcomes.
There were associations between metabolic factors and radiographic knee OA, even in those with normal body mass index at baseline. In addition, clinical hand OA was positively associated with fasting plasma glucose. We also found that modifiable factors as increased visceral fat and total body fat were associated with increased pain sensitivity among individuals with knee pain.
By studying possible pathophysiological mechanisms of OA over time, we aim to provide new insights on OA progression, identify usable preventive measures helping the clinicians in the management of the disease and improve health for the patients. It is also important to study the development of chronic pain in OA, to get tools to identify individuals at risk and to be able to offer them treatment.
ClinicalTrials.gov (NCT04928170).
本研究的总体目标是探讨放射学膝关节骨关节炎（OA）的早期发展及其与手部或/和膝关节 OA、代谢性疾病、生物标志物、慢性疼痛、身体功能和日常体力活动类型的关系。
哈兰骨关节炎（HALLOA）队列是一项纵向队列研究，包括瑞典西南部膝关节疼痛的个体。招募工作于 2017 年至 2019 年进行。纳入标准为当前膝关节疼痛，无先前已知的放射学膝关节 OA，无交叉韧带断裂或风湿性疾病。参与者通过以下两种方式入选：（1）在初级保健机构就诊时因膝关节疼痛；（2）在当地报纸上刊登广告。该研究共纳入 306 名参与者，平均年龄（标准差）为 51.7（8.7）岁，69%为女性。基线和随访包括临床检查、影像学检查、血液样本、代谢测量、疼痛压力阈值、身体功能测试、日常体力活动类型和患者报告的结果。
即使在基线时 BMI 正常的人群中，代谢因素与放射学膝关节 OA 之间也存在关联。此外，临床手部 OA 与空腹血糖呈正相关。我们还发现，可改变的因素，如内脏脂肪和全身脂肪的增加，与膝关节疼痛患者的疼痛敏感性增加有关。
通过研究 OA 随时间推移的可能病理生理机制，我们旨在提供对 OA 进展的新见解，确定有助于临床医生管理疾病的可用预防措施，并改善患者的健康状况。研究 OA 中慢性疼痛的发展也很重要，以便获得识别处于风险中的个体的工具，并能够为他们提供治疗。
ClinicalTrials.gov（NCT04928170）。
