Kinesiology Department, Seattle University, Seattle, WA, USA.
STAPS, Université Sorbonne Paris Nord, Bobigny, France; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France.
Clin Biomech (Bristol). 2023 Feb;102:105887. doi: 10.1016/j.clinbiomech.2023.105887. Epub 2023 Jan 11.
Early-onset osteoarthritis has been attributed to pro-inflammatory factors and biomechanical changes in obesity. However, research has yet to explore whether knee joint moments are asymmetrical in children with obesity and could precede the onset of knee osteoarthritis. The present study compares knee moment asymmetry between adolescents with and without obesity and examines the relationship between asymmetries and inflammatory biomarkers.
Twenty-eight adolescents (13-16 years) were classified as with (n = 12) or without (n = 16) obesity. Lower extremity kinetics were measured using three-dimensional motion analysis. Bilateral knee joint moments were analyzed in the sagittal, frontal, and transverse planes across stance phase. Kinetic asymmetry was calculated between the right and left sides and represented by the R value. Enzyme-linked immunosorbent assays analyzed serum 25-hydroxy vitamin D, interferon gamma, tumor nercrosis factor alpha, interleukin-6, and C-reactive protein levels. Parametric and non-parametric tests determined significant group differences in asymmetries and biomarkers, respectively. Spearman's correlations identified relationships between biomarkers and asymmetries with statistically significant group differences.
Adolescents with obesity had greater sagittal (loading, midstance) and frontal (midstance, pre-swing) plane kinetic knee asymmetry and higher concentrations of interleukin-6 and C-reactive protein. A moderately negative correlation existed between C-reactive protein and sagittal (loading, midstance) plane asymmetry, and also between interleukin-6 and frontal (pre-swing) plane asymmetry.
Inflammatory response increases with greater knee joint asymmetry, suggesting knee joint damage and altered joint loading co-exist in adolescents with obesity. Increased risk to joint health may exist in sub-phases where knee joints are improperly loaded.
早发性骨关节炎归因于肥胖中的促炎因子和生物力学变化。然而，目前还没有研究探讨肥胖儿童的膝关节力矩是否存在不对称性，以及这种不对称性是否可能先于膝关节骨关节炎的发生。本研究比较了肥胖和非肥胖青少年之间的膝关节力矩不对称性，并研究了不对称性与炎症生物标志物之间的关系。
将 28 名青少年（13-16 岁）分为肥胖组（n=12）和非肥胖组（n=16）。采用三维运动分析测量下肢动力学。在矢状面、额状面和横断面分析双侧膝关节力矩，在支撑相分析双侧膝关节力矩。通过 R 值计算左右侧之间的动力学不对称性。酶联免疫吸附试验分析血清 25-羟维生素 D、干扰素 γ、肿瘤坏死因子 α、白细胞介素 6 和 C 反应蛋白水平。分别采用参数和非参数检验确定不对称性和生物标志物在组间的显著差异。Spearman 相关分析确定具有统计学显著组间差异的生物标志物和不对称性之间的关系。
肥胖青少年在矢状面（负荷期、中间期）和额状面（中间期、预摆动期）平面的动力学膝关节力矩不对称性更大，白细胞介素 6 和 C 反应蛋白浓度更高。C 反应蛋白与矢状面（负荷期、中间期）平面不对称性之间存在中度负相关，白细胞介素 6 与额状面（预摆动期）平面不对称性之间也存在中度负相关。
炎症反应随着膝关节力矩不对称性的增加而增加，这表明肥胖青少年的膝关节损伤和关节负荷改变同时存在。在膝关节不正确加载的亚相中，关节健康的风险可能会增加。
