Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Department of Clinical Immunology and Rheumatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Rheumatology & immunology Center, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands.
Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Department of Clinical Immunology and Rheumatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Rheumatology & immunology Center, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands.
Osteoarthritis Cartilage. 2023 Nov;31(11):1491-1500. doi: 10.1016/j.joca.2023.05.014. Epub 2023 Jun 14.
OBJECTIVE: To determine the effectiveness of the "Plants for Joints" multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA). DESIGN: Patients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0-96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences. RESULTS: Of the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6-16; p = 0.0001) compared to the control group. The intervention group also lost more weight (-5 kg), fat mass (-4 kg), and waist circumference (-6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups. CONCLUSION: The "Plants for Joints" lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.
目的：评估“关节植物”多学科生活方式方案在代谢综合征相关骨关节炎（MSOA）患者中的疗效。
设计：将髋或膝关节 MSOA 患者随机分为干预组或对照组。干预组在接受常规护理的基础上，还需遵循为期 16 周的方案，该方案基于全食物植物性饮食、身体活动和压力管理。对照组仅接受常规护理。主要结局为患者报告的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）总分（范围 0-96）。次要结局包括其他患者报告、人体测量和代谢指标。采用意向治疗分析，采用线性混合模型调整基线值，分析组间差异。
结果：在随机分组的 66 人中，有 64 人完成了研究。参与者（84%为女性）的平均（SD）年龄为 63（6）岁，体重指数为 33（5）kg/m²。16 周后，与对照组相比，干预组（n=32）的 WOMAC 评分平均改善了 11 分（95%CI 6-16；p=0.0001）。与对照组相比，干预组的体重（-5kg）、脂肪量（-4kg）和腰围（-6cm）也减少更多。与对照组相比，患者报告的健康测量信息系统（PROMIS）疲劳、疼痛干扰、C 反应蛋白、糖化血红蛋白、空腹血糖和低密度脂蛋白均有改善，而其他 PROMIS 指标、血压、高密度脂蛋白和甘油三酯在组间无显著差异。
结论：与常规护理相比，“关节植物”生活方式方案可减轻髋或膝关节 MSOA 患者的僵硬感、缓解疼痛并改善身体机能。
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