Mustari M Nasser, Massi Muh Nasrum, Usman Muhammad A, Fikry Achmad, Bukhari Agussalim, Idris Irfan, Zainuddin Andi A, Adnan Endy, Bakri Syakib, Hatta Mizwar
Department of Surgery.
Departement of Microbiology.
Ann Med Surg (Lond). 2023 Jun 20;85(8):3845-3851. doi: 10.1097/MS9.0000000000000973. eCollection 2023 Aug.
The risk factors most strongly associated with knee osteoarthritis (OA) are old age and obesity. However, few studies have evaluated the interaction between aging and obesity in conjunction with inflammatory markers and knee OA severity as part of a complete assessment of knee OA management. Therefore, this study aims to evaluate the interaction between obesity, age, inflammation [including the I/D polymorphism of angiotensin converting enzyme-1 (ACE-1)], and the severity of knee OA.
A total of 80 knee OA patients were included in this cross-sectional study. The severity of knee OA was determined based on the Kellgren-Lawrence system. All patients underwent physical and radiological examination; monocyte chemoattractant protein 1 (MCP-1) markers were measured. The parameters of the ACE-1 gene were examined with sequencing DNA.
There was a significant relationship between age and severity of knee OA (=0.007), with subjects aged greater than or equal to 65 having a 3.56-fold higher risk of developing moderate to severe OA than subjects aged less than 65. There was a significant difference between body weight and knee OA severity (=0.026), in which subjects weighing greater than or equal to 60 kg had 3.14 times the risk of experiencing severe knee OA. Multivariate regression analysis indicated that age was the strongest independent variable for knee OA severity compared with body weight. MCP-1 levels were significantly higher in mild knee OA than in moderate to severe knee OA. The DD genotype of the ACE-1 gene increases the risk of severe knee OA by four times in subjects aged greater than or equal to 65 compared to subjects aged less than 65. However, the DD genotype of the ACE-1 gene does not increase the risk of severe knee OA in subjects weighing greater than or equal to 60 kg.
While obesity and age were found to be associated with the severity of knee OA, age emerged as the independent risk factor for knee OA severity. Furthermore, MCP-1 levels were significantly higher in cases of mild knee OA compared to severe knee OA. It was observed that the DD genotype of the ACE-1 gene increases the risk of severe knee OA in individuals aged 65 years or older.
与膝关节骨关节炎(OA)关联最密切的风险因素是老年和肥胖。然而,很少有研究评估衰老与肥胖之间的相互作用,并结合炎症标志物以及膝关节OA严重程度,作为膝关节OA管理完整评估的一部分。因此,本研究旨在评估肥胖、年龄、炎症[包括血管紧张素转换酶-1(ACE-1)的I/D多态性]与膝关节OA严重程度之间的相互作用。
本横断面研究共纳入80例膝关节OA患者。膝关节OA的严重程度根据Kellgren-Lawrence系统确定。所有患者均接受体格检查和影像学检查;检测单核细胞趋化蛋白1(MCP-1)标志物。采用DNA测序检查ACE-1基因的参数。
年龄与膝关节OA严重程度之间存在显著关系(=0.007),65岁及以上的受试者发生中度至重度OA的风险比65岁以下的受试者高3.56倍。体重与膝关节OA严重程度之间存在显著差异(=0.026),体重≥60 kg的受试者发生严重膝关节OA的风险是其3.14倍。多因素回归分析表明,与体重相比,年龄是膝关节OA严重程度最强的独立变量。轻度膝关节OA患者的MCP-1水平显著高于中度至重度膝关节OA患者。与65岁以下的受试者相比,ACE-1基因的DD基因型使65岁及以上的受试者发生严重膝关节OA的风险增加四倍。然而,ACE-1基因的DD基因型在体重≥60 kg的受试者中并未增加严重膝关节OA的风险。
虽然发现肥胖和年龄与膝关节OA严重程度相关,但年龄是膝关节OA严重程度的独立危险因素。此外,轻度膝关节OA患者的MCP-1水平显著高于重度膝关节OA患者。观察到ACE-1基因的DD基因型会增加65岁及以上个体发生严重膝关节OA的风险。