Hackensack Meridian School of Medicine, United States; Hackensack Meridian Health, Department of Orthopedics, United States.
Rutgers Robert Wood Johnson Medical School, United States.
Osteoarthritis Cartilage. 2024 Jan;32(1):82-92. doi: 10.1016/j.joca.2023.08.013. Epub 2023 Sep 28.
Though health care providers (HCPs) know the importance of weight loss counsel for Osteoarthritis (OA), little is known about how frequently it is practiced and even less of its effectiveness. Thus, we analyzed the prevalence and effectiveness of weight counsel receipt in overweight/obese OA patients.
Using 2011-2018 National Health and Nutrition Examination Survey data, we cross-sectionally analyzed overweight/obese patients in the United States to determine the prevalence of receipt of HCP weight counsel in those with OA and among other variables. We used multivariate logistic regression models to calculate odds ratios of being counseled and of achieving ten percent weight loss in groups with and without counsel. Mean weight losses were also compared among groups.
39,156 patients were identified, of whom 1948 met inclusion criteria. Overall, 51.89% of overweight/obese OA patients received weight counseling. The odds of receiving counsel varied with several demographic variables. The odds of achieving 10% weight loss in those counseled was 1.84 times (95% confidence interval: 1.028, 3.299) that of those not counseled (p = 0.04). In contrast, patients counseled lost a mean of 0.49 pounds while those not counseled gained a mean of 0.03 pounds, a difference which was not statistically significant (p = 0.59).
Prevalence of weight counsel receipt for OA has not changed significantly between 2011 and 2018. Though counsel for weight more frequently leads to adequate weight loss in those with OA, the average weight loss is minimal regardless of counsel. Thus, refinement of this intervention may be needed to bolster weight loss.
尽管医疗保健提供者（HCP）知道减肥咨询对骨关节炎（OA）的重要性，但对其实施频率知之甚少，甚至对其有效性的了解更少。因此，我们分析了超重/肥胖 OA 患者接受体重咨询的频率及其效果。
我们利用 2011-2018 年全国健康和营养调查数据，对美国超重/肥胖患者进行横断面分析，以确定 OA 患者中 HCP 体重咨询的接受率及其它变量。我们使用多变量逻辑回归模型计算有和没有咨询的患者组被咨询的几率和实现 10%体重减轻的几率。还比较了各组之间的平均体重减轻量。
共确定了 39156 名患者，其中 1948 名符合纳入标准。总体而言，51.89%的超重/肥胖 OA 患者接受了体重咨询。接受咨询的几率因多种人口统计学变量而异。与未接受咨询的患者相比，接受咨询的患者实现 10%体重减轻的几率是未接受咨询患者的 1.84 倍（95%置信区间：1.028，3.299；p=0.04）。相比之下，接受咨询的患者平均减轻 0.49 磅，而未接受咨询的患者平均增加 0.03 磅，差异无统计学意义（p=0.59）。
2011 年至 2018 年期间，OA 体重咨询的接受率没有明显变化。尽管对 OA 患者进行减肥咨询更常导致足够的体重减轻，但无论是否咨询，平均体重减轻量都很小。因此，可能需要改进这种干预措施以增强减肥效果。
