Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China.
J Health Popul Nutr. 2023 Oct 13;42(1):108. doi: 10.1186/s41043-023-00438-7.
To identify the prevalence of obesity, sarcopenia, sarcopenic obesity in end-stage knee osteoarthritis (KOA) patients and analyze influences of obesity and sarcopenia in the progression of KOA.
A cross-sectional study was carried out among end-stage KOA patients who consecutively admitted to Orthopedic Department for TKA. We suppose that the level of decreased physical activities would be influenced by unilateral or bilateral KOA. Patient information, albumin, hemoglobin, pace, step frequency, number of comorbid conditions were collected. Bioelectrical impedance analyzer was used to analyze body composition. Obesity, sarcopenia, sarcopenic obesity rate were analyzed with accepted diagnosis criteria. Correlations between body mass index (BMI) or age and fat mass (FM), appendicular skeletal muscle mass (ASM) were analyzed.
138 patients (male 30, female 108) in southwest of China including 67 patients with unilateral KOA and 71 patients with bilateral KOA were analyzed. No statistic difference was found in mean albumin, prealbumin and hematocrystallin, body composition values and number of comorbid conditions. We found that BMI was positively correlated with FM (Male: R = 0.7177, p < 0.0001, Female: R = 0.8898, p < 0.0001), ASM (Male: R = 0.2640, p = 0.0037, Female: R = 0.2102, p < 0.0001), FM index (FMI) (Male: R = 0.6778, p < 0.0001, Female: R = 0.8801, p < 0.0001), and ASM index (ASMI) (Male: R = 0.3600, p = 0.0005, Female: R = 0.4208, p < 0.0001) in end-stage KOA patients. However, age was not obviously correlated with FM or FMI (Male: FM, R = 0.006911, p = 0.3924; FMI, R = 0.7554, p = 0.0009196; Female: FM, R = 0.001548, p = 0.8412; FMI, R = 0.002776, p = 0.7822). And slightly negatively correlated with ASM (Male: R = 0.05613, p = 0.0136, Female: R = 0.01327, p = 0.5433) and ASMI (Male: R = 0.02982, p = 0.3615; Female: R = 0.03696, p = 0.0462). The prevalence of obesity, sarcopenia and obesity sarcopenia differs according to different diagnosis criteria. No difference in the occurrence rate of obesity was found between bilateral KOA and unilateral KOA patients, and occurrence rates of sarcopenia and sarcopenic obesity were statistically higher in bilateral KOA than that in unilateral KOA patients.
Obesity, sarcopenia and sarcopenic obesity are highly prevalent in end-stage KOA patients, sarcopenic obesity are more prevalent in bilateral KOA patients than that in unilateral KOA patients.
确定终末期膝骨关节炎（KOA）患者中肥胖、肌肉减少症、肌肉减少性肥胖的流行率，并分析肥胖和肌肉减少症对 KOA 进展的影响。
对连续收治于骨科行 TKA 的终末期 KOA 患者进行横断面研究。我们假设单侧或双侧 KOA 会影响患者活动水平。收集患者信息、白蛋白、血红蛋白、步速、步频、合并症数量。采用生物电阻抗分析仪分析身体成分。采用公认的诊断标准分析肥胖、肌肉减少症、肌肉减少性肥胖的发生率。分析 BMI 或年龄与脂肪量（FM）、四肢骨骼肌量（ASM）的相关性。
分析了来自中国西南部的 138 例患者（男性 30 例，女性 108 例），其中单侧 KOA 患者 67 例，双侧 KOA 患者 71 例。白蛋白、前白蛋白和血球压积、身体成分值和合并症数量无统计学差异。我们发现 BMI 与 FM（男性：R=0.7177，p<0.0001，女性：R=0.8898，p<0.0001）、ASM（男性：R=0.2640，p=0.0037，女性：R=0.2102，p<0.0001）、FM 指数（FMI）（男性：R=0.6778，p<0.0001，女性：R=0.8801，p<0.0001）和 ASM 指数（ASMI）（男性：R=0.3600，p=0.0005，女性：R=0.4208，p<0.0001）呈正相关。然而，年龄与 FM 或 FMI 无明显相关性（男性：FM，R=0.006911，p=0.3924；FMI，R=0.7554，p=0.0009196；女性：FM，R=0.001548，p=0.8412；FMI，R=0.002776，p=0.7822）。并且与 ASM 呈轻度负相关（男性：R=0.05613，p=0.0136，女性：R=0.01327，p=0.5433）和 ASMI（男性：R=0.02982，p=0.3615；女性：R=0.03696，p=0.0462）。不同的诊断标准下肥胖、肌肉减少症和肌肉减少性肥胖的患病率不同。双侧 KOA 患者肥胖的发生率与单侧 KOA 患者无差异，而双侧 KOA 患者肌肉减少症和肌肉减少性肥胖的发生率高于单侧 KOA 患者。
肥胖、肌肉减少症和肌肉减少性肥胖在终末期 KOA 患者中患病率较高，双侧 KOA 患者中肌肉减少性肥胖的患病率高于单侧 KOA 患者。
