AdventHealth Orlando, Orlando, Florida.
California Pacific Medical Center Research Institute, San Francisco.
Arthritis Rheumatol. 2024 Dec;76(12):1764-1774. doi: 10.1002/art.42953. Epub 2024 Aug 22.
Our objective was to investigate the overall and sex-specific relationships between the presence and severity of knee osteoarthritis (KOA) and muscle composition, power, and energetics in older adults.
Male and female patients (n = 655, mean ± SD age 76.1 ± 4.9 years; 57% female) enrolled in the Study of Muscle, Mobility, and Aging completed standing knee radiographs and knee pain assessments. Participants were divided into three groups using Kellgren-Lawrence grade (KLG) of KOA severity (0-1, 2, or 3-4). Outcome measures included whole-body muscle mass, thigh fat-free muscle (FFM) volume and muscle fat infiltration (MFI), leg power, specific power (power normalized to muscle volume), and muscle mitochondrial energetics.
Overall, the presence and severity of KOA is associated with greater MFI, lower leg power and specific power, and reduced oxidative phosphorylation (P trend < 0.036). Sex-specific analysis revealed reduced energetics only in female patients with KOA (P trend < 0.007) compared to female patients without KOA. In models adjusted for age, sex, race, nonsteroidal anti-inflammatory drug administration, site or technician, physical activity, height, and participants with abdominal adiposity with KLG 3 to 4 had greater MFI (mean 0.008%, 95% confidence interval [CI] 0.004%-0.011%) and lower leg power (mean -51.56 W, 95% CI -74.03 to -29.10 W) and specific power (mean -5.38 W/L, 95% CI -7.31 to -3.45 W/L) than those with KLG 0 to 1. No interactions were found between pain and KLG status. Among those with KOA, MFI and oxidative phosphorylation were associated with thigh FFM volume, leg power, and specific power.
Muscle health is associated with the presence and severity of KOA and differs by sex. Although muscle composition and power are lower in both male and female patients with KOA, regardless of pain status, mitochondrial energetics is reduced only in female patients.
本研究旨在探讨老年人群中膝关节骨关节炎（KOA）的存在和严重程度与肌肉成分、力量和能量学之间的整体和性别特异性关系。
共纳入 655 名男性和女性患者（平均年龄 76.1 ± 4.9 岁；57%为女性）参与此项研究，他们均完成了站立膝关节放射摄影和膝关节疼痛评估。参与者根据 Kellgren-Lawrence（KLG）分级（0-1、2 或 3-4 级）分为三组。结果测量包括全身肌肉质量、大腿去脂肌肉（FFM）体积和肌肉脂肪浸润（MFI）、腿部力量、比功率（肌肉体积标准化后的功率）和肌肉线粒体能量学。
总体而言，KOA 的存在和严重程度与更高的 MFI、更低的腿部力量和比功率以及氧化磷酸化减少相关（P 趋势 < 0.036）。性别特异性分析显示，只有患有 KOA 的女性患者的能量学降低（与无 KOA 的女性患者相比，P 趋势 < 0.007）。在调整年龄、性别、种族、非甾体抗炎药使用、部位或技师、体力活动、身高以及腹部肥胖患者后，KLG 3 至 4 级的患者 MFI 更高（平均 0.008%，95%置信区间 [CI] 0.004%-0.011%），腿部力量更低（平均 -51.56 W，95% CI -74.03 至 -29.10 W）和比功率更低（平均 -5.38 W/L，95% CI -7.31 至 -3.45 W/L），而 KLG 0 至 1 级的患者则无此差异。疼痛和 KLG 状态之间没有发现交互作用。在患有 KOA 的患者中，MFI 和氧化磷酸化与大腿 FFM 体积、腿部力量和比功率相关。
肌肉健康与 KOA 的存在和严重程度相关，且存在性别差异。尽管患有 KOA 的男性和女性患者的肌肉成分和力量均较低，但无论疼痛状况如何，只有女性患者的线粒体能量学降低。
