Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China.
The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong, China.
Immun Inflamm Dis. 2024 Sep;12(9):e1371. doi: 10.1002/iid3.1371.
To examine the relationship between C-reactive protein (CRP) and knee pain, and further explore whether this association is mediated by obesity.
The population was derived from 1999 to 2004 National Health and Nutrition Examination Survey. Logistic regression was used to analyze the relationship between CRP and knee pain in three different models, and the linear trend was analyzed. A restricted cubic spline model to assess the nonlinear dose-response relationship between CRP and knee pain. Mediation analyses were used to assess the potential mediating role of obesity. Subgroup analyses and sensitivity analyses were performed to ensure robustness.
Compared with adults with lower CRP (first quartile), those with higher CRP had higher risks of knee pain (odds ratio 1.39, 95% confidence interval 1.12-1.72 in third quartile; 1.56, 1.25-1.95 in fourth quartile) after adjusting for covariates (except body mass index [BMI]), and the proportion mediated by BMI was 76.10% (p < .001). BMI and CRP were linear dose-response correlated with knee pain. The odds ratio for those with obesity compared with normal to knee pain was 2.27 (1.42-3.65) in the first quartile of CRP, 1.99 (1.38-2.86) in the second, 2.15 (1.38-3.33) in the third, and 2.92 (1.72-4.97) in the fourth.
Obesity mediated the systemic inflammation results in knee pain in US adults. Moreover, higher BMI was associated with higher knee pain risk in different degree CRP subgroups, supporting an important role of weight loss in reducing knee pain caused by systemic inflammation.
探讨 C 反应蛋白（CRP）与膝关节疼痛之间的关系，并进一步探讨这种关联是否受肥胖的影响。
该人群来源于 1999 年至 2004 年全国健康和营养调查。采用逻辑回归分析 CRP 与膝关节疼痛在三种不同模型中的关系，并进行线性趋势分析。采用受限立方样条模型评估 CRP 与膝关节疼痛之间的非线性剂量-反应关系。采用中介分析评估肥胖的潜在中介作用。进行亚组分析和敏感性分析以确保稳健性。
与 CRP 水平较低的成年人（第一四分位数）相比，CRP 水平较高的成年人发生膝关节疼痛的风险更高（第三四分位数时比值比为 1.39，95%置信区间为 1.12-1.72；第四四分位数时为 1.56，1.25-1.95），调整了协变量（除体重指数[BMI]外），BMI 介导的比例为 76.10%（p<0.001）。BMI 和 CRP 与膝关节疼痛呈线性剂量反应关系。CRP 第一四分位数时肥胖与膝关节疼痛的比值比为 2.27（1.42-3.65），第二四分位数时为 1.99（1.38-2.86），第三四分位数时为 2.15（1.38-3.33），第四四分位数时为 2.92（1.72-4.97）。
肥胖介导了全身性炎症导致美国成年人膝关节疼痛。此外，在不同程度 CRP 亚组中，较高的 BMI 与较高的膝关节疼痛风险相关，这支持了减肥在减轻由全身性炎症引起的膝关节疼痛方面的重要作用。
