Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, No. 528, Zhangheng Road, Pudong New Area, Shanghai, 201203, China.
BMC Public Health. 2024 Nov 13;24(1):3155. doi: 10.1186/s12889-024-20616-4.
BACKGROUND: This study aims to evaluate the mediation effect of dyslipidemia induced inflammation on the causal associations between obesity and Osteoarthritis (OA). METHODS: This cross-sectional study used data from the National Health and Nutrition Examination Survey (1999-2010). The association between general and abdominal obesity (exposure), OA (outcome) and mediators (total cholesterol, high-density lipoprotein, and C-reactive protein) was assessed using multivariate linear and logistic regression models and mediation analysis. RESULTS: A total of 23,308 participants were enrolled in this study, and 2,180 were diagnosed with OA. Participants with obesity were more likely to have OA (general obesity: OR = 2.508, 95%CI: 1.602, 4.197, P < 0.001; abdominal obesity: OR = 3.814, 95%CI: 3.242, 4.509, P < 0.001) than those without the obesity. High quantile of total cholesterol (OR:1.399; 95%CI:1.235, 1.257; P < 0.001), high-density lipoprotein (OR:1.644; 95%CI:1.443, 1.874; P < 0.001) and C-reactive protein (OR:1.952; 95%CI:1.707, 2.237; P < 0.001) increased the risk of OA when compared to lowest quartile. In the linear regression, the betas varied from 0.668 (95%CI: 0.635, 0.741; P < 0.001) to 0.693 (95%CI: 0.674, 0.712; P < 0.001), suggesting that individual with obesity had higher C-reactive protein levels. Additionally, total cholesterol and high-density lipoprotein were associated with C-reactive protein. Mediation analyses showed that the causal association of obesity with OA risk was mediated by high-density lipoprotein and C-reactive protein, with the mediation proportion ranging from 17.216 to 45.058%. Moreover, high-density lipoprotein to C-reactive protein path acting as serial mediators in the associations between obesity and OA (general obesity: β = 0.012; 95%CI: 0.009-0.014; abdominal obesity: β = 0.011; 95%CI: 0.008-0.014). CONCLUSION: The association between obesity and OA is partially mediated by systemic inflammation caused by dyslipidemia. Our study suggested anti-lipid therapy may be positive for obese individuals with OA.
背景：本研究旨在评估血脂异常诱导的炎症对肥胖与骨关节炎（OA）之间因果关系的中介作用。
方法：本横断面研究使用了来自国家健康和营养检查调查（1999-2010 年）的数据。使用多元线性和逻辑回归模型以及中介分析评估了一般和腹部肥胖（暴露）、OA（结局）和中介物（总胆固醇、高密度脂蛋白和 C 反应蛋白）之间的关联。
结果：本研究共纳入 23308 名参与者，其中 2180 名被诊断为 OA。与非肥胖者相比，肥胖者更易患 OA（一般肥胖：OR=2.508，95%CI：1.602，4.197，P<0.001；腹部肥胖：OR=3.814，95%CI：3.242，4.509，P<0.001）。总胆固醇高四分位数（OR：1.399；95%CI：1.235，1.257；P<0.001）、高密度脂蛋白（OR：1.644；95%CI：1.443，1.874；P<0.001）和 C 反应蛋白（OR：1.952；95%CI：1.707，2.237；P<0.001）升高均会增加 OA 的发病风险。在线性回归中，β 值范围为 0.668（95%CI：0.635，0.741；P<0.001）至 0.693（95%CI：0.674，0.712；P<0.001），表明肥胖者的 C 反应蛋白水平更高。此外，总胆固醇和高密度脂蛋白与 C 反应蛋白相关。中介分析表明，肥胖与 OA 风险的因果关系部分由血脂异常引起的系统性炎症介导，中介比例范围为 17.216%至 45.058%。此外，高密度脂蛋白至 C 反应蛋白的路径在肥胖与 OA 之间的关联中作为串联中介物（一般肥胖：β=0.012；95%CI：0.009-0.014；腹部肥胖：β=0.011；95%CI：0.008-0.014）。
结论：肥胖与 OA 之间的关联部分由血脂异常引起的系统性炎症介导。我们的研究表明，抗脂质治疗可能对肥胖合并 OA 的患者有益。
Nutr Metab Cardiovasc Dis. 2018-6-25
Sichuan Da Xue Xue Bao Yi Xue Ban. 2024-5-20
Osteoarthritis Cartilage. 2021-3
Arthritis Res Ther. 2024-1-31
Arthritis Res Ther. 2024-4-17
Cell Biochem Biophys. 2024-3
Curr Obes Rep. 2023-9
BMC Public Health. 2022-12-23
Zotero 插件
