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叶酸摄入与症状性膝骨关节炎患者膝关节疼痛、炎症介质和合并症的关系。

Associations between folate intake and knee pain, inflammation mediators and comorbid conditions in patients with symptomatic knee osteoarthritis.

机构信息

Department of Hospital Management, Southern Medical University, Guangzhou, 510515, Guangdong, China.

Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China.

出版信息

BMC Musculoskelet Disord. 2024 Nov 28;25(1):973. doi: 10.1186/s12891-024-08095-5.

Abstract

BACKGROUND

To investigate the associations between folate intake and changes in knee pain, inflammation mediators and comorbid conditions over 2 years in patients with symptomatic knee osteoarthritis (OA).

METHODS

A post-hoc analysis was performed based on data from the VIDEO study, a multicenter, randomized, double-blind, placebo-controlled clinical trial aimed at assessing the impact of vitamin D supplementation on patients with knee OA who were also vitamin D deficient. The original trial's design and inclusion and exclusion criteria were integrated into this subsequent post-hoc analysis. The average daily folate intake was evaluated using the Dietary Questionnaire for Epidemiological Studies version 2 over two years. The progression of knee symptoms was monitored at the baseline and then at months 3, 6, 12, and 24, utilizing the Western Ontario and McMaster Universities Index alongside a 100-mm visual analog scale. Levels of serum inflammatory mediators were quantified using ELISA techniques. Assessments of knee joint structures, leg muscle strength, depressive symptoms, feet pain, and low back pain were treated at both baseline and follow-up intervals.

RESULTS

Folate intake was correlated with reductions in overall knee pain, dysfunction, and stiffness, as well as decreased levels of Leptin and Apelin. Additionally, it was associated with enhanced leg muscle strength and diminished feet and low back pain. However, there is no association between folate intake and alterations in serum cytokine levels or knee joint structural changes. Within the subsets of overall knee pain, a significant relationship was identified between folate intake and the reduction of pain experienced when ascending or descending stairs and standing for two years.

CONCLUSIONS

Folate intake was linked with reduced knee pain, lower levels of adipokines, and a decreased prevalence of comorbid conditions in individuals with knee OA, implying that folate consumption may be associated with an improvement in knee OA symptoms, but further research is needed to verify this association.

摘要

背景

本研究旨在探讨叶酸摄入与膝关节骨性关节炎(OA)患者膝关节疼痛、炎症介质和合并症在 2 年内的变化之间的相关性。

方法

本研究基于 VIDEO 研究的数据进行了一项回顾性分析,这是一项多中心、随机、双盲、安慰剂对照的临床试验,旨在评估维生素 D 补充对同时缺乏维生素 D 的膝关节 OA 患者的影响。原始试验的设计以及纳入和排除标准被纳入到本次回顾性分析中。通过两年的饮食问卷进行叶酸的平均日摄入量评估。使用 Western Ontario 和 McMaster 大学指数以及 100mm 视觉模拟量表,在基线和第 3、6、12 和 24 个月监测膝关节症状的进展。采用 ELISA 技术定量检测血清炎症介质水平。评估膝关节结构、腿部肌肉力量、抑郁症状、足部疼痛和下腰痛分别在基线和随访时进行。

结果

叶酸摄入量与整体膝关节疼痛、功能障碍和僵硬的减轻以及瘦素和 Apelin 水平的降低有关。此外,它与腿部肌肉力量的增强和足部及下腰痛的减轻有关。但是,叶酸摄入量与血清细胞因子水平的变化或膝关节结构的改变无关。在整体膝关节疼痛的亚组中,叶酸摄入量与两年内上下楼梯和站立时疼痛减轻之间存在显著相关性。

结论

在膝关节 OA 患者中,叶酸摄入与膝关节疼痛减轻、脂肪因子水平降低和合并症患病率降低有关,这表明叶酸的摄入可能与膝关节 OA 症状的改善有关,但需要进一步的研究来验证这种相关性。

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