Rat Anne-Christine, Sellam Jérémie, Mazières Bernard, Ngueyon Sime Willy, Fardellone Patrice, Guillemin Francis
UMR_S 1075 COMETE, University of Caen Normandy, Caen, France
Rheumatology department, Caen Normandy University Hospital, Caen, Normandie, France.
RMD Open. 2025 Jan 2;11(1):e004733. doi: 10.1136/rmdopen-2024-004733.
The objective of this study was to analyse the association between body composition and changes in health-related quality of life (HRQoL) of patients followed for hip and knee osteoarthritis (OA).
Longitudinal data from the Knee and Hip OsteoArthritis Long-term Assessments (KHOALA) cohort, a multicentre cohort of 878 patients with symptomatic knee and/or hip OA, were used. The main outcome criteria were changes in patient-reported outcomes measures, the Study Short Form-36 (physical functioning, pain, mental health and vitality) and the OsteoArthritis Knee and Hip Quality Of Life (OAKHQOL)(physical activity, pain and mental health). Body composition measurements were obtained from dual X-ray absorptiometry (DXA) scans in a subsample of 381 patients at year 3. Body composition variables were fat mass index (FMI (kg/m²)), percentage of fat mass, trunk to leg fat mass ratio (TFM/LFM) and skeletal muscle mass index (SMI (kg/m²)). To account for the correlation of repeated measures in each individual, GEE models were used.
290 patients with knee and 114 patients with hip OA were included in the analysis. In multivariate analysis, higher FMI at baseline and the presence of low lean mass were independently associated with worse physical functioning over time (β -0.02, 95% CI -0.03 to -0.01, p<0.0001 and β -0.21, 95% CI -0.02 to 0.02, p=0.02) for SF-36 dimensions. Higher TFM/LFM and SMI at baseline were associated with better mental health (β 0.09, 95% CI 0.02 to 0.15, p=0.008 and β 0.01, 95% CI 0.006 to 0.02, p<0.0001) and vitality. No association between body composition measures and pain remained in the multivariate analysis.
Higher FMI at baseline and the presence of low muscle mass were independently associated with worse physical function over 4 years, but not with pain. Higher TFM/LFM and SMI at baseline were associated with better mental health and vitality over time.
本研究的目的是分析髋关节和膝关节骨关节炎（OA）患者的身体成分与健康相关生活质量（HRQoL）变化之间的关联。
使用来自膝关节和髋关节骨关节炎长期评估（KHOALA）队列的纵向数据，该队列是一个由878例有症状的膝关节和/或髋关节OA患者组成的多中心队列。主要结局标准是患者报告结局指标的变化，即研究简表36（身体功能、疼痛、心理健康和活力）以及骨关节炎膝关节和髋关节生活质量（OAKHQOL）（身体活动、疼痛和心理健康）。在第3年时，对381例患者的子样本进行双能X线吸收法（DXA）扫描以获取身体成分测量值。身体成分变量包括脂肪质量指数（FMI（kg/m²））、脂肪质量百分比、躯干与腿部脂肪质量比（TFM/LFM）和骨骼肌质量指数（SMI（kg/m²））。为了考虑个体内重复测量的相关性，使用了广义估计方程（GEE）模型。
分析纳入了290例膝关节OA患者和114例髋关节OA患者。在多变量分析中，基线时较高的FMI和低瘦体重的存在与随时间推移较差的身体功能独立相关（对于SF-36维度，β为-0.02，95%置信区间为-0.03至-0.01，p<0.0001；β为-0.21，95%置信区间为-0.02至0.02，p=0.02）。基线时较高的TFM/LFM和SMI与较好的心理健康（β为0.09，95%置信区间为0.02至0.15，p=0.008；β为0.01，95%置信区间为0.006至0.02，p<0.0001）和活力相关。在多变量分析中，身体成分测量与疼痛之间没有关联。
基线时较高的FMI和低肌肉量的存在与4年内较差的身体功能独立相关，但与疼痛无关。基线时较高的TFM/LFM和SMI与随时间推移较好的心理健康和活力相关。
