[社区老年人群骨量丢失与膝关节骨关节炎发病率的相关性]
[Correlation between bone mass loss and incidence of knee osteoarthritis in the elderly community-based population].
作者信息
Xia Chen-Jie, Li Jin, Li Xiang, Zhou Ke, Fang Liang, Jin Hong-Ting, Tong Pei-Jian
机构信息
Department of Orthopaedics, Li Huili Hospital Affiliated to Ningbo University, Ningbo 315040, Zhejiang, China.
Department of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou 310006, Zhejiang, China.
出版信息
Zhongguo Gu Shang. 2025 Apr 25;38(4):358-63. doi: 10.12200/j.issn.1003-0034.20231278.
OBJECTIVE
To explore the epidemiological characteristics of knee osteoarthritis (KOA) among the elderly in the community, and its correlation with bone mass loss.
METHODS
A cross-sectional study was conducted on elderly community population over 50 year old from 12 community health service centers in Zhejiang province. Their gender, age, body mass index (BMI), T value and KOA diagnosis were collected using face to face questionnaire survey. Univariate regression was used to analyze the influence of age, gender, BMI and bone loss on KOA. Logistic multivariate regression model was used to analyze the independent effect of bone mass loss on KOA.
RESULTS
Among 4 173 subjects in this study, 1 710 of them were had a KOA. The prevalence rate was 40.9%. The mean age, the proportion of females and the mean BMI in KOA patients were (65.5±3.8) years old, 67.7%(1 158/1 710) and(24.59±1.28) kg·m, respectively, which were significantly higher than (58.5±3.2) years old, 51.3%(1 263/2 463), and (23.48±1.25) kg·m in non-KOA subjects (<0.001). In the population aged from 60 to 69 years old, the influence of osteopenia and osteoporosis on the prevalence of KOA was[=1.21, 95%(1.00, 1.46), =0.053 2], [=1.42, 95%(1.14, 1.78), =0.002 2]. The influence of male and female osteoporosis on the prevalence of KOA was [=1.52, 95%(1.16, 1.99), =0.002 7] and [=1.87, 95%(1.51, 2.32), <0.000 1], respectively. In the population of 24 kg·m≤BMI<28 kg·m, the influence of osteopenia and osteoporosis on the prevalence of KOA was [=1.47, 95%(1.21, 1.80), =0.000 1], [=2.69, 95%(2.11, 3.42), <0.000 1], respectively. After controlling the confounding factors of age, gender and BMI, compared with people with normal bone mass, the effect of osteopenia on the prevalence of KOA was [=1.34, 95%(1.08, 1.67), =0.009 2], and the effect of osteoporosis on the prevalence of KOA was [=1.38, 95%(1.06, 1.79), =0.017 9].
CONCLUSION
Elderly overweight women are more likely to develop KOA. Bone mass loss is an independent risk factor for KOA, which will significantly increase the prevalence of KOA in people overweight or aged 60 to 69 years old.
目的
探讨社区老年人膝骨关节炎（KOA）的流行病学特征及其与骨质流失的相关性。
方法
对浙江省12个社区卫生服务中心50岁以上的社区老年人群进行横断面研究。通过面对面问卷调查收集他们的性别、年龄、体重指数（BMI）、T值和KOA诊断情况。采用单因素回归分析年龄、性别、BMI和骨质流失对KOA的影响。采用Logistic多因素回归模型分析骨质流失对KOA的独立作用。
结果
本研究4173名受试者中，1710人患有KOA，患病率为40.9%。KOA患者的平均年龄、女性比例和平均BMI分别为（65.5±3.8）岁、67.7%（1158/1710）和（24.59±1.28）kg·m，显著高于非KOA受试者的（58.5±3.2）岁、51.3%（1263/2463）和（23.48±1.25）kg·m（<0.001）。在60至69岁人群中，骨质减少和骨质疏松对KOA患病率的影响分别为[=1.21，95%（1.00，1.46），=0.053 2]，[=1.42，95%（1.14，1.78），=0.002 2]。男性和女性骨质疏松对KOA患病率的影响分别为[=1.52，95%（1.16，1.99），=0.002 7]和[=1.87，95%（1.51，2.32），<0.000 1]。在24 kg·m≤BMI<28 kg·m人群中，骨质减少和骨质疏松对KOA患病率的影响分别为[=1.47，95%（1.21，1.80）=0.000 1]，[=2.69，95%（2.11，3.42），<0.000 1]。在控制年龄、性别和BMI等混杂因素后，与骨质正常者相比，骨质减少对KOA患病率的影响为[=1.34，95%（1.08，1.67），=0.009 2]，骨质疏松对KOA患病率的影响为[=1.38，95%（1.06，1.79），=0.017 9]。
结论
老年超重女性更易发生KOA。骨质流失是KOA的独立危险因素，会显著增加超重或60至69岁人群的KOA患病率。
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