超加工食品的消费与膝骨关节炎有关：来自骨关节炎倡议组织的数据。
Ultra-processed food consumption is associated with knee osteoarthritis: Data from the Osteoarthritis Initiative.
作者信息
Akkaya Zehra, Sims Wynton M, Lynch John A, Löffler Maximillian T, Gassert Felix, Nevitt Michael, McCulloch Charles E, Lane Nancy E, Pedoia Valentina, Ziegeler Katharina, Link Thomas M, Joseph Gabby B
机构信息
Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA; Department of Radiology, Ankara University, Ankara, Turkey.
Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA.
出版信息
Osteoarthritis Cartilage. 2025 Jun 4. doi: 10.1016/j.joca.2025.05.011.
OBJECTIVE
To explore the relationship between ultra-processed food (UPF) intake and knee osteoarthritis (KOA)-related imaging and clinical outcomes in men and women.
DESIGN
Osteoarthritis Initiative participants with sufficient dietary and sociodemographic data (n = 4403) were included in this cross-sectional study. UPF was assessed by food frequency questionnaire-based NOVA Classification, categorizing diet according to processing level, with NOVA-4 indicating UPF. The exposure variable was standardized UPF proportion/day (%)-the proportion of NOVA-4 servings in the daily diet. The outcomes were Western Ontario and McMaster University OA Index (WOMAC) pain, activities of daily living (ADL), stiffness, total scores, average cartilage thickness (quantified using 3D-dual echo steady-state sequences on 3T MRI), Chair Stand Test (CST) and gait speed. Mixed effects and linear regression models were used for knee-level and participant-level outcomes, respectively. Models were adjusted for age, race, BMI, daily calories, physical activity, and medical insurance availability. Sex differences were tested by interactions between UPF and sex.
RESULTS
Sex interactions were significant for WOMAC-pain, ADL, total, gait speed, cartilage thickness (p-interaction-range < 0.001-0.006). Greater UPF was associated with significantly worse pain (β = 0.17 [0.093, 0.242], p < 0.001), ADL (β = 0.59 [0.365, 0.832], p < 0.001), total scores (β = 0.81 [0.483, 1.13], p < 0.001), thinner cartilage (β = -0.013 [-0.02, -0.006], p < 0.001), slower gait (β = -0.035 [-0.042, -0.027], p < 0.001) in women. Sex interactions were non-significant for CST and WOMAC-stiffness (p-interaction = 0.319, 0.573, respectively). With greater UPF, CST and WOMAC-stiffness showed significant poor outcomes (β = -0.008 [-0.013, -0.004], p < 0.001, β = 0.04 [0.008, 0.064], p = 0.011, respectively). WOMAC-stiffness results were not significant after Bonferroni corrections.
CONCLUSIONS
UPF-rich diet is linked to worse KOA outcomes disproportionately more in women.
目的
探讨超加工食品（UPF）摄入量与男性和女性膝关节骨关节炎（KOA）相关影像学及临床结局之间的关系。
设计
本横断面研究纳入了具有足够饮食和社会人口统计学数据的骨关节炎倡议参与者（n = 4403）。通过基于食物频率问卷的NOVA分类法评估UPF，根据加工水平对饮食进行分类，其中NOVA-4表示UPF。暴露变量为标准化的每日UPF比例（%），即每日饮食中NOVA-4份数的比例。结局指标包括西安大略和麦克马斯特大学骨关节炎指数（WOMAC）疼痛、日常生活活动（ADL）、僵硬程度、总分、平均软骨厚度（使用3T MRI上的3D双回波稳态序列进行量化）、椅子站立试验（CST）和步速。分别使用混合效应模型和线性回归模型分析膝关节水平和参与者水平的结局。模型对年龄、种族、体重指数、每日卡路里摄入量、身体活动和医疗保险情况进行了调整。通过UPF与性别的交互作用检验性别差异。
结果
UPF与性别的交互作用在WOMAC疼痛、ADL、总分、步速、软骨厚度方面具有统计学意义（交互作用p值范围<0.001 - 0.006）。在女性中，较高的UPF摄入量与显著更差的疼痛（β = 0.17 [0.093, 0.242]，p < 0.001）、ADL（β = 0.59 [0.365, 0.832]，p < 0.001）、总分（β = 0.81 [0.483, 1.13]，p < 0.001）、更薄的软骨（β = -0.013 [-?0.02, -0.006]，p < 0.001）、更慢的步速（β = -0.035 [-0.042, -0.027]，p < 0.001）相关。UPF与性别的交互作用在CST和WOMAC僵硬程度方面无统计学意义（交互作用p值分别为0.319和0.573）。随着UPF摄入量增加，CST和WOMAC僵硬程度显示出显著较差的结局（β = -0.008 [-0.013, -0.004]，p < 0.001，β = 0.04 [0.008, 0.064]，p = 0.011）。经Bonferroni校正后，WOMAC僵硬程度结果无统计学意义。
结论
富含UPF的饮食与女性KOA结局较差的关联尤为明显。
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