Hochberg M C, Lethbridge-Cejku M, Scott W W, Reichle R, Plato C C, Tobin J D
Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
J Rheumatol. 1995 Mar;22(3):488-93.
To examine the association of body weight, body fatness, and body fat distribution with osteoarthritis (OA) of the knee.
Bilateral standing knee radiographs, taken between 1985 and 1991, of 465 Caucasian men and 275 Caucasian women subjects aged 40 and above in the Baltimore Longitudinal Study of Aging were read by one investigator for grade of OA using Kellgren-Lawrence scales. Measures of obesity, assessed at same visit as the last radiograph during this interval, included body mass index, percent body fat, and body fat distribution.
Both men and women with definite knee OA had higher age adjusted mean levels of body mass index, while women only had higher age adjusted mean levels of percent body fat. Both women and men in the highest tertile of body mass index had significantly increased odds of both definite and bilateral knee OA; women in the middle and highest tertile of percent body fat had significantly increased odds of both definite and bilateral knee OA, and men in the highest tertile of waist-hip ratio had significantly increased odds of bilateral knee OA. After adjusting for body mass index, however, the association of percent body fat and waist-hip ratio with knee OA in women and men, respectively, was no longer significant.
These data further extend observations that body weight is associated with both definite and bilateral knee OA in both sexes, and support a stronger contribution of mechanical as opposed to systemic factors to explain this association.
研究体重、体脂率及体脂分布与膝关节骨关节炎(OA)之间的关联。
在巴尔的摩纵向衰老研究中,对465名40岁及以上的白人男性和275名40岁及以上的白人女性在1985年至1991年间拍摄的双侧站立位膝关节X线片,由一名研究人员使用凯尔格伦-劳伦斯量表对OA等级进行判读。在与最后一次X线检查相同的访视中评估肥胖指标,包括体重指数、体脂百分比和体脂分布。
确诊为膝关节OA的男性和女性年龄调整后的体重指数平均水平均较高,而只有女性年龄调整后的体脂百分比平均水平较高。体重指数处于最高三分位数的男性和女性患确诊膝关节OA和双侧膝关节OA的几率均显著增加;体脂百分比处于中间和最高三分位数的女性患确诊膝关节OA和双侧膝关节OA的几率均显著增加,腰臀比处于最高三分位数的男性患双侧膝关节OA的几率显著增加。然而,在调整体重指数后,体脂百分比和腰臀比分别与女性和男性膝关节OA之间的关联不再显著。
这些数据进一步扩展了体重与男女确诊膝关节OA和双侧膝关节OA均相关的观察结果,并支持机械因素而非全身因素在解释这种关联中发挥更大作用。