Jordan J M, Luta G, Renner J B, Linder G F, Dragomir A, Hochberg M C, Fryer J G
Thurston Arthritis Research Center, University of North Carolina, School of Medicine, Chapel Hill 27599-7330, USA.
Arthritis Care Res. 1996 Aug;9(4):273-8. doi: 10.1002/1529-0131(199608)9:4<273::aid-anr1790090412>3.0.co;2-f.
This study examined the roles of sociodemographic factors (age, race, gender, education, marital status), obesity, and severity of radiographic knee osteoarthritis (OA) and knee pain on self-reported functional status.
The sample included 1,272 African-American and Caucasian individuals, aged 45 years or older, from the Johnston County Osteoarthritis Project. Analysis of variance was used to assess variation in mean Health Assessment Questionnaire (HAQ) scores by the above variables.
Mean HAQ scores differed by severity of radiographic knee OA and knee pain, obesity, and all demographic factors (P < 0.0001), except race. Only age, female sex, obesity, and knee pain severity were independent effects (P < 0.0009). Disability associated with knee pain varied by both radiographic knee OA severity and obesity.
Knee pain severity was more important than radiographic knee OA severity in determining disability. Obesity was independently associated with disability and compounded disability from knee pain. Studies of disability in knee OA should include assessment of obesity, severity of radiographic knee OA, and severity of knee pain, as well as their interactions.
本研究探讨了社会人口学因素（年龄、种族、性别、教育程度、婚姻状况）、肥胖以及膝关节影像学骨关节炎（OA）的严重程度和膝关节疼痛对自我报告功能状态的影响。
样本包括来自约翰斯顿县骨关节炎项目的1272名年龄在45岁及以上的非裔美国人和白人个体。采用方差分析评估上述变量对健康评估问卷（HAQ）平均得分的差异。
除种族外，HAQ平均得分在膝关节影像学OA严重程度、膝关节疼痛、肥胖以及所有人口学因素方面均存在差异（P < 0.0001）。只有年龄、女性性别、肥胖和膝关节疼痛严重程度是独立影响因素（P < 0.0009）。与膝关节疼痛相关的残疾程度因膝关节影像学OA严重程度和肥胖程度而异。
在确定残疾方面，膝关节疼痛严重程度比膝关节影像学OA严重程度更重要。肥胖与残疾独立相关，并加重膝关节疼痛导致的残疾。膝关节OA残疾研究应包括对肥胖、膝关节影像学OA严重程度、膝关节疼痛严重程度及其相互作用的评估。
