I.A. Szilagyi , N.L. Nguyen , C.G. Boer , D. Schiphof , F. Ahmadizar , M. Kavousi , S.M.A. Bierma-Zeinstra , J.B.J. van Meurs
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Covariates adjusted for: age, smoking, alcohol use, education, sub-cohort, baseline K/L grade, months between radiographs and BMI.</p></div><div><h3>Results</h3><p>The presence of MetS (37.6 % in men, 39 % in women) and elevated blood pressure was associated with an increased risk of knee osteoarthritis progression in both men and women. MetS was associated with an increased risk of incident chronic knee pain (CKP) in men. In addition, abdominal obesity and high triglycerides showed higher riskfor incidence of CKP in men,but not in women. 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引用次数: 0
摘要
目的虽然骨关节炎与代谢综合征（MetS）之间存在关系，但大多数结果都是横断面的。因此，我们的目的是在一个大型前瞻性队列中调查 MetS（成分）与膝关节放射学骨关节炎和慢性疼痛进展之间的性别特异性纵向关系。我们使用广义估计方程、广义线性模型和竞争风险分析，研究了 MetS 及其组成部分（腹部肥胖、高甘油三酯、低高密度脂蛋白、血压升高和 2 型糖尿病）与骨关节炎进展之间的关系。分析按性别分层。结果在男性和女性中，MetS（男性为 37.6%，女性为 39%）和血压升高与膝关节骨性关节炎进展风险增加有关。在男性中，MetS 与慢性膝关节疼痛（CKP）的发病风险增加有关。此外，腹部肥胖和高甘油三酯在男性中显示出更高的慢性膝关节痛发病风险，但在女性中却没有。除了 MetS 和高甘油三酯与男性 CKP 发病率的关系仍然显著（MetS 的 OR 值为 1.04，95 %CI 为 1.00-1.07；高甘油三酯的 OR 值为 1.04，95 %CI 为 1.01-1.07）外，其他关系在进行体重指数调整后均有所减弱且不再显著。结论代谢综合征和个别代谢成分，如腹部肥胖和血压升高，与男性和女性膝关节 OA 的影像学进展有关，但与体重指数无关。代谢综合征和高甘油三酯仅与男性的 CKP 发生率有关。
Metabolic syndrome, radiographic osteoarthritis progression and chronic pain of the knee among men and women from the general population: The Rotterdam study
Objective
Although a relationship between osteoarthritis and components of metabolic syndrome (MetS) has been suggested, most of the results have been cross-sectional. We, therefore, aimed to investigate the sex-specific longitudinal association of (components of) MetS with progression of radiographic osteoarthritis and chronic pain in the knee joints in a large prospective cohort.
Method
In the large population-based Rotterdam study of up to 6,138 individuals, median follow-up time 5.7 (IQR 5.5) years, we examined the relation between MetS and its components (abdominal obesity, high triglycerides, low high-density lipoprotein, elevated blood pressure, and type 2 diabetes) with the progression of osteoarthritis using generalized estimating equations, generalized linear models and competing risk analysis. Analyses were stratified for sex. Covariates adjusted for: age, smoking, alcohol use, education, sub-cohort, baseline K/L grade, months between radiographs and BMI.
Results
The presence of MetS (37.6 % in men, 39 % in women) and elevated blood pressure was associated with an increased risk of knee osteoarthritis progression in both men and women. MetS was associated with an increased risk of incident chronic knee pain (CKP) in men. In addition, abdominal obesity and high triglycerides showed higher riskfor incidence of CKP in men,but not in women. The associations were attenuated and no longer significant after BMI-adjustment, except for the association of MetS and high triglycerides with incidence of CKP in men that stayed significant (OR 1.04, 95 %CI 1.00–1.07 for MetS and OR 1.04, 95 %CI 1.01–1.07 for high triglycerides).
Conclusion
Metabolic syndrome and individual metabolic components, such as abdominal obesity and elevated blood pressure, were associated with radiographic progression of knee OA in both men and women, but not independent of BMI. Metabolic syndrome and high triglycerides were associated with incidence of CKP only in men.
期刊介绍：
Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.
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