目的:膝关节骨性关节炎(OA)是导致残疾和关节疼痛的主要原因。尽管已经确定了膝关节OA的其他危险因素,体力活动如何影响膝关节OA的发生尚不清楚.
方法:使用约翰斯顿县骨关节炎项目研究的第一(1999-2004)和第二(2005-2010)随访期的数据,我们在1,522名年龄≥45岁的成年人中测试了满足体育锻炼指南与膝关节意外结局之间的相关性.中位随访时间为6.5年(范围4.0-10.2年)。使用明尼苏达州休闲时间体力活动问卷计算基线时的体力活动(中等当量的体力活动分钟/周)。膝关节X线照相OA(ROA)定义为随访时膝关节Kellgren/Lawrence等级≥2。发生膝关节症状性ROA(sROA)定义为随访时至少有1个膝关节出现ROA和症状。Weibull回归模型用于估计间隔删失数据的风险比(HR)和95%置信区间(95%CIs)。
结果:在多变量模型中,符合2008年卫生与人类服务部(HHS)指南的体力活动(≥150分钟/周)与ROA(HR1.20[95%CI0.92-1.56])或sROA(HR1.24[95%CI0.87-1.76])无显著相关.与不活动(0至<10分钟/周)参与者相比,体力活动水平最高(≥300分钟/周)的成年人患膝关节ROA和sROA的风险更高;然而,这些关联没有统计学意义(HR1.62[95%CI0.97-2.68]和HR1.42[95%CI0.76-2.65],分别)。
结论:在中老年人队列中,符合HHS体力活动指南与膝关节ROA或sROA无关。
OBJECTIVE: Knee osteoarthritis (OA) is a leading cause of disability and joint pain. Although other risk factors of knee OA have been identified, how physical activity affects incident knee OA remains unclear.
METHODS: Using data from the first (1999-2004) and second (2005-2010) followup periods of the Johnston County Osteoarthritis Project
study, we tested the association between meeting physical activity guidelines and incident knee outcomes among 1,522 adults ages ≥45 years. The median followup time was 6.5 years (range 4.0-10.2 years). Physical activity at baseline (moderate-equivalent physical activity minutes/week) was calculated using the Minnesota Leisure Time Physical Activity questionnaire. Incident knee radiographic OA (ROA) was defined as the development of Kellgren/Lawrence grade ≥2 in a knee at followup. Incident knee symptomatic ROA (sROA) was defined as the development of ROA and symptoms in at least 1 knee at followup. Weibull regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for interval-censored data.
RESULTS: In multivariable models, meeting the 2008 Department of Health and Human Services (HHS) physical activity guidelines (≥150 minutes/week) was not significantly associated with ROA (HR 1.20 [95% CI 0.92-1.56]) or sROA (HR 1.24 [95% CI 0.87-1.76]). Adults in the highest level (≥300 minutes/week) of physical activity had a higher risk of knee ROA and sROA compared with inactive (0 to <10 minutes/week) participants; however, these associations were not statistically significant (HR 1.62 [95% CI 0.97-2.68] and HR 1.42 [95% CI 0.76-2.65], respectively).
CONCLUSIONS: Meeting the HHS physical activity guidelines was not associated with incident knee ROA or sROA in a cohort of middle-aged and older adults.