■膝关节骨关节炎(OA膝关节)是一种常见的老年病,需要进行全膝关节置换术。假体周围骨折是常见的并发症之一,这与代谢性骨病密切相关。
■我们在2020年11月至2021年4月期间对291名OA膝关节门诊患者进行了一项前瞻性研究。基线特征,双能X线骨密度仪和血液检测结果采用logistic回归分析,以比值比表示,95%置信区间和P值。
■在82.91%的患者中发现了总体代谢性骨疾病。维生素D不足(53.38%)是最普遍的,其次是骨量减少(44.38%),肾功能受损(26.69%),和骨质疏松症(17.45%)。维生素D不足的危险因素为年龄≥71岁(OR0.33,P=0.003)和双侧患侧(OR1.99,P=0.007)。对于骨质减少和骨质疏松症,危险因素是年龄,身体质量指数,患侧,慢性肾脏病(P<0.05)。
■在维生素D不足方面,年龄>70岁和双侧OA膝关节在许多方面显着相关,如减少皮肤合成和日常暴露于阳光和各种疾病,包括CKD和GI吸收不良。骨质减少和骨质疏松症的危险因素可以在多种机制中解释。例如,激素和细胞因子代谢异常会导致脂肪细胞分化和脂肪积累的增加。这种情况可能导致成骨细胞分化减少和破骨细胞活性增加,这可能导致对骨强度的负面影响。
■代谢性骨病在大多数OA膝关节患者中很常见,和维生素D(血清25-羟维生素D)的量不足,骨质疏松,主要确定了骨量减少的条件。这些可预防的疾病具有大多可以纠正的风险因素,这些可预防的疾病具有大多可以纠正的风险因素,例如,获得更多的户外活动,服用维生素D补充剂或开始骨质疏松症治疗计划。需要进一步分析以建立可靠的证据来比较OA和非OA组之间的危险因素。
UNASSIGNED: Osteoarthritis of the knee (OA knee) is a common geriatric disease that require total knee arthroplasty. Periprosthetic fracture is one of the common complications, which is strongly related to metabolic bone disease.
UNASSIGNED: We conducted a prospective study on 291 outpatients with OA knee between November 2020 and April 2021. Baseline characteristics, dual-energy X-ray absorptiometry and blood test results were analysed using logistic regression analysis and expressed as odds ratio, 95% confidence intervals and P-values.
UNASSIGNED: Overall metabolic bone diseases were found in 82.91% of patients. Vitamin D insufficiency (53.38%) was the most prevalent, followed by osteopenia (44.38%), impaired renal function (26.69%), and osteoporosis (17.45%). Risk factors of vitamin D insufficiency are age ≥71 years (OR 0.33, P = 0.003) and bilateral affected side (OR 1.99, P = 0.007). For osteopenia and osteoporosis, risk factors were age, body mass index, affected side, and chronic kidney disease (P < 0.05).
UNASSIGNED: In the aspect of Vit D insufficiency, age>70 and bilateral OA knee were significantly related in many ways, such as reduction in cutaneous synthesis and daily exposure to sunlight and various diseases, including CKD and GI malabsorption. The risk factors of osteopenia and osteoporosis can be explained throughout several mechanisms. For instance, abnormality in hormone and cytokines metabolism will lead to the increase in adipocyte differentiation and fat accumulation. And that situation may lead to the decrease in osteoblast differentiation and increased osteoclast activity which could lead to negative impact on bone strength.
UNASSIGNED: Metabolic bone diseases were common in most patients with OA knee, and the insufficiency in amount of vitamin D(serum 25-hydroxyvitamin D), osteoporosis, and osteopenia conditions were mainly identified. These preventable conditions have risk factors that are mostly correctable These preventable conditions have risk factors that are mostly correctable, for example gain more outdoor activities, consume vitamin D supplement or start osteoporosis treatment program. Further analysis is necessary to establish solid evidence in the comparison of risk factors between the OA and non-OA groups.