老年膝关节骨性关节炎患者代谢综合征发生频率及其对体力活动影响的研究

S. Abou‐Raya, Doria Meyers, Eman Sayed, Mervat Kamal-El Deen
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The study included two groups: Gp A: Sixty patients >65 years with primary OA. Gp B: Forty apparently healthy elderly persons without knee OA as a control group. Exclusion Criteria: Patients with secondary knee OA. Methods All Patients were subjected to the following: Complete history taking, self-rated was measured by (SF-36), BMI, complete clinical musculoskeletal examination. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) 1st hr,fasting glucose level, 2 hr-post-prandial glucose level, triglycerides (TG), cholesterol, uric acid, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and radiographic imaging of affected knee joints. Results According to (k/L) score of severity; grade 3 and grade 4 OA were significantly higher in patients with Met S than patients without Met S. The mean WOMAC pain subscale score was significantly higher in patients with OA and Met S than in patients with OA and without Met S with P value (<0.001). 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引用次数: 1

摘要

肥胖与骨关节炎(OA)的风险增加有关。代谢综合征(Met S)与慢性低度炎症状态和脂肪组织中巨噬细胞增加有关。高血压和高血糖似乎是骨关节炎关节变化的重要非bmi因素。此外,2型糖尿病(DM)已被发现是关节置换术的独立风险预测因子。目的探讨老年膝关节骨性关节炎患者代谢综合征的发生频率、与代谢综合征的相关性及其对老年膝关节骨性关节炎患者身体活动的影响。该研究包括65岁以上主诉原发性膝关节OA的患者。该研究包括两组:Gp A组:60例>65岁的原发性OA患者。Gp B: 40例无膝关节OA的明显健康老年人作为对照组。排除标准:继发性膝关节OA患者。方法对所有患者进行完整的病史记录、SF-36自评、BMI、完整的临床肌肉骨骼检查。c反应蛋白(CRP)、红细胞沉降率(ESR)第1小时、空腹血糖水平、餐后2小时血糖水平、甘油三酯(TG)、胆固醇、尿酸、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)及患病膝关节影像学检查。结果根据(k/L)严重程度评分;伴有Met S的OA患者的3级和4级OA评分明显高于未伴有Met S的患者。伴有Met S的OA患者的WOMAC疼痛亚量表平均评分显著高于伴有OA和未伴有Met S的患者,P值均<0.001。关节疼痛、僵硬度与空腹血糖水平呈正相关(r= - 0.463 P=<0.001;r=0.324, P=0.012);结论:骨性关节炎患者(I组)的收缩压、舒张压和腰围与骨性关节炎患者(I组)的Met S成分相关。
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Study of metabolic syndrome frequency in elderly patients with knee osteoarthritis and its impact on the physical activity
Background Obesity is associated with an increased risk of osteoarthritis (OA). Metabolic syndrome (Met S) has been associated with a state of chronic low-grade inflammation and increased macrophages in the fat tissue. Hypertension and hyperglycaemia seem to be important BMI-independent factors of changes in osteoarthritic joints. Moreover, type 2 diabetes mellitus (DM) has been found to be an independent risk predictor for arthroplasty. Aim of the work To determine frequency and association of metabolic syndrome with knee osteoarthritis in elderly patients and its impact on the physical activity in elderly patients with knee osteoarthritis. Patients The study included patients aged above 65 years complaining of primary knee OA. The study included two groups: Gp A: Sixty patients >65 years with primary OA. Gp B: Forty apparently healthy elderly persons without knee OA as a control group. Exclusion Criteria: Patients with secondary knee OA. Methods All Patients were subjected to the following: Complete history taking, self-rated was measured by (SF-36), BMI, complete clinical musculoskeletal examination. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) 1st hr,fasting glucose level, 2 hr-post-prandial glucose level, triglycerides (TG), cholesterol, uric acid, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and radiographic imaging of affected knee joints. Results According to (k/L) score of severity; grade 3 and grade 4 OA were significantly higher in patients with Met S than patients without Met S. The mean WOMAC pain subscale score was significantly higher in patients with OA and Met S than in patients with OA and without Met S with P value (<0.001). There was a significant positive correlation between the both joint pain, stiffness and fasting blood glucose level (r=−0.463 P=<0.001; r=0.324, P=0.012 respectively); systolic, diastolic blood pressure and waist circumference in OA patients (group I) with Met S. Conclusion Elevated systemic markers of inflammation are linked with components of Met S, with an increased prevalence of radiographic OA and joint symptoms.
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