摘要
目的本研究拟分析膝骨关节炎(KOA)患者群体中的肌少症(SP)发病率以及发病特点,分析两种疾病的共同发病特征。方法按纳入排除标准共收集2022年11月至2023年7月于广州中医药大学第三附属医院关节中心住院治疗的KOA患者共129例(215侧下肢)。纳入标准:近1个月内膝关节疼痛,年龄≥50岁,晨僵时间≤30 min,X线片提示膝关节间隙变窄、软骨下骨硬化和/或囊性变、骨赘形成;排除标准:诊断为其他类型关节炎,合并有影响下肢肢体功能的其他疾病,无法配合数据收集。提取一般资料[性别、年龄、身高、体重、身体质量指数(BMI)],及四肢骨骼肌质量指数(ASMI)、髋膝踝角(HKA)、关节线夹角(JLCA)、膝关节内侧关节间隙宽度(MJSW)、外侧关节间隙宽度(LJSW)等相关数据。按照亚洲肌少症工作组提出的肌少症诊断将患者分为肌少症-膝骨关节炎(SP-KOA)组和膝骨关节炎(KOA)组,采用秩和检验、独立样本t检验、卡方检验等对不同数据类型的资料进行组间分析。根据logistic回归分析KOA患者患SP的危险因素,采用R语言根据logistic回归筛选的影响因素构建评估KOA患者的SP患病风险的列线图模型,并评估模型区分度与准确度。结果129例KOA患者中合并SP者共28例,SP患病率为21.7%。总样本分析显示SP-KOA组下肢力线状况更好(Z=2.901,P<0.05),KOA严重程度更轻(χ^(2)=10.290,P<0.05),同时BMI更低(Z=7.175,P<0.05),男性比例更高(χ^(2)=7.224,P<0.05)。二元logistic回归分析提示男性KOA患者的BMI[比值比(OR)=0.254,95%置信区间(CI)(0.087,0.747)],以及女性KOA患者的BMI[OR=0.782,95%CI(0.679,0.899)]、LJSW[OR=0.596,95%CI(0.396,0.897)]、年龄[OR=1.066,95%CI(1.003,1.132)]对SP发病的影响有统计学意义(均为P<0.05)。结论本研究表明在KOA患者中,男性KOA患者、BMI偏低的患者可能更易合并SP,这提示在膝骨关节炎早期应提倡患者均衡膳食,纠正体重偏低,同时进行非负重性锻�
Objective To analyze the incidence and characteristics of sarcopenia(SP)in the population of knee osteoarthritis(KOA)patients and explore common features between the two conditions.Methods A total of 129 KOA patients(215 lower limbs)treated at the Joint Center of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from November 2022 to July 2023 were included based on specific criteria.Inclusion criteria:knee joint pain within the past month,age≥50 years,morning stiffness≤30 min,and X-ray evidence of narrowed knee joint space,subchondral bone sclerosis,and/or cystic changes,and osteophyte formation.Exclusion criteria:other types of arthritis,concurrent lower limb impairing conditions,and inability to cooperate with data collection.General information[gender,age,height,weight,body mass index(BMI)],and relevant data such as appendicular skeletal muscle mass index(ASMI),hip-knee-ankle angle(HKA),joint line convergence angle(JLCA),medial joint space width(MJSW),and lateral joint space width(LJSW)were collected.According to the criteria proposed by the Asian Working Group for Sarcopenia,patients were categorized into the SP-KOA group and KOA group.Group analysis was conducted using rank-sum tests,independent sample t tests,and chi-square tests.Logistic regression analysis was performed to identify risk factors for SP in KOA patients.A nomogram model was constructed using R language based on logistic regression-selected influencing factors,and the model's discriminative ability and accuracy were assessed.Results Among the 129 KOA patients,28 had concomitant SP,resulting in a sarcopenia incidence rate of 21.7%.The overall analysis showed that the lower limb alignment was better in the SP-KOA group(Z=2.901,P<0.05),KOA severity was milder(χ^(2)=10.290,P<0.05),BMI was lower(Z=7.175,P<0.05),and the proportion of males was higher(χ^(2)=7.224,P<0.05).Binary logistic regression analysis indicated that BMI in male KOA patients[odds ratio(OR)=0.254,95%confidence interval(CI)(0.087,0.747)],and in femal
作者
姚放鸣
焦莹莹
何敏聪
曾子俊
何晓铭
刘良燕
何伟
魏秋实
刘文刚
Yao Fangming;Jiao Yingying;He Mincong;Zeng Zijun;He Xiaoming;Liu Liangyan;He Wei;Wei Qiushi;Liu Wengang(The Third Clinical College of Guangzhou University of Chinese Medicine,Guangzhou 510145,China;Science and Technology Innovation Center of Guangzhou University of Chinese Medicine,Guangzhou 510080,China;Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine,Guangzhou 510095,China;The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510145,China;Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine,Guangzhou 510145,China;Doctoral Workstation of Jiexi County Chinese Medicine Hospital,Jieyang 515400,China;Guangdong Second Traditional Chinese Medicine Hospital(Guangdong Research Institute of Traditional Chinese Medicine Manuracturing Technology),Guangzhou 510030,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2024年第1期30-38,共9页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
广东省中医药研究开发重点实验室开放基金资助课题(KFKT01-003)
广东省中医药局中医药科研项目(科研平台专项)(20233002)
广东省中医骨伤研究院开放课题基金项目(GYH202201-01)
广东省中医药局科研项目(20211209)
关键词
肌减少症
骨关节炎
膝
横断面研究
危险因素
列线图
Sarcopenia
Osteoarthritis,knee
Cross-sectional studies
Risk factors
Nomograms
