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Authors Hellevik AI, Johnsen MB, Langhammer A, Baste V, Furnes O, Storheim K, Zwart JA, Flugsrud GB, Nordsletten L
Received 10 July 2017
Accepted for publication 25 October 2017
Published 10 January 2018 Volume 2018:10 Pages 83—96
DOI https://doi.org/10.2147/CLEP.S145823
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 5
Editor who approved publication: Professor Henrik Toft Sørensen
Objective: Biochemical changes associated with obesity may accelerate
osteoarthritis beyond the effect of mechanical factors. This study investigated
whether metabolic syndrome and its components (visceral obesity, hypertension,
dyslipidemia and insulin resistance) were risk factors for subsequent total hip
replacement (THR) or total knee replacement (TKR) due to primary
osteoarthritis.
Design: In this prospective cohort study, data from the
second survey of the Nord-Trøndelag Health Study 2 (HUNT2) were linked to the
Norwegian Arthroplasty Register for identification of the outcome of THR or
TKR. The analyses were stratified by age (<50, 50–69.9 and ≥70 years) and
adjusted for gender, body mass index, smoking, physical activity and education.
Results: Of the 62,661 participants, 12,593 (20.1%) were
identified as having metabolic syndrome, and we recorded 1,840 (2.9%) THRs and
1,111 (1.8%) TKRs during a mean follow-up time of 15.4 years. Cox regression
analyses did not show any association between full metabolic syndrome and THR
or TKR, except in persons <50 years with metabolic syndrome who had a
decreased risk of THR (hazard ratio [HR] 0.58, 95% CI 0.40–0.83). However, when
including only participants whose exposure status did not change during
follow-up, this protective association was no longer significant. Increased
waist circumference was associated with increased risk of TKR in participants
<50 years (HR 1.62, 95% CI 1.10–2.39) and 50–69.9 years (HR 1.43, 95% CI
1.14–1.80). Hypertension significantly increased the risk of TKR in
participants <50 years (HR 1.38, 95% CI 1.05–1.81), and this risk was
greater for men.
Conclusion: This study found an increased risk of TKR in men
<50 years with hypertension and persons <70 years with increased waist
circumference. Apart from this, neither metabolic syndrome nor its components
were associated with increased risk of THR or TKR due to primary
osteoarthritis.
Keywords: osteoarthritis,
metabolic syndrome, total hip replacement, total knee replacement
摘要视频链接:Metabolic syndrome and THR or
TKR: a prospective cohort study