期刊论文详细信息
BMC Musculoskeletal Disorders
Body mass index, occupational activity, and leisure-time physical activity: an exploration of risk factors and modifiers for knee osteoarthritis in the 1946 British birth cohort
Andrew K Wills5  David Coggon4  Jack M Guralnik2  Tamara B Harris3  Diana Kuh1  Kathryn R Martin1 
[1] MRC Unit for Lifelong Health and Ageing, University College London, London, UK;Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland, Maryland, USA;Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Avenue, Room 3C309, Bethesda, Maryland 20814, USA;MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK;MRC CAiTE, School of Social & Community Medicine, University of Bristol, Bristol, UK
关键词: Occupational activity;    Physical activity;    Body mass index;    Knee osteoarthritis;   
Others  :  1130186
DOI  :  10.1186/1471-2474-14-219
 received in 2013-02-04, accepted in 2013-07-19,  发布年份 2013
PDF
【 摘 要 】

Background

Knee osteoarthritis (kOA) risk is increased by obesity and physical activities (PA) which mechanically stress the joint. We examined the associations of midlife kOA with body mass index (BMI) and activity exposure across adult life and their interaction.

Methods

Data are from a UK birth cohort of 2597 participants with a clinical assessment for kOA at age 53. At ages 36, 43 and 53 BMI (kg/m2), self-reported leisure-time PA, and occupational activity (kneeling/squatting; lifting; climbing; sitting; assigned using a job-exposure matrix) were ascertained. Associations were explored using the multiplicative logistic model.

Results

BMI was strongly and positively associated with kOA in men and women. Men and women in manual occupations also had greater odds of kOA; there was a weak suggestion that kOA risk was higher among men exposed to lifting or kneeling at work. For men, the only evidence of a multiplicative interaction between BMI and activities was for lifting (p = 0.01) at age 43; BMI conferred higher kOA risk among those most-likely to lift at work (OR per increase in BMI z-score: 3.55, 95% CI: 1.72-7.33). For women, the only evidence of an interaction was between BMI and leisure-time PA (p = 0.005) at age 43; BMI conferred higher kOA risk among those at higher PA levels (OR per increase in BMI z-score: 1.59, 95% CI: 1.26-2.00 in inactive; 1.70, 95% CI: 1.14-2.55 (less-active); and 4.44; 95% CI: 2.26-8.36 (most-active).

Conclusions

At the very least, our study suggests that more active individuals (at work and in leisure) may see a greater reduction in risk of kOA from avoiding a high BMI than those less active.

【 授权许可】

   
2013 Martin et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150226181307560.pdf 389KB PDF download
Figure 1. 48KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Blagojevic M, Jinks C, Jeffery A, Jordan KP: Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthr Cartil 2010, 18:24-33.
  • [2]Manninen P, Riihimaki H, Heliovaara M, Makela P: Overweight, gender and knee osteoarthritis. Int J Obes Relat Metab Disord 1996, 20:595-597.
  • [3]Felson DT, Zhang Y: An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998, 41:1343-1355.
  • [4]D’Souza JC, Werner RA, Keyserling WM, Gillespie B, Rabourn R, Ulin S, et al.: Analysis of the Third National Health and Nutrition Examination Survey (NHANES III) using expert ratings of job categories. Am J Ind Med 2008, 51:37-46.
  • [5]Dawson J, Juszczak E, Thorogood M, Marks SA, Dodd C, Fitzpatrick R: An investigation of risk factors for symptomatic osteoarthritis of the knee in women using a life course approach. J Epidemiol Community Health 2003, 57:823-830.
  • [6]Manninen P, Heliovaara M, Riihimaki H, Suoma-Iainen O: Physical workload and the risk of severe knee osteoarthritis. Scand J Work Environ Health 2002, 28:25-32.
  • [7]Coggon D, Croft P, Kellingray S, Barrett D, McLaren M, Cooper C: Occupational physical activities and osteoarthritis of the knee. Arthritis Rheum 2000, 43:1443-1449.
  • [8]Yoshimura N, Nishioka S, Kinoshita H, Hori N, Nishioka T, Ryujin M, et al.: Risk factors for knee osteoarthritis in Japanese women: heavy weight, previous joint injuries, and occupational activities. J Rheumatol 2004, 31:157-162.
  • [9]Sandmark H, Vingard E: Sports and risk for severe osteoarthrosis of the knee. Scand J Med Sci Sports 1999, 9:279-284.
  • [10]Cooper C, McAlindon T, Coggon D, Egger P, Dieppe P: Occupational activity and osteoarthritis of the knee. Ann Rheum Dis 1994, 53:90-93.
  • [11]Klussmann A, Gebhardt H, Nubling M, Liebers F, Quiros PE, Cordier W, et al.: Individual and occupational risk factors for knee osteoarthritis: results of a case–control study in Germany. Arthritis Res Ther 2010, 12:R88. BioMed Central Full Text
  • [12]Lau EC, Cooper C, Lam D, Chan VN, Tsang KK, Sham A: Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: obesity, joint injury, and occupational activities. Am J Epidemiol 2000, 152:855-862.
  • [13]Vingard E: Osteoarthrosis of the knee and physical load from occupation. Ann Rheum Dis 1996, 55:677-679.
  • [14]Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, et al.: Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 2000, 133:635-646.
  • [15]Ding C, Cicuttini F, Scott F, Cooley H, Jones G: Knee structural alteration and BMI: a cross-sectional study. Obes Res 2005, 13:350-361.
  • [16]Amin S, Goggins J, Niu J, Guermazi A, Grigoryan M, Hunter DJ, et al.: Occupation-related squatting, kneeling, and heavy lifting and the knee joint: a magnetic resonance imaging-based study in men. J Rheumatol 2008, 35:1645-1649.
  • [17]Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al.: National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011, 377:557-567.
  • [18]Vrezas I, Elsner G, Bolm-Audorff U, Abolmaali N, Seidler A: Case-control study of knee osteoarthritis and lifestyle factors considering their interaction with physical workload. Int Arch Occup Environ Health 2010, 83:291-300.
  • [19]Toivanen AT, Heliovaara M, Impivaara O, Arokoski JP, Knekt P, Lauren H, et al.: Obesity, physically demanding work and traumatic knee injury are major risk factors for knee osteoarthritis–a population-based study with a follow-up of 22 years. Rheumatology (Oxford) 2010, 49:308-314.
  • [20]Imeokparia RL, Barrett JP, Arrieta MI, Leaverton PE, Wilson AA, Hall BJ, et al.: Physical activity as a risk factor for osteoarthritis of the knee. Ann Epidemiol 1994, 4:221-230.
  • [21]Cheng Y, Macera CA, Davis DR, Ainsworth BE, Troped PJ, Blair SN: Physical activity and self-reported, physician-diagnosed osteoarthritis: is physical activity a risk factor? J Clin Epidemiol 2000, 53:315-322.
  • [22]Hootman JM, Macera CA, Helmick CG, Blair SN: Influence of physical activity-related joint stress on the risk of self-reported hip/knee osteoarthritis: a new method to quantify physical activity. Prev Med 2003, 36:636-644.
  • [23]Felson DT, Niu J, Clancy M, Sack B, Aliabadi P, Zhang Y: Effect of recreational physical activities on the development of knee osteoarthritis in older adults of different weights: the Framingham Study. Arthritis Rheum 2007, 57:6-12.
  • [24]Verweij LM, van Schoor NM, Deeg DJ, Dekker J, Visser M: Physical activity and incident clinical knee osteoarthritis in older adults. Arthritis Rheum 2009, 61:152-157.
  • [25]Mork PJ, Holtermann A, Nilsen TI: Effect of body mass index and physical exercise on risk of knee and hip osteoarthritis: longitudinal data from the Norwegian HUNT Study. J Epidemiol Community Health 2012, 66:678-683.
  • [26]McAlindon TE, Wilson PW, Aliabadi P, Weissman B, Felson DT: Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framingham study. Am J Med 1999, 106:151-157.
  • [27]Szoeke C, Cicuttini F, Guthrie J, Clark M, Dennerstein L: Factors affecting the prevalence of osteoarthritis in healthy middle-aged women: data from the longitudinal Melbourne women’s midlife health project. Bone 2006, 39:1149-1155.
  • [28]Wills AK, Black S, Cooper R, Coppack RJ, Hardy R, Martin KR, et al.: Life course body mass index and risk of knee osteoarthritis at the age of 53 years: evidence from the 1946 British birth cohort study. Ann Rheum Dis 2011, 71:655-660.
  • [29]Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al.: Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum 1986, 29:1039-1049.
  • [30]Cole TJ: The LMS method for constructing normalized growth standards. Eur J Clin Nutr 1990, 44:45-60.
  • [31]Kuh DJ, Cooper C: Physical activity at 36 years: patterns and childhood predictors in a longitudinal study. J Epidemiol Community Health 1992, 46:114-119.
  • [32]Kuh DJ, Coggan D, Mann S, Cooper C, Yusuf E: Height, occupation and back pain in a national prospective study. Br J Rheumatol 1993, 32:911-916.
  • [33]Baker P, Reading I, Cooper C, Coggon D: Knee disorders in the general population and their relation to occupation. Occup Environ Med 2003, 60:794-797.
  • [34]Holmberg S, Thelin A, Thelin N: Knee osteoarthritis and body mass index: a population-based case–control study. Scand J Rheumatol 2005, 34:59-64.
  • [35]Sandmark H, Hogstedt C, Lewold S, Vingard E: Osteoarthrosis of the knee in men and women in association with overweight, smoking, and hormone therapy. Ann Rheum Dis 1999, 58:151-155.
  • [36]Wadsworth M, Kuh D, Richards M, Hardy R: Cohort profile: the 1946 National Birth Cohort (MRC National Survey of Health and Development). Int J Epidemiol 2006, 35:49-54.
  • [37]Wadsworth ME, Butterworth SL, Hardy RJ, Kuh DJ, Richards M, Langenberg C, et al.: The life course prospective design: an example of benefits and problems associated with study longevity. Soc Sci Med 2003, 57:2193-2205.
  • [38]Oliveria SA, Felson DT, Reed JI, Cirillo PA, Walker AM: Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum 1995, 38:1134-1141.
  • [39]Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G: A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthr Cartil 2005, 13:769-781.
  • [40]Vingard E, Alfredsson L, Goldie I, Hogstedt C: Occupation and osteoarthrosis of the hip and knee: a register-based cohort study. Int J Epidemiol 1991, 20:1025-1031.
  • [41]Anderson JJ, Felson DT: Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol 1988, 128:179-189.
  • [42]McWilliams DF, Leeb BF, Muthuri SG, Doherty M, Zhang W: Occupational risk factors for osteoarthritis of the knee: a meta-analysis. Osteoarthr Cartil 2011, 19:829-839.
  文献评价指标  
  下载次数:0次 浏览次数:0次