膝骨关节炎合并代谢综合征的临床研究

Clinical investigation of knee osteoarthritis with metabolic syndrome

目的 探讨膝OA患者合并代谢综合征（MS）的患病情况、临床特点.方法 选取在我院风湿免疫科门诊诊断的膝OA患者410例,按有无合并MS分为单纯膝OA组（无MS组）245例,膝OA合并MS组（合并MS组）165例,比较2组患者的临床资料.结果 膝OA合并MS的患病率为40.2％,2组患者的性别比差异有统计学意义（x2=5.853,P=0.001）,发病年龄差异无统计学意义（P＞0.05）;合并MS组患者的腰围、BMI、收缩压、TG、LDL-C、糖化血红蛋白（HbA1c）均较单纯膝OA组明显增高（t值分别为3.123,4.679,2.818,3.697,2.632,2.907,P均＜0.05）,但是舒张压、血清TC、HDL-C和空腹血糖差异无统计学意义（P＞0.05）;膝OA合并MS组冠心病及高血压病的发生率较无MS组显著增高（x2值分别为6.676和10.421,P均＜0.05）,而糖尿病的发生率并未明显增高（P＞0.05）.结论 膝OA合并MS患者并发症发生率高,代谢异常程度严重,应给予有效的干预措施.

Objective To explore the morbidity and clinical characteristics of knee osteoarthritis （OA） complicated with metabolic syndrome （MS）.Methods Four hundred and ten patients with knee OA were enrolled into this survey.The subjects were divided into two groups：those with knee OA only：those with both OA and MS.Clinical data in the two groups were evaluated.Results The prevalence of MS was 40.2% in all knee OA patients,there was significant difference between the two groups according to the ratio of male to female （x2=5.853,P=0.001）,but no difference between the two groups according to age distribution respectively （P〉0.05）.For metabolic parameters,waist circumference,triglyceride （TG）,low density lipoprotein cholesterol （LDL-C）,systolic blood pressure and glycosylated hemoglobin （HbA1c） were significantly increased in the group with both of the two diseases （OA and MS）,comparing with those with knee OA only （t=3.123,4.679,2.818,3.697,2.632,2.907,P〈0.05）.However,there was no difference in both group in serum total cholesterol （TC）,high density lipoprotein cholesterol （HDL-C） and fasting plasma glucose level （P〉0.05）.Incidence of coronary heart disease,diabetes mellitus and hypertension was higher in the group with both OA and MS than that in knee OA only group （x2=6.676 and 104.12,P〈0.05）.The incidence of diabetes mellitus was not different between the two groups （P〉0.05）.Conclusion The incidence of metabolic syndrome in knee OA patients is relatively high.Effective treatment should be invited to treat knee OA with MS.