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| 膝骨关节炎和肌肉减少症的独立和联合作用与髋部骨折风险的关联 |
| Independent and combined effects of knee osteoarthritis and sarcopenia on the risk of hip fracture |
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| DOI：10.3969/j.issn.1006-7108.2026.01.009 |
| 中文关键词: 中老年人 膝骨关节炎 肌少症 髋部骨折 中国健康与养老追踪调查 |
| 英文关键词:middle-aged and elderly people knee osteoarthritis sarcopenia hip fracture China health and retirement longitudinal study |
| 基金项目:山东省医药卫生科技项目（202304071439）；山东省自然科学基金（ZR2023LZY018）；日照市中医药科技项目（RZY2023C06） |
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| 中文摘要: |
| 目的 基于中国人群探究膝骨关节炎和肌肉减少症的独立和联合作用对髋部骨折风险的影响，为我国中老年人群髋部骨折的防治工作提供科学依据。方法 本研究为前瞻性队列研究，使用中国健康与养老追踪调查2011年基线数据和2013年、2015年、2018年、2020年随访数据，采用多因素Cox回归模型分析膝骨关节炎和肌肉减少症对中国中老年人髋部骨折风险的独立和联合作用，并进行敏感性分析以检验结果的可靠性。结果 共纳入9106例研究对象，其中膝骨关节炎1026例，患病率为11.3%，肌肉减少症742例，患病率为8.1%，随访期间，共319例研究对象发生髋部骨折事件，发生率为3.5%。独立作用分析显示，膝骨关节炎（HR=1.67，95%CI：1.25～2.23）和肌肉减少症（HR=1.86，95%CI：1.31～2.62）均是髋部骨折的独立危险因素；联合作用分析显示，以非膝骨关节炎/非肌肉减少症组为参照，膝骨关节炎/肌肉减少症组（HR=2.49，95%CI：1.34～4.62）髋部骨折风险最高，高于非膝骨关节炎/肌肉减少症组（HR=1.97，95%CI：1.34～2.88）和膝骨关节炎/非肌肉减少症组（HR=1.75，95%CI：1.27～2.39），敏感性分析显示结果稳定可靠。结论 膝骨关节炎和肌肉减少症均会增加中国中老年人髋部骨折发生风险，两者的联合作用强于各自的独立作用，对膝骨关节炎和肌肉减少症的早期识别和及时治疗有助于我国中老年人群髋部骨折的防治工作。 |
| 英文摘要: |
| Objective To evaluate the independent and combined effects of knee osteoarthritis (KOA) and sarcopenia on the risk of hip fracture based on the Chinese population, and to provide scientific evidence for the prevention and treatment of hip fracture in middle-aged and elderly people in China. Methods This study was a prospective cohort study based on the baseline data of year 2011 and the follow-up data of the years 2013, 2015, 2018, 2020 from the CHARL. Multivariate Cox regression models were established to analyze the independent and combined effects of KOA and sarcopenia on the risk of hip fracture. The sensitivity analysis was performed to test the reliability of the results. Results A total of 9106 participants were enrolled in this study. The prevalence of KOA was 11.3% (1026 cases), while the prevalence of sarcopenia was 8.1% (742 cases). During the follow-up period, 319 participants experienced hip fracture events, with an incidence of 3.5%. The independent effect analysis showed that KOA (HR=1.67, 95%CI: 1.25-2.23) and sarcopenia (HR=1.86, 95%CI: 1.31-2.62) were both independent risk factors for hip fracture. Compared with the non-KOA/non-sarcopenia group, the combined effect analysis showed that the KOA/sarcopenia group (HR=2.49, 95%CI: 1.34-4.62) had the highest risk of hip fracture, which was higher than that of the non-KOA/sarcopenia group (HR=1.97, 95%CI: 1.34-2.88) and KOA/non-sarcopenia group (HR=1.75, 95%CI: 1.27-2.39). Sensitivity analysis showed that the results were stable and reliable. Conclusion Both KOA and sarcopenia could increase the risk of hip fracture in middle-aged and elderly people in China. The combined effects were stronger than their independent effects. Early identification and timely treatment of KOA and sarcopenia would be helpful for the prevention and treatment of hip fracture in middle-aged and elderly people in China. |
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