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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(03): 310-316
DOI: 10.1055/s-0040-1701281
Artigo Original
Joelho
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Associação entre osteoartrite de joelho e síndrome metabólica em pacientes idosos não institucionalizados[*]

Article in several languages: português | English
Maura Fernandes Franco 
1   Programa de Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
,
Glaucia Regina Falsarella 
2   Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
,
Beatriz Lavras Costallat
3   Departamento de Radiologia, Hospital Vera Cruz, Campinas, Brasil
,
Ibsen Bellini Coimbra 
2   Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
,
Arlete Maria Valente Coimbra 
2   Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
› Author Affiliations
Further Information

Publication History

10 October 2018

19 March 2019

Publication Date:
16 March 2020 (online)

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Resumo

Objetivo Este estudo teve o objetivo de analisar a associação entre a osteoartrite (OA) de joelho e a síndrome metabólica (SM) em pacientes idosos não institucionalizados.

Métodos Pesquisa transversal, aleatorizada, extraída de um estudo probabilístico por conglomerado realizado com 416 idosos de uma Unidade de Saúde da Família do nosso município. A SM foi definida de acordo com o National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), e a OA de acordo com a escala Kellgren-Lawrence (KL) (≥ 2).

Resultados Para a análise estatística, foi realizada uma análise exploratória de dados, testes de Mann-Whitney ou Qui-quadrado e regressões logísticas uni e multivariadas, com nível de significância de p < 0,05; a concordância entre os avaliadores foi verificada através do coeficiente de Kappa. Verificou-se associação entre OA e índice de massa corpórea (IMC) (p = 0,0021) e entre OA e circunferência de cintura (CC) (p < 0,001; razão de chances [RC] = 3,524). Não foi encontrada associação significativa entre a OA e o número de componentes metabólicos nem com a SM em si.

Conclusão Conclui-se que a OA de joelho associa-se à CC, independente do peso, e que o aumento em sua medida reflete em uma maior chance de SM em idosos não institucionalizados.

Palavras-chave

osteoartrite - síndrome metabólica - obesidade - envelhecimento - promoção da saúde

* Trabalho desenvolvido na Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.


 

  • Referências

  • 1 Kluzek S, Newton JL, Arden NK. Is osteoarthritis a metabolic disorder?. Br Med Bull 2015; 115 (01) 111-121
    CrossrefPubMedGoogle Scholar
  • 2 Farnaghi S, Crawford R, Xiao Y, Prasadam I. Cholesterol metabolism in pathogenesis of osteoarthritis disease. Int J Rheum Dis 2017; 20 (02) 131-140
    CrossrefPubMedGoogle Scholar
  • 3 World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1: Diagnosis and classification of diabetes mellitus (No. WHO/NCD/NCS/99.2). Geneva: World health organization; 1999
    Google Scholar
  • 4 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285 (19) 2486-2497
    CrossrefPubMedGoogle Scholar
  • 5 Einhorn D, Reaven GM, Cobin RH. , et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9 (03) 237-252
    PubMedGoogle Scholar
  • 6 Balkau B, Charles MA, Drivsholm T. , et al. European Group For The Study Of Insulin Resistance (EGIR). Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab 2002; 28 (05) 364-376
    PubMedGoogle Scholar
  • 7 Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica. Diretrizes brasileiras de obesidade 2009/2010. 3a ed. Itapevi, SP: AC Farmacêutica; 2009
    Google Scholar
  • 8 Le Clanche S, Bonnefont-Rousselot D, Sari-Ali E, Rannou F, Borderie D. Inter-relations between osteoarthritis and metabolic syndrome: A common link?. Biochimie 2016; 121: 238-252
    CrossrefPubMedGoogle Scholar
  • 9 Courties A, Sellam J, Berenbaum F. Metabolic syndrome-associated osteoarthritis. Curr Opin Rheumatol 2017; 29 (02) 214-222
    CrossrefPubMedGoogle Scholar
  • 10 Grundy SM, Cleeman JI, Daniels SR. , et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112 (17) 2735-2752
    CrossrefPubMedGoogle Scholar
  • 11 Findlay DM. Vascular pathology and osteoarthritis. Rheumatology (Oxford) 2007; 46 (12) 1763-1768
    CrossrefPubMedGoogle Scholar
  • 12 Redon J, Cifkova R, Laurent S. , et al. Scientific Council of the European Society of Hypertension. The metabolic syndrome in hypertension: European society of hypertension position statement. J Hypertens 2008; 26 (10) 1891-1900
    CrossrefPubMedGoogle Scholar
  • 13 Carnevale Schianca GP, Fra GP, Steffanini M. , et al. Impaired glucose metabolism in hypertensive patients with/without the metabolic syndrome. Eur J Intern Med 2014; 25 (05) 477-481
    CrossrefPubMedGoogle Scholar
  • 14 Sellam J, Berenbaum F. Is osteoarthritis a metabolic disease?. Joint Bone Spine 2013; 80 (06) 568-573
    CrossrefPubMedGoogle Scholar
  • 15 Sun AR, Friis T, Sekar S, Crawford R, Xiao Y, Prasadam I. Is synovial macrophage activation the inflammatory link between obesity and osteoarthritis?. Curr Rheumatol Rep 2016; 18 (09) 57
    CrossrefPubMedGoogle Scholar
  • 16 Schett G, Kleyer A, Perricone C. , et al. Diabetes is an independent predictor for severe osteoarthritis: results from a longitudinal cohort study. Diabetes Care 2013; 36 (02) 403-409
    CrossrefPubMedGoogle Scholar
  • 17 Marques CDL, Duarte ALB. A importância do reconhecimento de comorbidades em pacientes com osteoartrite. Temas Reumatol 2011; 12 (01) 3-6
    Google Scholar
  • 18 Kellgren JH, Lawrence JS. The Epidemiology of Chronic Rheumatism: Atlas of Standard Radiographs of Arthritis. Oxford: Blackwell Scientific; 1963
    Google Scholar
  • 19 Dahaghin S, Bierma-Zeinstra SM, Koes BW, Hazes JM, Pols HA. Do metabolic factors add to the effect of overweight on hand osteoarthritis? The Rotterdam Study. Ann Rheum Dis 2007; 66 (07) 916-920
    CrossrefPubMedGoogle Scholar
  • 20 Eymard F, Parsons C, Edwards MH. , et al. Diabetes is a risk factor for knee osteoarthritis progression. Osteoarthritis Cartilage 2015; 23 (06) 851-859
    CrossrefPubMedGoogle Scholar
  • 21 Jungmann PM, Kraus MS, Alizai H. , et al. Association of metabolic risk factors with cartilage degradation assessed by T2 relaxation time at the knee: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 2013; 65 (12) 1942-1950
    CrossrefPubMedGoogle Scholar
  • 22 Atayde SA, Yoshinari NH, Nascimento DP. , et al. Experimental diabetes modulates collagen remodelling of joints in rats. Histol Histopathol 2012; 27 (11) 1471-1479
    PubMedGoogle Scholar
  • 23 Oliviero F, Lo Nigro A, Bernardi D. , et al. A comparative study of serum and synovial fluid lipoprotein levels in patients with various arthritides. Clin Chim Acta 2012; 413 (1-2): 303-307
    CrossrefPubMedGoogle Scholar
  • 24 Gierman LM, van der Ham F, Koudijs A. , et al. Metabolic stress-induced inflammation plays a major role in the development of osteoarthritis in mice. Arthritis Rheum 2012; 64 (04) 1172-1181
    CrossrefPubMedGoogle Scholar
  • 25 Yasuda E, Nakamura R, Matsugi R. , et al. Association between the severity of symptomatic knee osteoarthritis and cumulative metabolic factors. Aging Clin Exp Res 2018; 30 (05) 481-488
    CrossrefPubMedGoogle Scholar
  • 26 Maddah S, Mahdizadeh J. Association of metabolic syndrome and its components with knee osteoarthritis. Acta Med Iran 2015; 53 (12) 743-748
    PubMedGoogle Scholar
  • 27 Han CD, Yang IH, Lee WS, Park YJ, Park KK. Correlation between metabolic syndrome and knee osteoarthritis: data from the Korean National Health and Nutrition Examination Survey (KNHANES). BMC Public Health 2013; 13: 603
    CrossrefPubMedGoogle Scholar
  • 28 Niu J, Clancy M, Aliabadi P, Vasan R, Felson DT. Metabolic syndrome, its components, and knee osteoarthritis: the Framingham osteoarthritis study. Arthritis Rheumatol 2017; 69 (06) 1194-1203
    Google Scholar
  • 29 Shin D. Association between metabolic syndrome, radiographic knee osteoarthritis, and intensity of knee pain: results of a national survey. J Clin Endocrinol Metab 2014; 99 (09) 3177-3183
    CrossrefPubMedGoogle Scholar
  • 30 Chi WC, Wolff J, Greer R, Dy S. Multimorbidity and decision-making preferences among older adults. Ann Fam Med 2017; 15 (06) 546-551
    CrossrefPubMedGoogle Scholar
  • 31 Yarnall AJ, Sayer AA, Clegg A, Rockwood K, Parker S, Hindle JV. New horizons in multimorbidity in older adults. Age Ageing 2017; 46 (06) 882-888
    CrossrefPubMedGoogle Scholar