The risk factors for knee osteoarthritis among Chinese population: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

XU Chengyan ¹ , CHEN Junxiang ¹ , WANG Jiaoming ¹ , DING Qing ¹ , WANG Hui ² , YU Wenya ² , SHI Jianwei ² , WANG Zhaoxin ² ,  LI Liqiu ¹

1. Zhuanqiao Community Health Service Center, Minhang District, Shanghai 201108, P.R.China;
2. School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R.China;

Corresponding author：

LI Liqiu, Email: liliqiu344@163.com

Keywords：

Chinese; Knee osteoarthritis; Risk factor; Meta-analysis; Systematic review; Case-control study; Cross-sectional study

DOI：

10.7507/1672-2531.202102072

Video：

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Objective To systematically review the risk factors for knee osteoarthritis among Chinese population.Methods CNKI, WanFang Data, PubMed and EMbase databases were electronically searched to collect studies related to risk factors for knee osteoarthritis in Chinese population from January 2005 to November 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; meta-analysis was then performed using RevMan 5.4 software.Results A total of 18 studies involving 46 375 patients were included. The results of meta-analysis showed that body mass index (BMI)≥28 kg/m² (OR=1.78, 95%CI 1.47 to 2.14, P<0.000 1), females (OR=2.20, 95%CI 1.98 to 2.45, P<0.000 1), family history of osteoarthritis (OR=3.56, 95%CI 1.88 to 6.73, P<0.000 1), age≥60 years old (OR=1.42, 95%CI 1.26 to 1.59, P<0.000 1), history of joint trauma (OR=4.11, 95%CI 2.85 to 5.93, P<0.000 1), manual labor (OR=1.57, 95%CI 1.32 to 1.86, P<0.000 1), heavy housework (OR=1.63, 95%CI 1.20 to 2.22, P<0.000 1), humid environment (OR=4.33, 95%CI 2.99 to 6.29, P<0.000 1), drinking habit (OR=1.69, 95%CI 1.21 to 2.36, P=0.002), non-elevator building (OR=1.78, 95%CI 1.18 to 2.70, P=0.006), joint load (OR=9.14, 95%CI 3.05 to 27.45, P<0.000 1), cold environment (OR=2.13, 95%CI 1.32 to 3.44, P=0.002), and habit of sitting cross-legged (OR=7.56, 95%CI 1.74 to 32.79, P=0.007) were risk factors for knee osteoarthritis among Chinese population.Conclusions Controlling and reducing weight, preventing knee injuries, keeping joints warm, controlling alcohol consumption, improving humid and cold living environment, appropriately reducing heavy physical labor, reducing joint weight, and changing the habit of sitting cross-legged can prevent the occurrence of knee osteoarthritis.

Citation： XU Chengyan, CHEN Junxiang, WANG Jiaoming, DING Qing, WANG Hui, YU Wenya, SHI Jianwei, WANG Zhaoxin, LI Liqiu. The risk factors for knee osteoarthritis among Chinese population: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(7): 772-778. doi: 10.7507/1672-2531.202102072 Copy

1.	Klareskog L, Catrina AI, Paget S. Rheumatoid arthritis. Lancet, 2009, 373(9664): 659-672.
2.	中华医学会风湿病学分会. 骨关节炎诊断及治疗指南. 中华风湿病学杂志, 2010, 14(6): 416-419.
3.	Cross M, Smith E, Hoy D, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis, 2014, 73(7): 1323-1330.
4.	郑双, 徐建华, 黄淑婷, 等. 某三甲医院 148 例膝骨关节炎患者就医及治疗现状分析. 中华疾病控制杂志, 2015, 19(1): 91-92, 106.
5.	郭燕梅, 黄鹏, 陈蔚, 等. 老年单, 双膝痛骨关节炎患者的平衡功能及其跌倒风险对比分析. 中国康复理论与实践, 2012, 18(1): 25-29.
6.	王秋华, 翁长水, 郭燕梅, 等. 单双膝痛老年骨关节炎患者生活质量状况的比较. 中华保健医学杂志, 2011, 13(4): 303-306.
7.	Wells GA. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
8.	曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
9.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions, 2014-02-25. Available at: http://handbook.cochrane.org/.
10.	赵昌, 李红, 胡志富, 等. 云南大理地区膝关节骨性关节炎危险因素分析. 大理大学学报, 2019, 4(4): 75-78.
11.	沈锋, 夏正明, 周满春. 广州市南石头社区中老年群体膝骨关节炎的危险因素分析. 江西医药, 2019, 54(2): 144-146.
12.	张洪逵, 陈国华, 叶壮益. 膝骨关节炎发生的影响因素分析. 实用中西医结合临床, 2018, 18(7): 120-121.
13.	杨迎春, 顾海伦, 白伦浩, 等. 辽宁省某三甲医院膝关节骨性关节炎患者常见影响因素的调查. 现代预防医学, 2018, 45(8): 1516-1519.
14.	马翅, 陈铖, 张莹, 等. 驻某地团级以上军队干部骨关节炎流行病学调查. 中华关节外科杂志(电子版), 2018, 12(2): 217-221.
15.	张思恒, 董晓梅, 叶云凤, 等. 广州地区 15 岁及以上人群骨关节炎流行病学特征及危险因素分析. 中华疾病控制杂志, 2015, 19(1): 9-12.
16.	向珍蛹, 茅建春, 曲环汝, 等. 浦东上钢社区中老年人群膝骨关节炎危险因素的流行病学研究. 上海交通大学学报(医学版), 2013, 33(3): 318-322.
17.	林炎水. 膝关节骨性关节炎影响因素分析. 现代预防医学, 2012, 39(4): 815-816.
18.	向湘松, 谢诗涓, 熊莺. 老年人膝关节骨性关节炎影响因素分析研究. 中国骨质疏松杂志, 2011, 17(7): 613-616.
19.	徐辉燕, 黄伟钢, 傅可琪. 广州市城区成人膝骨关节炎相关因素调查研究. 中华全科医学, 2011, 9(5): 774-776.
20.	颜斌, 李溥, 梁家龙, 等. 少数民族地区骨性关节炎患病及危险因素分析. 中国公共卫生, 2010, 26(10): 1267-1268.
21.	何春红, 谭妃英, 谢小鸣, 等. 广州市越秀区 126 例老年人膝关节骨性关节炎患病危险因素: 与 121 例老年组的病例-对照分析. 中国组织工程研究与临床康复, 2009, 13(33): 6581-6584.
22.	孙国梁, 吕发明. 膝关节骨性关节炎危险因素的病例对照研究. 新疆中医药, 2008, 26(3): 44-45.
23.	蓝常贡. 百色地区膝骨关节炎病因探讨. 南宁: 广西医科大学, 2007: 1-60.
24.	劳山, 郭艾军. 骨关节炎与遗传关系的研究. 广西医科大学学报, 2007, 24(4): 602-603.
25.	史冬泉, 戴进, 刘澄, 等. 体质指数与膝关节骨性关节炎. 中国公共卫生, 2007, 23(3): 299-300.
26.	Zhang JF, Song LH, Wei JN, et al. Prevalence of and risk factors for the occurrence of symptomatic osteoarthritis in rural regions of Shanxi Province, China. Int J Rheum Dis, 2016, 19(8): 781-789.
27.	Jiang L, Rong J, Zhang Q, et al. Prevalence and associated factors of knee osteoarthritis in a community-based population in Heilongjiang, Northeast China. Rheumatol Int, 2012, 32(5): 1189-1195.
28.	Rasheed Z, Rasheed N, Al-Shobaili HA. Epigallocatechin-3-O-gallate up-regulates microRNA-199a-3p expression by down-regulating the expression of cyclooxygenase-2 in stimulated human osteoarthritis chondrocytes. J Cell Mol Med, 2016, 20(12): 2241-2248.
29.	卢敏强, 钟庆, 贾兆锋, 等. 雌激素与骨关节炎. 国际骨科学杂志, 2018, 39(1): 41-44.
30.	马晓军, 郭浩辉, 郝绍文, 等. 宁夏回族原发性膝骨性关节炎与瘦素受体基因多态性的相关性. 遗传, 2013, 35(3): 359-364.
31.	尹丽, 邱丽颖. 中老年膝骨关节炎发病的相关因素分析. 吉林医学, 2015, (18): 4139-4140.
32.	李玉飞, 李康华, 中南大学, 等. 湖南省中老年膝骨关节炎的流行病学调查研究.
33.	洪俊毅, 张小春, 许冠华. 膝骨性关节炎发病主要危险因素 Meta 分析. 浙江中西医结合杂志, 2016, 26(11): 1042-1044, 1045.
34.	吴鹏, 夏伊明, 单新平, 等. 昭苏高寒高海拔地区人群膝骨性关节炎情况调查. 兵团医学, 2016, 47(1): 44-47.
35.	Jennifer NG, David S, Ashish T, et al. Weather changes and pain rheumatology patients. Aplar J Rheumatol, 2004, (7): 204-206.
36.	Dekker J, van Dijk GM, Veenhof C. Risk factors for functional decline in osteoarthritis of the hip or knee. Curr Opin Rheumatol, 2009, 21(5): 520-524.
37.	Takahashi D, Iwasaki N, Kon S, et al. Down-regulation of cathepsin K in synovium leads to progression of osteoarthritis in rabbits. Arthritis Rheum, 2009, 60(8): 2372-2380.
38.	康广明, 孟庆波, 王金宝, 等. 膝关节骨关节炎与盘坐的配对研究. 临床骨科杂志, 1998, (1): 3-5.
39.	荣杰生, 陶天遵, 陶树清, 等. 高寒地区城市汉族人群膝骨关节炎情况调查. 中国骨质疏松杂志, 2007, 13(10): 723-726.
40.	任燕, 石娅娅, 谭波, 等. 中国人群膝骨关节炎危险因素的 Meta 分析. 现代预防医学, 2015, 42(12): 2282-2284, 2292.
41.	Järvholm B, Lewold S, Malchau H, et al. Age, bodyweight, smoking habits and the risk of severe osteoarthritis in the hip and knee in men. Eur J Epidemiol, 2005, 20(6): 537-542.
42.	陈颂春, 王欣欣, 高翔. 膝骨关节炎危险因素的系统评价与 Meta 分析. 老年医学与保健, 2016, 22(6): 405-410.
43.	Henrotin Y, Kurz B, Aigner T. Oxygen and reactive oxygen species in cartilage degradation: friends or foes? Osteoarthritis Cartilage, 2005, 13(8): 643-654.
44.	隋聪, 刘德宝, 潘发明, 等. 吸烟与骨关节炎关系研究进展. 实用医学杂志, 2017, 33(17): 2960-2962.

1. Klareskog L, Catrina AI, Paget S. Rheumatoid arthritis. Lancet, 2009, 373(9664): 659-672.
2. 中华医学会风湿病学分会. 骨关节炎诊断及治疗指南. 中华风湿病学杂志, 2010, 14(6): 416-419.
3. Cross M, Smith E, Hoy D, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis, 2014, 73(7): 1323-1330.
4. 郑双, 徐建华, 黄淑婷, 等. 某三甲医院 148 例膝骨关节炎患者就医及治疗现状分析. 中华疾病控制杂志, 2015, 19(1): 91-92, 106.
5. 郭燕梅, 黄鹏, 陈蔚, 等. 老年单, 双膝痛骨关节炎患者的平衡功能及其跌倒风险对比分析. 中国康复理论与实践, 2012, 18(1): 25-29.
6. 王秋华, 翁长水, 郭燕梅, 等. 单双膝痛老年骨关节炎患者生活质量状况的比较. 中华保健医学杂志, 2011, 13(4): 303-306.
7. Wells GA. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
8. 曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
9. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions, 2014-02-25. Available at: http://handbook.cochrane.org/.
10. 赵昌, 李红, 胡志富, 等. 云南大理地区膝关节骨性关节炎危险因素分析. 大理大学学报, 2019, 4(4): 75-78.
11. 沈锋, 夏正明, 周满春. 广州市南石头社区中老年群体膝骨关节炎的危险因素分析. 江西医药, 2019, 54(2): 144-146.
12. 张洪逵, 陈国华, 叶壮益. 膝骨关节炎发生的影响因素分析. 实用中西医结合临床, 2018, 18(7): 120-121.
13. 杨迎春, 顾海伦, 白伦浩, 等. 辽宁省某三甲医院膝关节骨性关节炎患者常见影响因素的调查. 现代预防医学, 2018, 45(8): 1516-1519.
14. 马翅, 陈铖, 张莹, 等. 驻某地团级以上军队干部骨关节炎流行病学调查. 中华关节外科杂志(电子版), 2018, 12(2): 217-221.
15. 张思恒, 董晓梅, 叶云凤, 等. 广州地区 15 岁及以上人群骨关节炎流行病学特征及危险因素分析. 中华疾病控制杂志, 2015, 19(1): 9-12.
16. 向珍蛹, 茅建春, 曲环汝, 等. 浦东上钢社区中老年人群膝骨关节炎危险因素的流行病学研究. 上海交通大学学报(医学版), 2013, 33(3): 318-322.
17. 林炎水. 膝关节骨性关节炎影响因素分析. 现代预防医学, 2012, 39(4): 815-816.
18. 向湘松, 谢诗涓, 熊莺. 老年人膝关节骨性关节炎影响因素分析研究. 中国骨质疏松杂志, 2011, 17(7): 613-616.
19. 徐辉燕, 黄伟钢, 傅可琪. 广州市城区成人膝骨关节炎相关因素调查研究. 中华全科医学, 2011, 9(5): 774-776.
20. 颜斌, 李溥, 梁家龙, 等. 少数民族地区骨性关节炎患病及危险因素分析. 中国公共卫生, 2010, 26(10): 1267-1268.
21. 何春红, 谭妃英, 谢小鸣, 等. 广州市越秀区 126 例老年人膝关节骨性关节炎患病危险因素: 与 121 例老年组的病例-对照分析. 中国组织工程研究与临床康复, 2009, 13(33): 6581-6584.
22. 孙国梁, 吕发明. 膝关节骨性关节炎危险因素的病例对照研究. 新疆中医药, 2008, 26(3): 44-45.
23. 蓝常贡. 百色地区膝骨关节炎病因探讨. 南宁: 广西医科大学, 2007: 1-60.
24. 劳山, 郭艾军. 骨关节炎与遗传关系的研究. 广西医科大学学报, 2007, 24(4): 602-603.
25. 史冬泉, 戴进, 刘澄, 等. 体质指数与膝关节骨性关节炎. 中国公共卫生, 2007, 23(3): 299-300.
26. Zhang JF, Song LH, Wei JN, et al. Prevalence of and risk factors for the occurrence of symptomatic osteoarthritis in rural regions of Shanxi Province, China. Int J Rheum Dis, 2016, 19(8): 781-789.
27. Jiang L, Rong J, Zhang Q, et al. Prevalence and associated factors of knee osteoarthritis in a community-based population in Heilongjiang, Northeast China. Rheumatol Int, 2012, 32(5): 1189-1195.
28. Rasheed Z, Rasheed N, Al-Shobaili HA. Epigallocatechin-3-O-gallate up-regulates microRNA-199a-3p expression by down-regulating the expression of cyclooxygenase-2 in stimulated human osteoarthritis chondrocytes. J Cell Mol Med, 2016, 20(12): 2241-2248.
29. 卢敏强, 钟庆, 贾兆锋, 等. 雌激素与骨关节炎. 国际骨科学杂志, 2018, 39(1): 41-44.
30. 马晓军, 郭浩辉, 郝绍文, 等. 宁夏回族原发性膝骨性关节炎与瘦素受体基因多态性的相关性. 遗传, 2013, 35(3): 359-364.
31. 尹丽, 邱丽颖. 中老年膝骨关节炎发病的相关因素分析. 吉林医学, 2015, (18): 4139-4140.
32. 李玉飞, 李康华, 中南大学, 等. 湖南省中老年膝骨关节炎的流行病学调查研究.
33. 洪俊毅, 张小春, 许冠华. 膝骨性关节炎发病主要危险因素 Meta 分析. 浙江中西医结合杂志, 2016, 26(11): 1042-1044, 1045.
34. 吴鹏, 夏伊明, 单新平, 等. 昭苏高寒高海拔地区人群膝骨性关节炎情况调查. 兵团医学, 2016, 47(1): 44-47.
35. Jennifer NG, David S, Ashish T, et al. Weather changes and pain rheumatology patients. Aplar J Rheumatol, 2004, (7): 204-206.
36. Dekker J, van Dijk GM, Veenhof C. Risk factors for functional decline in osteoarthritis of the hip or knee. Curr Opin Rheumatol, 2009, 21(5): 520-524.
37. Takahashi D, Iwasaki N, Kon S, et al. Down-regulation of cathepsin K in synovium leads to progression of osteoarthritis in rabbits. Arthritis Rheum, 2009, 60(8): 2372-2380.
38. 康广明, 孟庆波, 王金宝, 等. 膝关节骨关节炎与盘坐的配对研究. 临床骨科杂志, 1998, (1): 3-5.
39. 荣杰生, 陶天遵, 陶树清, 等. 高寒地区城市汉族人群膝骨关节炎情况调查. 中国骨质疏松杂志, 2007, 13(10): 723-726.
40. 任燕, 石娅娅, 谭波, 等. 中国人群膝骨关节炎危险因素的 Meta 分析. 现代预防医学, 2015, 42(12): 2282-2284, 2292.
41. Järvholm B, Lewold S, Malchau H, et al. Age, bodyweight, smoking habits and the risk of severe osteoarthritis in the hip and knee in men. Eur J Epidemiol, 2005, 20(6): 537-542.
42. 陈颂春, 王欣欣, 高翔. 膝骨关节炎危险因素的系统评价与 Meta 分析. 老年医学与保健, 2016, 22(6): 405-410.
43. Henrotin Y, Kurz B, Aigner T. Oxygen and reactive oxygen species in cartilage degradation: friends or foes? Osteoarthritis Cartilage, 2005, 13(8): 643-654.
44. 隋聪, 刘德宝, 潘发明, 等. 吸烟与骨关节炎关系研究进展. 实用医学杂志, 2017, 33(17): 2960-2962.

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