Hannan M T, Anderson J J, Pincus T, Felson D T
Boston University Arthritis Center, Boston City Hospital, MA.
J Clin Epidemiol. 1992 Feb;45(2):139-47. doi: 10.1016/0895-4356(92)90006-9.
Educational attainment has been negatively associated with the prevalence, morbidity and mortality of many diseases. With knee osteoarthritis as an example, we used NHANES I data to examine whether the cross-sectional association between formal education and disease is due to known risk factors, and also whether educational attainment is more strongly associated with self-reported symptoms or with radiographic change. We found univariate associations between osteoarthritis and low levels of education. For radiographic knee osteoarthritis in women, and in both sexes combined, this relationship was explained by controlling for known risk factors, which included age, knee injury, race, obesity, and occupation. However, even after adjusting for these major risk factors and the presence of radiographic changes, reporting of knee pain and arthritis at any site remained significantly associated with low educational attainment, especially for those with less than or equal to 8 years of education.
教育程度与许多疾病的患病率、发病率和死亡率呈负相关。以膝关节骨关节炎为例，我们利用美国国家健康和营养检查调查（NHANES I）的数据来研究正规教育与疾病之间的横断面关联是否归因于已知的风险因素，以及教育程度与自我报告的症状或影像学改变之间的关联是否更强。我们发现骨关节炎与低教育水平之间存在单变量关联。对于女性以及男女合并的膝关节影像学骨关节炎，通过控制已知的风险因素（包括年龄、膝关节损伤、种族、肥胖和职业）可以解释这种关系。然而，即使在调整了这些主要风险因素以及影像学改变的存在之后，膝关节疼痛和任何部位关节炎的报告仍与低教育程度显著相关，尤其是对于受教育年限小于或等于8年的人。
