Saleh A S, Najjar S S, Muller D C, Shetty V, Ferrucci L, Gelber A C, Ling S M
Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Osteoarthritis Cartilage. 2007 Mar;15(3):357-61. doi: 10.1016/j.joca.2006.09.008. Epub 2006 Nov 9.
Osteoarthritis (OA) and vascular stiffening may share elements of common pathogenesis, but their potential relatedness has been the focus of little prior inquiry. We tested the hypothesis that these two aging-associated conditions are related to each other.
We analyzed cross-sectional data from 256 participants of the Baltimore Longitudinal Study of Aging (BLSA), a study of normative aging. All underwent measurement of arterial pulse wave velocity (PWV), an index of vascular stiffness, as well as hand radiographs that were graded for evidence of OA. Twenty total joints across three joint groups (distal interphalangeal [DIP], proximal interphalangeal [PIP], carpal-metacarpal [CMC]) were each assigned a Kellgren-Lawrence grade (K-L) of 0 (normal) through 4 (severe), with K-L grades >or=2 considered evidence of definite OA. Radiographic hand OA was defined as definite OA changes in at least two of the three anatomic hand sites (DIP, PIP, CMC). OA burden was represented by the total number of affected OA joints, and a cumulative K-L grade was aggregated across all hand joint groups. The relationship of PWV with these three measures of hand OA was assessed by linear regression.
Upon univariate analysis, the presence of radiographic hand OA (beta=218.1, P<0.01), the total number of OA joints (beta=32.9, P<0.01), and the cumulative K-L grade across all joint groups (beta=12.2, P<0.01) were each associated with increased PWV. These associations, however, were no longer significant in age-adjusted models.
Although significant individual relationships between PWV and several measures of hand OA were observed, these associations were largely attributable to the confounding effect of age.
骨关节炎(OA)与血管硬化可能具有共同的发病机制,但它们之间潜在的关联性此前很少受到关注。我们检验了这两种与衰老相关的病症相互关联的假设。
我们分析了来自巴尔的摩衰老纵向研究(BLSA)的256名参与者的横断面数据,该研究旨在探究正常衰老情况。所有参与者均接受了动脉脉搏波速度(PWV)测量,这是血管硬化的一项指标,同时还进行了手部X光片检查,并根据骨关节炎的证据进行分级。三个关节组(远端指间关节[DIP]、近端指间关节[PIP]、腕掌关节[CMC])的20个关节分别被赋予0(正常)至4(重度)的凯尔格伦 - 劳伦斯分级(K - L),K - L分级≥2被视为明确骨关节炎的证据。手部X光片骨关节炎定义为三个手部解剖部位(DIP、PIP、CMC)中至少两个部位出现明确的骨关节炎变化。骨关节炎负担用受影响的骨关节炎关节总数表示,所有手部关节组的累积K - L分级进行汇总。通过线性回归评估PWV与这三种手部骨关节炎测量指标之间的关系。
单因素分析显示,手部X光片骨关节炎的存在(β = 218.1,P < 0.01)、骨关节炎关节总数(β = 32.9,P < 0.01)以及所有关节组的累积K - L分级(β = 12.2,P < 0.01)均与PWV升高相关。然而,在年龄调整模型中,这些关联不再显著。
尽管观察到PWV与多种手部骨关节炎测量指标之间存在显著的个体关系,但这些关联很大程度上归因于年龄的混杂效应。