Health outcomes and Pharmacoeconomics, Endo Pharmaceuticals Inc., Chadds Ford, PA 19317, USA.
Postgrad Med. 2009 Nov;121(6):9-20. doi: 10.3810/pgm.2009.11.2073.
Osteoarthritis (OA) and cardiovascular disease (CVD) share age and obesity as risk factors, but may also be linked by pathogenic mechanisms involving metabolic abnormalities and systemic inflammation. This study compared the prevalence of OA and metabolic syndrome (MetS) in subjects with OA versus the general population without OA to determine whether having OA predicts increased cardiovascular risk.
National Health and Nutrition Examination Survey III data were used as a representative sample of the general US population. Subjects included adults aged > or = 18 years with records of history, physical, radiographic, and laboratory data adequate to assess for diagnoses of MetS and OA. Logistic regression was used to examine the association between MetS and population-weighted variables.
The general population sample included 7714 subjects (weighted value representing 174.9 million population), of whom 975 subjects had OA (weighted value 17.5 million) and 6739 did not (weighted value 157.4 million). Metabolic syndrome was prevalent in 59% of the OA population and 23% of the population without OA. Each of the 5 cardiovascular risk factors that comprise MetS was more prevalent in the OA population versus the population without OA: hypertension (75% vs 38%), abdominal obesity (63% vs 38%), hyperglycemia (30% vs 13%), elevated triglycerides (47% vs 32%), and low high-density lipoprotein cholesterol (44% vs 38%). Metabolic syndrome was more prevalent in subjects with OA regardless of sex or race. The association between OA and MetS was greater in younger subjects and diminished with increasing age. Having OA at age 43.8 years (mean age of the general population) was associated with a 5.26-fold (SE = 1.58, P < 0.001) increased risk of MetS. This association remained strong when obesity was controlled for in additional regression models.
Osteoarthritis is associated with an increased prevalence of MetS, particularly in younger individuals. Global cardiovascular risk should be assessed in individuals aged < or = 65 years with OA, and should be considered when prescribing analgesics for OA patients.
骨关节炎（OA）和心血管疾病（CVD）有年龄和肥胖等共同的危险因素，但也可能存在代谢异常和全身炎症等致病机制的联系。本研究比较了 OA 患者与无 OA 的一般人群中 OA 的患病率和代谢综合征（MetS），以确定是否患有 OA 预示着心血管风险增加。
使用国家健康和营养调查 III 数据作为美国一般人群的代表性样本。研究对象包括年龄> = 18 岁、有记录病史、体检、影像学和实验室数据足以评估 MetS 和 OA 诊断的成年人。采用 logistic 回归分析 MetS 与人群加权变量之间的关系。
一般人群样本包括 7714 名受试者（代表 1.749 亿人口的加权值），其中 975 名受试者患有 OA（代表 1750 万人口的加权值），6739 名受试者没有 OA（代表 1.574 亿人口的加权值）。OA 人群的代谢综合征患病率为 59%，无 OA 人群的患病率为 23%。代谢综合征的 5 种心血管危险因素在 OA 人群中均比无 OA 人群更为常见：高血压（75%比 38%）、腹部肥胖（63%比 38%）、高血糖（30%比 13%）、甘油三酯升高（47%比 32%）和低高密度脂蛋白胆固醇（44%比 38%）。无论性别或种族如何，OA 患者的代谢综合征患病率均较高。OA 与 MetS 的关联在年轻人群中更大，随年龄增长而减弱。在平均年龄为 43.8 岁的人群中，OA 患者患 MetS 的风险增加 5.26 倍（SE = 1.58，P < 0.001）。当在其他回归模型中控制肥胖因素时，这种关联仍然很强。
OA 与 MetS 的患病率增加有关，尤其是在年轻个体中。应评估<或= 65 岁的 OA 患者的整体心血管风险，并在为 OA 患者开具镇痛药时考虑这一因素。
