类风湿关节炎患者无明显动脉疾病时动脉僵硬与斯坦福健康评估问卷残疾之间的关系。

Relationship between arterial stiffness and Stanford Health Assessment Questionnaire disability in rheumatoid arthritis patients without overt arterial disease.

机构信息

Institute of Applied Health Sciences, Section of Population Health, Aberdeen University Medical School, Aberdeen, Scotland.

出版信息

J Rheumatol. 2010 May;37(5):946-52. doi: 10.3899/jrheum.091052. Epub 2010 Mar 15.

DOI:10.3899/jrheum.091052

PMID:20231203

Abstract

OBJECTIVE

To quantify the relationship between Stanford Health Assessment Questionnaire (HAQ) disability and arterial stiffness in patients with rheumatoid arthritis (RA).

METHODS

A consecutive series of 114 patients with RA but without overt arterial disease, aged 40-65 years, were recruited from rheumatology clinics. A research nurse measured blood pressure (BP), arterial stiffness (heart rate-adjusted augmentation index), fasting lipids, glucose, erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF). A self-completed patient questionnaire included HAQ, damaged joint count, EuroQol measure of health outcome, and Godin physical activity score. Multiple linear regression (MLR) adjusted for age, sex, smoking pack-years, cholesterol, mean arterial BP, physical activity, daily fruit and vegetable consumption, arthritis duration, ESR, and RA criteria.

RESULTS

Mean age was 54 years (81% women) with a median HAQ of 1.13 (interquartile range 0.50; 1.75). Median RA duration was 10 years, 83% were RF-positive, and median ESR was 16 mm/h. Mean arterial stiffness was 31.5 (SD 7.7), BP 125/82 mm Hg, cholesterol 5.3 mmol/l, and 24% were current smokers. Current therapy included RA disease-modifying agents (90%), prednisolone (11%), and antihypertensive therapy (18%). Arterial stiffness was positively correlated with HAQ (r = 0.42; 95% CI 0.25 to 0.56). On MLR, a 1-point increase in HAQ disability was associated with a 2.8 increase (95% CI 1.1 to 4.4; p = 0.001) in arterial stiffness. Each additional damaged joint was associated with a 0.17 point increase (95% CI 0.04 to 0.29; p = 0.009) in arterial stiffness. The relationship between EuroQol and arterial stiffness was not statistically significant.

CONCLUSION

In patients with RA who are free of overt arterial disease, higher RA disability is associated with increased arterial stiffness independently of traditional cardiovascular risk factors and RA characteristics.

摘要

目的

定量评估斯坦福健康评估问卷（HAQ）残疾与类风湿关节炎（RA）患者动脉僵硬之间的关系。

方法

连续招募了 114 名年龄在 40-65 岁之间、无明显动脉疾病的 RA 患者。一名研究护士测量了血压（BP）、动脉僵硬（心率校正增强指数）、空腹血脂、血糖、红细胞沉降率（ESR）和类风湿因子（RF）。一份自我完成的患者问卷包括 HAQ、受损关节计数、欧洲五维健康量表（EQ-5D）健康结果测量、Godin 体力活动评分。多元线性回归（MLR）调整了年龄、性别、吸烟包年数、胆固醇、平均动脉压、体力活动、每日水果和蔬菜摄入量、关节炎持续时间、ESR 和 RA 标准。

结果

平均年龄为 54 岁（81%为女性），平均 HAQ 为 1.13（四分位距 0.50；1.75）。中位 RA 病程为 10 年，83%为 RF 阳性，中位 ESR 为 16mm/h。平均动脉僵硬为 31.5（标准差 7.7），BP 为 125/82mmHg，胆固醇为 5.3mmol/L，24%为当前吸烟者。目前的治疗包括 RA 疾病修饰药物（90%）、泼尼松（11%）和降压治疗（18%）。动脉僵硬与 HAQ 呈正相关（r=0.42；95%置信区间 0.25 至 0.56）。在 MLR 中，HAQ 残疾程度增加 1 分，动脉僵硬增加 2.8（95%置信区间 1.1 至 4.4；p=0.001）。每增加一个受损关节，动脉僵硬增加 0.17 分（95%置信区间 0.04 至 0.29；p=0.009）。欧洲五维健康量表（EQ-5D）与动脉僵硬之间的关系无统计学意义。