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心血管疾病和未来骨关节炎相关关节置换术的风险因素:来自瑞典马尔默的一项基于人群的男性和女性队列研究。

Risk factors for cardiovascular disease and future osteoarthritis-related arthroplasty: a population-based cohort study in men and women from Malmö, Sweden.

机构信息

Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK.

出版信息

Scand J Rheumatol. 2011 Nov;40(6):478-85. doi: 10.3109/03009742.2011.585619. Epub 2011 Sep 21.

Abstract

OBJECTIVE

To investigate the hypothesis that cardiovascular risk factors increase the likelihood of future osteoarthritis (OA)-related arthroplasty in adult men and women.

METHODS

Baseline cohort data on cardiovascular risk factors [age, socio-economic class, family history, obesity, smoking, glucose, cholesterol, blood pressure, and early cardiovascular disease (CVD) history] were linked to clinical registers of OA-related arthroplasty data. The study included 8749 women and 14 821 men with up to a 30-year follow-up.

RESULTS

In women, higher cardiovascular risk groups were more likely to have an OA outcome compared to the lowest risk quartile group (trend p < 0.001). The estimates were as follows: second quartile risk: rate ratio (RR) 2.15, 95% confidence interval (CI) 1.6-2.9, third quartile risk: 3.32 (2.5-4.5); and highest risk quartile: 3.47 (2.6-4.7). In men, higher cardiovascular risk groups were also more likely to have an OA outcome compared to the lowest risk quartile group (trend p = 0.001). The estimates were as follows: second quartile risk: RR 1.44, 95% CI 1.1-1.9; third quartile risk: 1.38 (1.1-1.8); and highest risk quartile: 1.67 (1.3-2.2).

CONCLUSIONS

Our large cohort study with up to a 30-year follow-up period provides evidence to support the hypothesis of shared risk factors in CVD and OA, and the findings suggest an alternative aetiological process in the pathogenesis of OA.

摘要

目的

探究心血管危险因素增加成年男女未来骨关节炎(OA)相关关节置换可能性的假说。

方法

将心血管危险因素(年龄、社会经济阶层、家族史、肥胖、吸烟、血糖、胆固醇、血压和早期心血管疾病(CVD)病史)的基线队列数据与 OA 相关关节置换数据的临床登记进行了关联。该研究纳入了 8749 名女性和 14821 名男性,随访时间最长达 30 年。

结果

在女性中,与最低风险四分位组相比,心血管风险较高的组更有可能出现 OA 结局(趋势 p < 0.001)。具体估计值如下:第二四分位风险:比率比(RR)2.15,95%置信区间(CI)1.6-2.9;第三四分位风险:3.32(2.5-4.5);最高风险四分位风险:3.47(2.6-4.7)。在男性中,与最低风险四分位组相比,心血管风险较高的组也更有可能出现 OA 结局(趋势 p = 0.001)。具体估计值如下:第二四分位风险:RR 1.44,95% CI 1.1-1.9;第三四分位风险:1.38(1.1-1.8);最高风险四分位风险:1.67(1.3-2.2)。

结论

我们的大型队列研究随访时间最长达 30 年,提供了证据支持 CVD 和 OA 存在共同危险因素的假说,并且研究结果提示 OA 发病机制中存在另一种病因学过程。

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