Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK.
Scand J Rheumatol. 2011 Nov;40(6):478-85. doi: 10.3109/03009742.2011.585619. Epub 2011 Sep 21.
To investigate the hypothesis that cardiovascular risk factors increase the likelihood of future osteoarthritis (OA)-related arthroplasty in adult men and women.
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.
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).
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.
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。
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。
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)。
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。