Erasmus University Medical Centre, General Practice, Rotterdam 3015 CA, The Netherlands.
Ann Rheum Dis. 2013 May;72(5):646-51. doi: 10.1136/annrheumdis-2011-201178. Epub 2012 May 6.
This study examined whether vascular alterations are associated with the presence and progression of osteoarthritis of the knee, the hip and the different hand joints in a large prospective cohort study.
In this population-based study involving participants aged 55 years and older (Rotterdam Study I), men (n=2372) and women (n=3278) were analysed separately. x-Rays of the knee, hip and hand were scored using the Kellgren and Lawrence score for osteoarthritis at baseline, after 6.6 years and 10 years. Measures of atherosclerosis (carotid intima media thickness (IMT) and carotid plaque) and data on covariates (age, body mass index, hypertension, cholesterol ratio, diabetes mellitus and smoking) were collected at baseline. Multivariate logistic regression models with generalised estimated equations were used to calculate OR and corresponding 95% CI. Secondary multiple comparison adjustment resulted in a significance level of p<0.0021.
In women, IMT showed an independent association with the prevalence of knee osteoarthritis (adjusted OR (aOR) 1.7, 1.1 to 2.7), and carotid plaque with distal interphalangeal (DIP) osteoarthritis (aOR 1.4, 1.2 to 1.7) and with metacarpophalangeal osteoarthritis (aOR 1.5, 1.1 to 2.2). An independent association for IMT with progression of metacarpophalangeal osteoarthritis was found in women (aOR 2.9, 1.18 to 6.93). Additional adjustment for multiple testing yielded a significant association between carotid plaque and DIP osteoarthritis in women (p<0.001).
This study showed independent associations of atherosclerosis with osteoarthritis of the knee and hand joints in women. The evidence was most solid for a relation with DIP osteoarthritis. More research is needed to confirm the associations and examine the differential association with various joints.
本研究旨在通过一项大型前瞻性队列研究，探讨血管改变与膝关节、髋关节和不同手部关节骨关节炎的发生和进展是否有关。
在这项基于人群的研究中，纳入了年龄在 55 岁及以上的参与者（鹿特丹研究 I），男性（n=2372）和女性（n=3278）分别进行分析。在基线、6.6 年和 10 年时，使用 Kellgren 和 Lawrence 评分对膝关节、髋关节和手部关节进行 x 光检查，以评估骨关节炎的情况。在基线时还收集了动脉粥样硬化的测量指标（颈动脉内膜中层厚度（IMT）和颈动脉斑块）以及协变量（年龄、体重指数、高血压、胆固醇比值、糖尿病和吸烟）的数据。使用广义估计方程的多变量逻辑回归模型计算比值比（OR）和相应的 95%置信区间（CI）。二次多重比较调整使显著性水平达到 p<0.0021。
在女性中，IMT 与膝关节骨关节炎的患病率呈独立相关（调整后的 OR（aOR）为 1.7，1.1 至 2.7），颈动脉斑块与远侧指间关节（DIP）骨关节炎（aOR 为 1.4，1.2 至 1.7）和掌指关节骨关节炎（aOR 为 1.5，1.1 至 2.2）呈独立相关。在女性中，还发现 IMT 与掌指关节骨关节炎的进展呈独立相关（aOR 为 2.9，1.18 至 6.93）。进一步进行多重测试调整后，在女性中发现颈动脉斑块与 DIP 骨关节炎之间存在显著关联（p<0.001）。
本研究显示，动脉粥样硬化与女性膝关节和手部关节骨关节炎之间存在独立关联。证据最确凿的是与 DIP 骨关节炎之间的关系。需要进一步的研究来证实这些关联，并研究与不同关节的差异关联。
