波多黎各西班牙裔人群中手或膝关节骨关节炎与糖尿病的相关性。
Association of hand or knee osteoarthritis with diabetes mellitus in a population of Hispanics from Puerto Rico.
机构信息
Puerto Rico Clinical & Translational Research Consortium, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
出版信息
J Clin Rheumatol. 2013 Jan;19(1):1-6. doi: 10.1097/RHU.0b013e31827cd578.
BACKGROUND
Although a higher prevalence of osteoarthritis (OA) has been reported among diabetes mellitus (DM) patients, inconsistencies and limitations of observational studies have precluded a conclusive association.
OBJECTIVE
The objective of this study was to evaluate the association of hand or knee OA with DM in a population of Hispanics from Puerto Rico.
METHODS
A cross-sectional study was performed in 202 subjects (100 adult DM patients as per the National Diabetes Data Group Classification and 102 nondiabetic subjects). Osteoarthritis of hand and knee was ascertained using the American College of Rheumatology classification criteria. Sociodemographic characteristics, health-related behaviors, comorbidities, pharmacotherapy, and DM clinical manifestations were determined. Multivariable logistic regression was used to evaluate the association of DM with hand or knee OA and to evaluate factors associated with hand or knee OA among DM patients.
RESULTS
The mean (SD) age for DM patients was 51.6 (13.1) years; 64.0% were females. The mean (SD) DM duration was 11.0 (10.4) years. The prevalence of OA in patients with DM and nondiabetic subjects was 49.0% and 26.5%, respectively (P < 0.01). In the multivariable analysis, patients with DM had 2.18 the odds of having OA when compared with nondiabetic subjects (95% confidence interval [CI], 1.12-4.24). In a subanalysis among DM patients, female patients were more likely to have hand or knee OA (odds ratio [95% CI], 5.06 [1.66-15.66]), whereas patients who did not use insulin alone for DM therapy were more likely to have OA (odds ratio [95% CI], 4.44 [1.22-16.12]).
CONCLUSIONS
In this population of Hispanics from Puerto Rico, DM patients were more likely to have OA of hands or knees than were nondiabetic subjects. This association was retained in multivariable models accounting for established risk factors for OA. Among DM patients, females were at greater risk for OA, whereas the use of insulin was negatively associated.
背景
尽管有研究报道称糖尿病（DM）患者中骨关节炎（OA）的患病率较高，但观察性研究的结果并不一致且存在局限性，因此无法得出明确的关联。
目的
本研究旨在评估波多黎各西班牙裔人群中手或膝关节 OA 与 DM 的相关性。
方法
本研究为横断面研究，纳入了 202 名受试者（100 名按照美国国立糖尿病数据组分类标准诊断的成年 DM 患者和 102 名非糖尿病患者）。使用美国风湿病学会分类标准确定手和膝关节 OA。确定社会人口统计学特征、健康相关行为、合并症、药物治疗和 DM 临床表现。采用多变量逻辑回归评估 DM 与手或膝关节 OA 的相关性，并评估 DM 患者中手或膝关节 OA 的相关因素。
结果
DM 患者的平均（标准差）年龄为 51.6（13.1）岁，64.0%为女性。DM 病程的平均（标准差）为 11.0（10.4）年。DM 患者和非糖尿病患者的 OA 患病率分别为 49.0%和 26.5%（P＜0.01）。多变量分析显示，与非糖尿病患者相比，DM 患者发生 OA 的可能性是其 2.18 倍（95%置信区间，1.12-4.24）。在 DM 患者的亚组分析中，女性患者更有可能出现手或膝关节 OA（比值比[95%置信区间]，5.06[1.66-15.66]），而仅使用胰岛素治疗 DM 的患者更有可能发生 OA（比值比[95%置信区间]，4.44[1.22-16.12]）。
结论
在波多黎各的西班牙裔人群中，DM 患者发生手或膝关节 OA 的可能性高于非糖尿病患者。这种相关性在考虑 OA 既定危险因素的多变量模型中仍然存在。在 DM 患者中，女性发生 OA 的风险更高，而使用胰岛素则与之呈负相关。
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