职业活动累积关节负荷与膝骨关节炎的关系。

Association between cumulative joint loading from occupational activities and knee osteoarthritis.

机构信息

School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Arthritis Care Res (Hoboken). 2013 Oct;65(10):1634-42. doi: 10.1002/acr.22033.

DOI:10.1002/acr.22033

PMID:23609965

Abstract

OBJECTIVE

To determine the associations between cumulative occupational physical load (COPL) and 3 definitions of knee osteoarthritis (OA).

METHODS

Cross-sectional analyses were performed from 2 population-based cohorts (n = 327). Eligible symptomatic participants were those with pain, aching, or discomfort in or around the knee on most days of a month at any time in the past and any pain in the past 12 months. Asymptomatic participants responded "no" to both knee pain questions. Self-reported COPL was calculated over each participant's lifetime and then categorized into quarters (QCOPL). Radiographic OA (ROA) and symptomatic OA (SOA) were defined by Kellgren/Lawrence grade ≥2, with SOA also including pain. Magnetic resonance imaging (MRI) OA was defined using criteria by Hunter et al. Logistic regression, adjusted with population weights, examined the associations between QCOPL and each of ROA, SOA, and MRI-OA after controlling for covariates and two-way interactions.

RESULTS

Participants had a mean ± SD age of 58.5 ± 11.0 years and a mean ± SD body mass index of 26.3 ± 4.7 kg/m(2) . Of those, 109 (33.3%) had ROA, 102 (31.2%) had SOA, and 131 (40.1%) had MRI-OA. Compared with QCOPL-1, increased odds of ROA were found for QCOPL-4 (odds ratio [OR] 3.15, 95% confidence interval [95% CI] 1.02-9.70) and QCOPL-3 (OR 4.19, 95% CI 1.55-11.34). Statistically significant relationships were found in SOA (QCOPL-4: OR 8.16, 95% CI 1.89-35.27; QCOPL-3: OR 5.73, 95% CI 1.36-24.12) and MRI-OA (QCOPL-4: OR 9.54, 95% CI 2.65-34.27; QCOPL-3: OR 9.04, 95% CI 2.65-30.88; QCOPL-2: OR 7.18, 95% CI 2.17-23.70).

CONCLUSION

Occupational activity is associated with knee OA, with dose-response relationships observed in SOA and MRI-OA.

摘要

目的

确定累积职业体力负荷（COPL）与三种膝关节骨关节炎（OA）定义之间的关联。

方法

对来自两个基于人群的队列（n=327）进行了横断面分析。有症状的合格参与者是指在过去任何时候的一个月中有多数日子感到膝关节疼痛、酸痛或不适，或膝关节周围疼痛，并且在过去 12 个月中有任何疼痛。无症状的参与者对两个膝关节疼痛问题均回答“否”。根据每个参与者的整个生命周期计算 COPL，并将其分为四个季度（QCOPL）。通过 Kellgren/Lawrence 分级≥2 定义放射学 OA（ROA）和症状性 OA（SOA），SOA 还包括疼痛。使用 Hunter 等人的标准定义 MRI-OA。在控制协变量和双向相互作用后，使用具有人群权重的逻辑回归调整，检查 QCOPL 与 ROA、SOA 和 MRI-OA 之间的关联。

结果

参与者的平均年龄±标准差为 58.5±11.0 岁，平均体重指数±标准差为 26.3±4.7kg/m²。其中，109 人（33.3%）有 ROA，102 人（31.2%）有 SOA，131 人（40.1%）有 MRI-OA。与 QCOPL-1 相比，QCOPL-4（比值比[OR]3.15，95%置信区间[95%CI]1.02-9.70）和 QCOPL-3（OR 4.19，95%CI 1.55-11.34）的 ROA 发生几率更高。在 SOA（QCOPL-4：OR 8.16，95%CI 1.89-35.27；QCOPL-3：OR 5.73，95%CI 1.36-24.12）和 MRI-OA（QCOPL-4：OR 9.54，95%CI 2.65-34.27；QCOPL-3：OR 9.04，95%CI 2.65-30.88；QCOPL-2：OR 7.18，95%CI 2.17-23.70）中，存在统计学显著的关系。