Oxford NIHR Musculoskeletal BRU, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK GREMPAL Research Group, IDIAP Jordi Gol Primary Care Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK URFOA-IMIM and RETICEF, Parc Salut Mar & Instituto de Salud Carlos III-FEDER, Barcelona, Spain.
Oxford NIHR Musculoskeletal BRU, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Ann Rheum Dis. 2014 Sep;73(9):1659-64. doi: 10.1136/annrheumdis-2013-203355. Epub 2013 Jun 6.
Data on the incidence of symptomatic osteoarthritis (OA) are scarce. We estimated incidence of clinical hip, knee and hand OA, and studied the effect of prevalent OA on joint-specific incident OA.
SIDIAP contains primary care records for>5 million people from Catalonia (Spain). Participants aged ≥40 years with an incident diagnosis of knee, hip or hand OA between 2006 and 2010 were identified using International Classification of Diseases (ICD)-10 codes. Incidence rates and female-to-male rate ratios (RRs) for each joint site were calculated. Age, gender and body mass index-adjusted HR for future joint-specific OA according to prevalent OA at other sites were estimated using Cox regression.
3 266 826 participants were studied for a median of 4.45 years. Knee and hip OA rates increased continuously with age, and female-to-male RRs were highest at age 70-75 years. In contrast, female hand OA risk peaked at age 60-64 years, and corresponding female-to-male RR was highest at age 50-55 years. Adjusted HR for prevalent knee OA on risk of hip OA was 1.35 (99% CI 1.28 to 1.43); prevalent hip OA on incident knee OA: HR 1.15 (1.08 to 1.23). Prevalent hand OA predicted incident knee and hip OA: HR 1.20 (1.14 to 1.26) and 1.23 (1.13 to 1.34), respectively.
The effect of age is greatest in the elderly for knee and hip OA, but around the menopause for hand OA. OA clusters within individuals, with higher risk of incident knee and hip disease from prevalent lower limb and hand OA.
有关症状性骨关节炎（OA）发病率的数据很少。我们估计了临床髋、膝和手部 OA 的发病率，并研究了现患 OA 对特定关节新发 OA 的影响。
SIDIAP 包含了来自西班牙加泰罗尼亚的超过 500 万人的初级保健记录。通过使用国际疾病分类（ICD）第 10 版代码，确定了 2006 年至 2010 年间患有膝、髋或手部 OA 的新发诊断的患者。计算了每个关节部位的发病率和女性与男性的比率（RR）。使用 Cox 回归估计了根据其他部位的现患 OA 对未来特定关节 OA 的年龄、性别和体重指数调整的 HR。
共研究了 3266826 名参与者，中位随访时间为 4.45 年。膝关节和髋关节 OA 发病率随年龄持续增加，70-75 岁时女性与男性的 RR 最高。相比之下，女性手部 OA 风险在 60-64 岁时达到峰值，相应的女性与男性 RR 在 50-55 岁时最高。现患膝关节 OA 对髋部 OA 的发病风险比为 1.35（99%CI 1.28-1.43）；现患髋部 OA 对新发膝关节 OA：HR 为 1.15（1.08-1.23）。现患手部 OA 预测新发膝关节和髋关节 OA：HR 分别为 1.20（1.14-1.26）和 1.23（1.13-1.34）。
年龄对膝关节和髋关节 OA 的影响在老年人中最大，但对手部 OA 的影响在绝经前后。OA 在个体中聚集，下肢和手部现患 OA 会增加新发膝关节和髋关节疾病的风险。
