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皮质骨骨密度低、软组织钙化、血管钙化与软骨钙质沉着症的相关性:一项病例对照研究。

Association between low cortical bone mineral density, soft-tissue calcification, vascular calcification and chondrocalcinosis: a case-control study.

机构信息

Academic Rheumatology, University of Nottingham, Nottingham, UK.

Respiratory and Inflammation iMed, AstraZeneca, MoIndal, Sweden.

出版信息

Ann Rheum Dis. 2014 Nov;73(11):1997-2002. doi: 10.1136/annrheumdis-2013-203400. Epub 2013 Aug 2.

Abstract

OBJECTIVES

To examine the association between bone mineral density (BMD), soft-tissue calcification, vascular calcification and chondrocalcinosis (CC).

METHODS

A case-control study within the Genetics of Osteoarthritis and Lifestyle (GOAL) database (n=3170). All GOAL participants completed a questionnaire self-reporting current and early adult life exposures. Radiographs of knees, hands and pelvis were scored for osteoarthritis (OA), CC, pelvic vascular calcification, peri-articular knee calcification and metacarpal index (MCI-measure of cortical BMD). Calcaneal dual-energy X-ray absorptiometry (DEXA) was performed. Cases had radiographic CC, while controls did not have CC at any radiographed site. OR, 95% CI were used to measure association between risk factors and CC. Logistic regression was used to adjust for confounding and to estimate the adjusted OR (aOR).

RESULTS

Low MCI (aOR (95%) for CC in 1st tertile 1.41 (1.06 to 1.89), with 3rd tertile referent), soft-tissue calcification (aOR (95%) for CC 1.81 (1.36 to 2.42)), and vascular calcification (aOR (95%) for CC 1.76 (1.13 to 2.75)) independently associated with CC. There was a negative association between body mass index and CC (aOR (95%) for CC in 2nd and 3rd tertiles 0.68 (0.53 to 0.89), and 0.67 (0.51 to 0.88) respectively with 1st tertile referent). Age and OA associated with CC. However, only age and low MCI independently associated with CC at >1 joint. Self-reported meniscectomy, low cortical BMD, vascular calcification, and soft-tissue calcification independently associated with knee CC.

CONCLUSIONS

This study identifies several novel associations of CC including low cortical BMD. The association between vascular calcification, soft-tissue calcification, and CC suggests a generalised constitutional predisposition to calcium crystal formation.

摘要

目的

研究骨密度(BMD)、软组织钙化、血管钙化与软骨钙质沉着症(CC)之间的关系。

方法

GOAL 数据库(n=3170)内的病例对照研究。所有 GOAL 参与者均完成了一份问卷,报告了当前和成年早期的暴露情况。对膝关节、手部和骨盆的 X 光片进行评分,以评估骨关节炎(OA)、CC、骨盆血管钙化、膝关节周围钙化和掌指指数(MCI-皮质 BMD 测量)。对跟骨进行双能 X 线吸收法(DEXA)检查。病例组有 X 线 CC,而对照组在任何 X 线照射部位均无 CC。使用 OR、95%CI 来测量危险因素与 CC 之间的关联。使用逻辑回归来调整混杂因素,并估计调整后的 OR(aOR)。

结果

低 MCI(CC 第 1 三分位的 aOR(95%CI)为 1.41(1.06 至 1.89),第 3 三分位为参照)、软组织钙化(CC 的 aOR(95%CI)为 1.81(1.36 至 2.42))和血管钙化(CC 的 aOR(95%CI)为 1.76(1.13 至 2.75))与 CC 独立相关。BMI 与 CC 呈负相关(CC 第 2 和第 3 三分位的 aOR(95%CI)分别为 0.68(0.53 至 0.89)和 0.67(0.51 至 0.88),第 1 三分位为参照)。年龄和 OA 与 CC 相关。然而,只有年龄和低 MCI 与 CC 存在独立关联(≥ 1 个关节)。自我报告的半月板切除术、低皮质 BMD、血管钙化和软组织钙化与膝关节 CC 独立相关。

结论

本研究发现了 CC 的几个新的关联,包括低皮质 BMD。血管钙化、软组织钙化与 CC 的关联提示存在普遍的钙晶体形成的体质倾向。

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