van Schoor N M, Zambon S, Castell M V, Cooper C, Denkinger M, Dennison E M, Edwards M H, Herbolsheimer F, Maggi S, Sánchez-Martinez M, Pedersen N L, Peter R, Schaap L A, Rijnhart J J M, van der Pas S, Deeg D J H
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Department of Medical and Surgical Sciences, University of Padova, Padua, Italy.
Qual Life Res. 2016 Jun;25(6):1423-32. doi: 10.1007/s11136-015-1171-8. Epub 2015 Nov 7.
Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH.
Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index.
The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function.
Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.
骨关节炎（OA）已被证明与身体功能下降有关，这可能会影响一个人的自评健康状况（SRH）。仅有少数研究在普通人群中探讨了OA与SRH之间的关联，但迄今为止尚无研究采用OA的临床定义。本研究的目的是：（1）在普通人群中检验临床OA与中重度自评健康状况之间的横断面关联；（2）检验这种关联在不同国家之间是否存在差异；（3）检验身体功能是否在临床OA与SRH之间的关联中起中介作用。
使用欧洲骨关节炎项目（EPOSA）的基线数据，其中包括来自六项欧洲队列研究（n = 2709）的预协调数据。临床OA根据美国风湿病学会标准进行定义。SRH通过一个问题进行评估：你的总体健康状况如何？身体功能使用西安大略和麦克马斯特大学骨关节炎指数以及澳大利亚/加拿大手部骨关节炎指数进行评估。
自评健康状况为中重度的患病率在英国为19.8%，在意大利为63.5%。尽管观察到各国之间关联强度存在差异，但在六个欧洲国家中的五个国家，髋、膝和手部的临床OA与中重度自评健康状况显著相关。在大多数国家和大多数部位，临床OA与中重度自评健康状况之间的关联部分或完全由身体功能介导。
不同部位的临床OA与普通人群中重度自评健康状况相关。大多数关联（部分）由身体功能介导，这表明OA患者身体功能的恶化应成为患者护理中的一个关注点。
