University of Padua, Padua, Italy.
National Research Council, Neuroscience Institute, Padua, Italy.
Arthritis Rheumatol. 2016 May;68(5):1136-44. doi: 10.1002/art.39564.
The possible relevance of osteoarthritis (OA) as a cardiovascular disease (CVD) risk factor is still debated. The aim of this study was to investigate the association between OA and the onset of CVD in older individuals.
Among a sample of 3,099 elderly subjects, 2,158 were identified as having no CVD at baseline and were followed up for a mean ± SD 4.4 ± 1.2 years. OA was defined using a standardized algorithm that investigated disease history, medical documentation (including radiographic reports), symptoms, and physical examination of the joints. Incident CVD was defined as the onset of coronary artery disease, heart failure, stroke/transient ischemic attack, peripheral artery disease, and CVD-related hospitalization or mortality.
At baseline, 1,336 (61.9%) of the 2,158 study participants had OA. Participants with OA had more potential CVD risk factors, including obesity, hypertension, high levels of low-density lipoprotein, greater severity of inflammation, and worse renal function, than did those without OA. During the follow-up, 47.8% of the subjects with OA developed a new CVD event, compared to 41.3% of those without OA. Using an adjusted Cox regression analysis, the presence of OA significantly increased the risk of CVD (hazard ratio 1.22, 95% confidence interval 1.02-1.49; P = 0.04). The association between OA and CVD was stronger when the hip or knee was affected, and also was stronger in women than in men and when ≥2 joints were involved. Considering single CVD outcomes, the presence of OA significantly increased the risk of new coronary artery disease, heart failure, and hospitalization for CVD.
OA may be a significant predictor of the onset of CVD in elderly individuals, particularly in women with OA and when OA affects the lower limbs or ≥2 joints are involved.
骨关节炎（OA）作为心血管疾病（CVD）的一个危险因素的可能性仍存在争议。本研究旨在探讨老年人群中 OA 与 CVD 发病之间的关系。
在一个 3099 名老年人样本中，有 2158 人在基线时无 CVD，并随访平均 4.4±1.2 年。OA 采用标准化算法定义，该算法调查疾病史、医疗记录（包括影像学报告）、关节症状和体格检查。新发 CVD 定义为冠心病、心力衰竭、卒中和短暂性脑缺血发作、外周动脉疾病、CVD 相关住院或死亡的发病。
在基线时，2158 名研究参与者中有 1336 人（61.9%）患有 OA。与无 OA 者相比，OA 患者具有更多的潜在 CVD 危险因素，包括肥胖、高血压、低密度脂蛋白水平升高、炎症严重程度更高以及肾功能更差。在随访期间，OA 患者中有 47.8%发生了新的 CVD 事件，而无 OA 患者中有 41.3%发生了新的 CVD 事件。采用调整后的 Cox 回归分析，OA 的存在显著增加了 CVD 的风险（危险比 1.22，95%置信区间 1.02-1.49；P=0.04）。当髋关节或膝关节受累时，OA 与 CVD 之间的关联更强，在女性中比在男性中更强，并且当≥2 个关节受累时也更强。考虑到单一 CVD 结局，OA 的存在显著增加了新发冠心病、心力衰竭和 CVD 住院的风险。
OA 可能是老年人群 CVD 发病的一个重要预测因素，特别是在女性 OA 患者和 OA 影响下肢或≥2 个关节受累时。
