Zhang Yi, Zeng Chao, Wei Jie, Li Hui, Yang Tuo, Yang Ye, Deng Zhen-han, Ding Xiang, Lei Guanghua
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China.
BMJ Open. 2016 Mar 11;6(3):e010763. doi: 10.1136/bmjopen-2015-010763.
High-sensitivity C-reactive protein (hsCRP) is possibly related to osteoarthritis (OA) progression and a variety of OA-related symptoms. This study aimed to examine associations between cigarette smoking, betel quid chewing and alcohol consumption and hsCRP in early radiographic knee OA.
Cross-sectional health examination survey.
This primary study was conducted in a health examination centre in China.
936 (656 men and 280 women) patients with early radiographic knee OA were included in this cross-sectional study.
Smoking status was classified into four levels based on daily smoking habit: 0/day, 1-10/day, 11-20/day and >20/day. Betel quid chewing and alcohol consumption status was divided into 'Yes' or 'No'. Early radiographic knee OA was defined as Kellgren Lawrence (K-L) grade 1 or 2 in at least one leg, and elevated hsCRP was assessed as ≥ 3.0 mg/L.
After adjustment for a number of potential confounding factors, a significant positive association between cigarette smoking and hsCRP was observed in the multivariable model. The multivariable-adjusted ORs (95% CI) of elevated hsCRP (≥ 3.0 mg/L) in the second (1-10/day, n=133), third (11-20/day, n=59) and highest (>20/day, n=104) cigarette smoking categories were 1.54 (95% CI 0.91 to 2.61), 1.27 (95% CI 0.57 to 2.79) and 2.09 (95% CI 1.20 to 3.64), respectively, compared with the non-smoker category (n=640). In addition, there was a positive dose-response relationship between cigarette smoking and elevated hsCRP (p for trend=0.01). No significant associations between betel quid chewing and alcohol consumption and hsCRP were observed in the multivariable model.
This study indicated that cigarette smoking was positively associated with serum hsCRP level in patients with early radiographic knee OA. However, in view of the nature of cross-sectional designs, the results need to be confirmed by further prospective studies.
高敏C反应蛋白（hsCRP）可能与骨关节炎（OA）进展及多种OA相关症状有关。本研究旨在探讨早期膝关节影像学OA患者中吸烟、嚼槟榔和饮酒与hsCRP之间的关联。
横断面健康检查调查。
本初步研究在中国一家健康检查中心进行。
936名（656名男性和280名女性）早期膝关节影像学OA患者纳入本横断面研究。
根据每日吸烟习惯，吸烟状况分为四个等级：0/天、1 - 10/天、11 - 20/天和>20/天。嚼槟榔和饮酒状况分为“是”或“否”。早期膝关节影像学OA定义为至少一条腿的Kellgren Lawrence（K-L）分级为1级或2级，hsCRP升高定义为≥3.0 mg/L。
在调整了多个潜在混杂因素后，多变量模型中观察到吸烟与hsCRP之间存在显著正相关。与不吸烟组（n = 640）相比, 第二（1 - 10/天，n = 133）、第三（11 - 20/天，n = 59）和最高（>20/天，n = 104）吸烟组hsCRP升高（≥3.0 mg/L）的多变量调整OR（95%CI）分别为1.54（95%CI 0.91至2.61）、1.27（95%CI 0.57至2.79）和2.09（95%CI 1.20至3.64）。此外，吸烟与hsCRP升高之间存在正剂量反应关系（趋势p = 0.01）。多变量模型中未观察到嚼槟榔和饮酒与hsCRP之间存在显著关联。
本研究表明，早期膝关节影像学OA患者中吸烟与血清hsCRP水平呈正相关。然而，鉴于横断面设计的性质，结果需要进一步的前瞻性研究来证实。
