Hacquebord Jacques H, Chiu Vicki Y, Harness Neil G
Department of Orthopaedic Surgery, New York University, New York, NY.
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
J Hand Surg Am. 2017 Mar;42(3):149-155. doi: 10.1016/j.jhsa.2016.12.010. Epub 2017 Jan 19.
Dupuytren disease is a common benign fibroproliferative disorder causing thickening and shortening of the palmar fascia of the hand. The exact etiology of the disease is unclear but known risk factors such as increased age, male sex, and northern European ethnicity have been established. A link between body mass index (BMI) and Dupuytren disease has not been established previously. The purpose of this study was to test the hypothesis that lower BMI is associated with increased risk for Dupuytren disease diagnosis.
After we obtained institutional review board approval, we performed a retrospective review using an electronic medical record and an administrative database from Kaiser Permanente Southern California to identify all enrolled patients there between 2007 and 2014 who were diagnosed with Dupuytren disease. Basic demographic data including age, sex, ethnicity, and BMI were collected. Bivariate and multivariable logistical regression analyses were performed to evaluate for associations between Dupuytren disease and BMI.
A total of 2,049,803 patients aged 18 years and older were enrolled in Kaiser Permanente Southern California from 2007 to 2014. During that period, 14,844 patients were identified as having Dupuytren disease. The data were consistent with well-defined demographic trends in Dupuytren disease, with increased rates seen in males, Caucasians, and patients aged 50 years and older. In the multivariable analysis, when controlling for age, race, and sex, the risk of Dupuytren disease was inversely proportional to BMI.
The current study showed that higher BMI is associated with decreased odds of having Dupuytren disease. Further work will be required to determine the cause for the apparent relationship between Dupuytren disease and BMI and whether physiologic factors related to obesity may be protective against the development of Dupuytren disease.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
掌腱膜挛缩症是一种常见的良性纤维增生性疾病,可导致手部掌腱膜增厚和缩短。该病的确切病因尚不清楚,但已知的风险因素如年龄增长、男性性别和北欧种族已得到确认。此前尚未确定体重指数(BMI)与掌腱膜挛缩症之间的联系。本研究的目的是检验以下假设:较低的BMI与掌腱膜挛缩症诊断风险增加相关。
获得机构审查委员会批准后,我们使用南加州永久医疗集团的电子病历和管理数据库进行了一项回顾性研究,以确定2007年至2014年期间在该机构被诊断为掌腱膜挛缩症的所有登记患者。收集了包括年龄、性别、种族和BMI在内的基本人口统计学数据。进行了二元和多变量逻辑回归分析,以评估掌腱膜挛缩症与BMI之间的关联。
2007年至2014年期间,共有2,049,803名18岁及以上的患者登记加入南加州永久医疗集团。在此期间,14,844名患者被确诊为掌腱膜挛缩症。数据与掌腱膜挛缩症明确的人口统计学趋势一致,男性、白种人和50岁及以上患者的发病率较高。在多变量分析中,在控制年龄、种族和性别后,掌腱膜挛缩症的风险与BMI成反比。
当前研究表明,较高的BMI与患掌腱膜挛缩症的几率降低相关。需要进一步开展工作,以确定掌腱膜挛缩症与BMI之间明显关系的原因,以及与肥胖相关的生理因素是否可能对掌腱膜挛缩症的发展具有保护作用。
研究类型/证据水平:预后性研究II级