National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Vinderen, Box 23, 0319, Oslo, Norway.
Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
Rheumatol Int. 2017 Sep;37(9):1541-1550. doi: 10.1007/s00296-017-3721-6. Epub 2017 Apr 27.
The objective of the study was to examine the hand-, knee- and hip osteoarthritis (OA) distribution, risk factor profiles and health-related quality of life (HRQoL) in a population-based OA cohort. Persons with self-reported OA responded to questionnaires and attended a clinical examination (N = 606). We analyzed cross-sectional associations to risk factor profiles and HRQoL dimensions (Short Form 36) in four mutually exclusive groups based on fulfillment of The American College of Rheumatology criteria: no OA (NOA), monoarticular upper extremity (hand) OA (MOAupper-ex.), monoarticular lower extremity (hip or knee) OA (MOAlower-ex.) and polyarticular OA (POA). Multivariate regression analyses and correspondence analysis were performed. The distribution of NOA, MOAupper-ex. MOAlower-ex. and POA was 21.1, 25.4, 22.4 and 31.0%, respectively. Compared to NOA, minor differences were found in risk factor profile in MOAupper-ex., whereas POA was significantly associated with sociodemographic, metabolic and mechanical features. The correspondence analysis identified different risk factor profiles between the four OA phenotypes, but the differences were not statistically significant (p = 0.13). Regarding HRQoL, neither OA groups were associated with poorer mental functioning. MOAlower-ex. and POA were associated with, among other things, poorer physical functioning (β = -6.2, 95% CI -11.2 to -1.2 and β = -12.5, 95% CI -17.4 to -7.9, respectively) and more pain (β = -5.4, 95% CI -10.4 to -0.3 and β = -10.5, 95% CI -15.3 to -5.8, respectively). In this cohort of persons with self-reported OA, POA was the most prevalent phenotype and was associated with an unfortunate risk factor profile and several diminished HRQoL dimensions. POA needs further attention in research and clinical care.
本研究旨在考察基于人群的骨关节炎(OA)队列中手部、膝部和髋部 OA 的分布、危险因素特征和与健康相关的生活质量(HRQoL)。自报 OA 的个体回答了调查问卷并接受了临床检查(N=606)。我们根据美国风湿病学院(ACR)标准的满足情况,将个体分为四个相互排斥的组别,分析了各组间与危险因素特征和 HRQoL 维度(SF-36)的横断面相关性:无 OA(NOA)、单关节上肢(手部)OA(MOAupper-ex.)、单关节下肢(髋或膝)OA(MOAlower-ex.)和多关节 OA(POA)。采用多元回归分析和对应分析进行分析。NOA、MOAupper-ex.、MOAlower-ex.和 POA 的分布分别为 21.1%、25.4%、22.4%和 31.0%。与 NOA 相比,MOAupper-ex.组的危险因素特征差异较小,而 POA 与社会人口统计学、代谢和力学特征显著相关。对应分析确定了四种 OA 表型之间的不同危险因素特征,但差异无统计学意义(p=0.13)。在 HRQoL 方面,OA 组与较差的心理功能均无相关性。MOAlower-ex.和 POA 与较差的躯体功能(β=-6.2,95%CI-11.2 至-1.2 和 β=-12.5,95%CI-17.4 至-7.9)和更多的疼痛(β=-5.4,95%CI-10.4 至-0.3 和 β=-10.5,95%CI-15.3 至-5.8)有关。在本项自报 OA 人群队列研究中,POA 是最常见的表型,与不幸的危险因素特征和多个 HRQoL 维度受损相关。POA 需要在研究和临床护理中进一步关注。