综合职业队列中肱骨外上髁炎与心血管危险因素的关联
Association between Epicondylitis and Cardiovascular Risk Factors in Pooled Occupational Cohorts.
作者信息
Hegmann Kurt T, Thiese Matthew S, Kapellusch Jay, Merryweather Andrew, Bao Stephen, Silverstein Barbara, Wood Eric M, Kendall Richard, Foster James, Drury David L, Garg Arun
机构信息
Rocky Mountain Center for Occupational and Environmental Health (RMCOEH), School of Medicine, University of Utah, 391 Chipeta Way Suite C, Salt Lake City, UT, 84108, USA.
Department of Occupational Science & Technology, College of Health Sciences, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI, 53201, USA.
出版信息
BMC Musculoskelet Disord. 2017 May 30;18(1):227. doi: 10.1186/s12891-017-1593-2.
BACKGROUND
The pathophysiology of lateral epicondylitis (LE) is unclear. Recent evidence suggests some common musculoskeletal disorders may have a basis in cardiovascular disease (CVD) risk factors. Thus, we examined CVD risks as potential LE risks.
METHODS
Workers (n = 1824) were enrolled in two large prospective studies and underwent structured interviews and physical examinations at baseline. Analysis of pooled baseline data assessed the relationships separately between a modified Framingham Heart Study CVD risk score and three prevalence outcomes of: 1) lateral elbow pain, 2) positive resisted wrist or middle finger extension, and 3) a combination of both symptoms and at least one resisted maneuver. Quantified job exposures, personal and psychosocial confounders were statistically controlled. Odds ratios (ORs) and 95% Confidence Intervals (CIs) were calculated.
RESULTS
There was a strong relationship between CVD risk score and lateral elbow symptoms, resisted wrist or middle finger extension and LE after adjustment for confounders. The adjusted ORs for symptoms were as high as 3.81 (95% CI 2.11, 6.85), for positive examination with adjusted odds ratios as high as 2.85 (95% CI 1.59, 5.12) and for combined symptoms and physical examination 6.20 (95% CI 2.04, 18.82). Relationships trended higher with higher CVD risk scores.
CONCLUSIONS
These data suggest a potentially modifiable disease mechanism for LE.
背景
肱骨外上髁炎（LE）的病理生理学尚不清楚。最近的证据表明，一些常见的肌肉骨骼疾病可能与心血管疾病（CVD）风险因素有关。因此，我们将心血管疾病风险作为潜在的肱骨外上髁炎风险进行了研究。
方法
1824名工人参与了两项大型前瞻性研究，并在基线时接受了结构化访谈和体格检查。对汇总的基线数据进行分析，分别评估改良的弗明汉心脏研究心血管疾病风险评分与以下三种患病率结果之间的关系：1）外侧肘部疼痛；2）抗阻腕关节或中指伸展试验阳性；3）同时出现上述两种症状且至少一项抗阻动作阳性。对量化的工作暴露、个人和社会心理混杂因素进行了统计学控制。计算了比值比（OR）和95%置信区间（CI）。
结果
在对混杂因素进行调整后，心血管疾病风险评分与外侧肘部症状、抗阻腕关节或中指伸展试验阳性以及肱骨外上髁炎之间存在密切关系。症状的调整后OR高达3.81（95%CI 2.11，6.85），检查阳性的调整后比值比高达2.85（95%CI 1.59，5.12），症状与体格检查均阳性的调整后比值比为6.20（95%CI 2.04，1
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