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肌肉骨骼疾病对死亡率的影响——与内科疾病的比较:一项15年的纵向研究。

The impact of musculoskeletal diseases on mortality-comparison with internal diseases: A 15-year longitudinal study.

作者信息

Kasai Takehiro, Hasegawa Yukiharu, Imagama Shiro, Sakai Tadahiro, Wakai Kenji, Suzuki Koji, Ishiguro Naoki

机构信息

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.

Department of Rehabilitation, Kansai University of Welfare and Sciences, 11-1, Asahigaoka 3-chome, Kashiwara, Osaka 582-0026, Japan.

出版信息

J Orthop Sci. 2017 Nov;22(6):1126-1131. doi: 10.1016/j.jos.2017.06.014. Epub 2017 Jul 25.

Abstract

BACKGROUND

Aging is associated with an increased incidence of diabetes (DM), hypertension (HT), hyperlipidemia (HL), as well as musculoskeletal disorders, such as osteoarthritis (OA) and osteoporosis (OP). However, the impact of musculoskeletal disorders on mortality remains unclear. This study investigated the risk of mortality if having knee OA or OP.

METHODS

601 participants (mean age 67.8 ± 5.3 years) who underwent musculoskeletal check-ups in Yakumo town were enrolled in this study, 248 were males and 353 were females. The following parameters were assessed: age, sex, body mass index, smoking habit, alcohol drinking habit, physical exercise habit, knee OA, OP, HT, DM and HL. Kaplan-Meier survival curves for smoking, drinking and physical exercise habits, knee OA, OP, HT, DM and HL were prepared, and the log-rank test was performed. Furthermore, the Cox hazard model was used for multivariate analysis of all variables.

RESULTS

Knee OA, OP, HT, and DM were associated with a significantly higher mortality rate. Cox regression analysis results showed a hazard ratio of 1.972 for OA (95%CI: 1.356-2.867), 1.965 for DM (1.146-3.368), 1.706 for smoking habits (1.141-2.552), and 1.614 for OP (1.126-2.313). Cardiovascular diseases were the most common causes of death.

CONCLUSIONS

Smoking, knee OA, OP and DM were all associated with increased risk of mortality. Knee OA had a high hazard ratio, comparable to that of DM. These findings suggest that interventions against smoking, knee OA, OP and DM may reduce the risk of mortality.

摘要

背景

衰老与糖尿病(DM)、高血压(HT)、高脂血症(HL)的发病率增加以及肌肉骨骼疾病有关,如骨关节炎(OA)和骨质疏松症(OP)。然而,肌肉骨骼疾病对死亡率的影响仍不清楚。本研究调查了患膝骨关节炎或骨质疏松症时的死亡风险。

方法

本研究纳入了在八云镇接受肌肉骨骼检查的601名参与者(平均年龄67.8±5.3岁),其中男性248名,女性353名。评估了以下参数:年龄、性别、体重指数、吸烟习惯、饮酒习惯、体育锻炼习惯、膝骨关节炎、骨质疏松症、高血压、糖尿病和高脂血症。绘制了吸烟、饮酒和体育锻炼习惯、膝骨关节炎、骨质疏松症、高血压、糖尿病和高脂血症的Kaplan-Meier生存曲线,并进行了对数秩检验。此外,使用Cox风险模型对所有变量进行多变量分析。

结果

膝骨关节炎、骨质疏松症、高血压和糖尿病与显著更高的死亡率相关。Cox回归分析结果显示,骨关节炎的风险比为1.972(95%CI:1.356-2.867),糖尿病为1.965(1.146-3.368),吸烟习惯为1.706(1.141-2.552),骨质疏松症为1.614(1.126-2.313)。心血管疾病是最常见的死亡原因。

结论

吸烟、膝骨关节炎、骨质疏松症和糖尿病均与死亡风险增加有关。膝骨关节炎的风险比很高,与糖尿病相当。这些发现表明,针对吸烟、膝骨关节炎、骨质疏松症和糖尿病的干预措施可能会降低死亡风险。

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