通过统计形状建模得出的踝关节形状变化、损伤史和种族之间的横断面关联：约翰斯顿县骨关节炎项目
Cross-sectional associations between variations in ankle shape by statistical shape modeling, injury history, and race: the Johnston County Osteoarthritis Project.
作者信息
Nelson Amanda E, Golightly Yvonne M, Lateef Shahmeer, Renner Jordan B, Jordan Joanne M, Aspden Richard M, Hillstrom Howard, Gregory Jennifer S
机构信息
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box 7280, Chapel Hill, NC 27599-7280 USA.
University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC USA.
出版信息
J Foot Ankle Res. 2017 Jul 26;10:34. doi: 10.1186/s13047-017-0216-3. eCollection 2017.
BACKGROUND
Injury is an important risk factor for osteoarthritis (OA), a highly prevalent and disabling joint disease. Joint shape is linked to OA, but the interplay of injury and joint shape and their combined role in OA, particularly at the ankle, is not well known. Therefore, we explored cross-sectional associations between ankle shape and injury in a large community-based cohort.
METHODS
Ankles without radiographic OA were selected from the current data collection of the Johnston County OA Project. Ankles with self-reported prior injury were included as injury cases ( = 108) along with 1:1 randomly selected non-injured ankles. To define ankle shape, a 68 point model on weight-bearing lateral ankle radiographs was entered into a statistical shape model, producing a mean shape and a set of continuous variables (modes) representing variation in that shape. Nineteen modes, explaining 80% of shape variance, were simultaneously included in a logistic regression model with injury status as the dependent variable, adjusted for intra-person correlation, sex, race, body mass index (BMI), baseline OA radiographic grade, and baseline symptoms.
RESULTS
A total of 194 participants (213 ankles) were included; mean age 71 years, BMI 30 kg/m, 67% white and 71% women. Injured ankles were more often symptomatic and from whites. In a model adjusted only for intra-person correlation, associations were seen between injury status and modes 1, 6, 13, and 19. In a fully adjusted model, race strongly affected the estimate for mode 1 (which was no longer statistically significant).
CONCLUSIONS
This study showed variations in ankle shape and history of injury as well as with race. These novel findings may indicate a change in ankle morphology following injury, or that ankle morphology predisposes to injury, and suggest that ankle shape is a potentially important factor in the development of ankle OA.
背景
损伤是骨关节炎（OA）的一个重要风险因素，OA是一种高度流行且致残的关节疾病。关节形状与OA有关，但损伤与关节形状之间的相互作用及其在OA中的综合作用，尤其是在踝关节，尚不清楚。因此，我们在一个大型社区队列中探讨了踝关节形状与损伤之间的横断面关联。
方法
从约翰斯顿县OA项目的当前数据收集中选择无放射学OA的踝关节。将有自我报告既往损伤的踝关节作为损伤病例（n = 108），并随机选取1:1的未受伤踝关节。为了定义踝关节形状，将负重侧位踝关节X线片上的68点模型输入统计形状模型，生成一个平均形状和一组代表该形状变化的连续变量（模式）。将解释80%形状方差的19种模式同时纳入以损伤状态为因变量的逻辑回归模型，对个体内相关性、性别、种族、体重指数（BMI）、基线OA放射学分级和基线症状进行校正。
结果
共纳入194名参与者（共213个踝关节）；平均年龄71岁，BMI为30kg/m²，67%为白人，71%为女性。受伤的踝关节更常出现症状，且多为白人。在仅对个体内相关性进行校正的模型中，损伤状态与模式1、6、13和19之间存在关联。在完全校正的模型中，种族对模式1的估计有强烈影响（该模式不再具有统计学意义）。
结论
本研究显示了踝关节形状、损伤史以及种族之间的差异。这些新发现可能表明损伤后踝关节形态发生了变化，或者踝关节形态易导致损伤，并提示踝关节形状可能是踝关节OA发生发展的一个潜在重要因素。
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