Johns Hopkins University School of Medicine, Baltimore, Maryland.
University System of Maryland, School of Medicine, Baltimore, Maryland.
Arthritis Rheumatol. 2018 Aug;70(8):1234-1239. doi: 10.1002/art.40463. Epub 2018 Jun 27.
To determine whether the presence, number, and topography (digit location and symmetry) of Heberden's nodes are associated with the incidence and progression of radiographic osteoarthritis (OA) of the knee.
We analyzed 8,023 knees (with 8 years of follow-up) from the Osteoarthritis Initiative. Cox regression was performed on Heberden's node presence, total number, location, and symmetry (using 2 symmetry index models) obtained at baseline physical examination as well as self-report of Heberden's node presence for evaluation of association with radiographic knee OA incidence (development of a Kellgren/Lawrence grade of ≥2) and progression (worsening in the medial joint space narrowing score of ≥1). Covariate adjustments relevant to OA outcomes were performed.
The presence of Heberden's nodes (in 64% of the subjects) at baseline physical examinations, but not subjective self-report of Heberden's nodes, was associated with radiographic knee OA incidence (hazard ratio [HR] 1.19 and 95% confidence interval [95% CI] 1.001-1.402 [approached statistical significance]). Each additional Heberden's node found on physical examination was associated with knee OA incidence (HR 1.03 [95% CI 1.000-1.054] [approached statistical significance]) and progression (HR 1.04 [95% CI 1.016-1.063]). Knee OA incidence and progression were associated with Heberden's nodes located on the third digit (HR 1.26 [95% CI 1.068-1.487] and 1.18 [95% CI 1.019-1.361], respectively) and first digit (HR 1.186 [95% CI 0.992-1.418] [approached statistical significance] and HR 1.26 [95% CI 1.084-1.453], respectively). Heberden's node symmetry was associated with knee OA incidence (model 1 HR 1.09 [95% CI 0.997-1.185] [approached statistical significance]) and progression (model 2 HR 1.13 [95% CI 1.035-1.234]).
The number of Heberden's nodes, their locations, and symmetry were associated with knee OA incidence and progression over 8 years.
确定赫伯登结节的存在、数量和分布（指位和对称性）是否与膝关节放射学骨关节炎（OA）的发生和进展相关。
我们对来自骨关节炎倡议（Osteoarthritis Initiative）的 8023 个膝关节（随访 8 年）进行了分析。使用 Cox 回归分析基线体格检查时获得的赫伯登结节的存在、总数、位置和对称性（使用 2 种对称性指数模型），以及自我报告的赫伯登结节的存在，以评估其与放射学膝关节 OA 发生率（发展为 Kellgren/Lawrence 分级≥2）和进展（内侧关节间隙狭窄评分恶化≥1）的相关性。对与 OA 结局相关的协变量进行了调整。
基线体格检查时赫伯登结节的存在（64%的受试者），而不是主观的自我报告的赫伯登结节，与放射学膝关节 OA 发生率相关（风险比[HR]1.19，95%置信区间[95%CI]1.001-1.402[接近统计学意义]）。体格检查时发现的每个额外赫伯登结节都与膝关节 OA 发生率相关（HR 1.03[95%CI 1.000-1.054[接近统计学意义]）和进展（HR 1.04[95%CI 1.016-1.063]）。膝关节 OA 发生率和进展与位于第三指（HR 1.26[95%CI 1.068-1.487]和 1.18[95%CI 1.019-1.361]）和第一指（HR 1.186[95%CI 0.992-1.418][接近统计学意义]和 HR 1.26[95%CI 1.084-1.453]）的赫伯登结节有关。赫伯登结节的对称性与膝关节 OA 发生率（模型 1 HR 1.09[95%CI 0.997-1.185][接近统计学意义]）和进展（模型 2 HR 1.13[95%CI 1.035-1.234]）相关。
赫伯登结节的数量、位置和对称性与 8 年内膝关节 OA 的发生和进展有关。
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