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骨关节炎相关的行走障碍与动脉僵硬度:一项横断面研究的结果。

Osteoarthritis-Related Walking Disability and Arterial Stiffness: Results From a Cross-Sectional Study.

机构信息

Diakonhjemmet Hospital, Oslo, Norway.

Diakonhjemmet Hospital, Oslo, Norway and Lund University, Lund, Sweden.

出版信息

Arthritis Care Res (Hoboken). 2019 Feb;71(2):252-258. doi: 10.1002/acr.23697.

Abstract

OBJECTIVE

To compare the 6-minute walking distance (6MWD) in a population-based cohort of patients with osteoarthritis (OA) with that in matched peers from the general population, and to explore the associations between walking ability and risk of cardiovascular disease (CVD) in the OA cohort.

METHODS

This cross-sectional study included individuals (ages 40-80 years) who had self-reported OA (n = 500) in a previous population-based study and age- and sex-matched peers from the general population (n = 235). Clinical examinations of the patients with OA included classification according to the American College of Rheumatology criteria, blood sampling, and measuring arterial stiffness (PWV; pulse wave velocity). Group differences in the 6MWD were calculated with t-tests. The association between walking ability and CVD risk in the OA cohort was examined using multivariate regression models.

RESULTS

In the age-stratified analyses, the largest mean difference in the 6MWD was observed in the youngest age groups (40-49 years); female patients in the OA group walked 84.6 fewer meters compared with the reference group (579.4 meters and 663.9 meters, respectively; P < 0.001), and male patients walked 88.3 fewer meters compared with the reference group (619.9 meters and 708.3 meters, respectively; P = 0.001). In the OA group, the 6MWD was significantly associated with PWV in the adjusted analysis (P = 0.001); an increase in the walking distance of 100 meters corresponded to a reduction in PWV of 0.3 meters/second.

CONCLUSION

Even at age 40 years, patients with OA had a significantly shorter mean walking distance compared with their matched peers, underlining the importance of an early clinical approach to OA. Furthermore, in the OA group, the 6MWD was significantly associated with arterial stiffness, suggesting that walking ability is important for the CVD risk profile in patients with OA.

摘要

目的

比较基于人群的骨关节炎(OA)患者的 6 分钟步行距离(6MWD)与一般人群中匹配的同龄人的 6MWD,并探讨 OA 患者中步行能力与心血管疾病(CVD)风险之间的关联。

方法

本横断面研究纳入了之前一项基于人群的研究中自我报告患有 OA(n=500)的个体(年龄 40-80 岁)和一般人群中年龄和性别匹配的同龄人(n=235)。OA 患者的临床检查包括根据美国风湿病学会标准进行分类、采血和测量动脉僵硬度(PWV;脉搏波速度)。使用 t 检验计算 6MWD 的组间差异。使用多变量回归模型检查 OA 患者队列中步行能力与 CVD 风险之间的关联。

结果

在年龄分层分析中,6MWD 的最大平均差异出现在最年轻的年龄组(40-49 岁);OA 组女性患者比参考组少走 84.6 米(分别为 579.4 米和 663.9 米,P<0.001),男性患者比参考组少走 88.3 米(分别为 619.9 米和 708.3 米,P=0.001)。在调整分析中,OA 组的 6MWD 与 PWV 显著相关(P=0.001);步行距离增加 100 米对应 PWV 降低 0.3 米/秒。

结论

即使在 40 岁时,OA 患者的平均步行距离也明显短于他们的同龄匹配者,这突显了对 OA 进行早期临床干预的重要性。此外,在 OA 组中,6MWD 与动脉僵硬度显著相关,表明步行能力对 OA 患者的 CVD 风险状况很重要。

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