From the School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Australian National University (ANU) College of Health and Medicine, Canberra; The Alfred Hospital, Melbourne, Australia.
S.M. Hussain, PhD, Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; C. Dawson, MPH, Medical Student, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and ANU College of Health and Medicine; Y. Wang, PhD, Senior Research Fellow, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.M. Tonkin, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; L. Chou, FRACP, Consultant, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and The Alfred Hospital; A.E. Wluka, PhD, Professor, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, Professor, School of Public Health and Preventive Medicine, Monash University. S.M. Hussain and C. Dawson are joint first authors.
J Rheumatol. 2020 May 1;47(5):748-760. doi: 10.3899/jrheum.181236. Epub 2019 Jun 1.
Vascular pathology (changes in blood vessels) and osteoarthritis (OA) are both common chronic conditions associated with aging and obesity, but whether vascular pathology is a risk factor for OA is unclear. The aim of this study was to systematically review the evidence for an association between vascular pathology and risk of joint-specific OA.
Scopus, Ovid Medline, and EMBASE were searched from inception to February 2019. MeSH terms and keywords were used to identify studies examining the association between vascular pathology and OA. Two reviewers independently extracted the data and assessed the methodological quality. Qualitative evidence synthesis was performed.
Fifteen studies with high (n = 3), fair (n = 3), or low (n = 9) quality were included. Features of vascular pathology included atherosclerosis, vascular stiffness, and endothelial dysfunction in different vascular beds. There was evidence for an association between vascular pathology and risk of hand OA in women but not men, and between vascular pathology and risk of knee OA in both men and women. Only 2 studies examined hip OA showing no association between vascular pathology and risk of hip OA.
There is evidence suggesting an association between vascular pathology and risk of hand and knee OA, with a potential causal relationship for knee OA. Based on the limited evidence, it is hard to conclude an association for hip OA. Further stronger evidence is needed to determine whether there is a causal relationship.
血管病理学（血管变化）和骨关节炎（OA）都是与衰老和肥胖相关的常见慢性疾病，但血管病理学是否是 OA 的危险因素尚不清楚。本研究旨在系统回顾血管病理学与特定关节 OA 风险之间关联的证据。
从建库至 2019 年 2 月，检索 Scopus、Ovid Medline 和 EMBASE。使用 MeSH 术语和关键词来确定研究血管病理学与 OA 之间关联的研究。两名审查员独立提取数据并评估方法学质量。进行定性证据综合。
纳入了 15 项高质量（n = 3）、中等质量（n = 3）或低质量（n = 9）的研究。血管病理学的特征包括不同血管床中的动脉粥样硬化、血管僵硬和内皮功能障碍。有证据表明血管病理学与女性手部 OA 风险之间存在关联，但与男性手部 OA 风险之间无关联，与男性和女性的膝关节 OA 风险之间存在关联。仅有 2 项研究检查了髋关节 OA，表明血管病理学与髋关节 OA 风险之间无关联。
有证据表明血管病理学与手部和膝关节 OA 风险之间存在关联，对于膝关节 OA 可能存在因果关系。基于有限的证据，很难得出髋关节 OA 的关联。需要进一步的更强有力的证据来确定是否存在因果关系。
