Rheumatology department, Gabriel Montpied Teaching Hospital, CHU Gabriel Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Rheumatology department, Gabriel Montpied Teaching Hospital, CHU Gabriel Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Joint Bone Spine. 2019 Nov;86(6):679-684. doi: 10.1016/j.jbspin.2019.06.013. Epub 2019 Jul 16.
Higher cardiovascular risk found in rheumatoid arthritis or psoriatic arthritis is largely due to systemic inflammation. In osteoarthritis (OA), occurrence of systemic inflammation has already been sometimes reported, but the possible association between OA and increased cardiovascular risk remains unclear. In this meta-analysis, we aimed to assess the incidences of myocardial infarction (MI) and stroke, and the cardiovascular risk factors in OA patients.
We searched PubMed, EMBase, and the Cochrane Library to find references of interest up to June 2018. MI and stroke incidence were calculated using meta-proportion analysis. Differences in cardiovascular risk factors between OA patients and controls were expressed as standardized mean differences using the inverse of variance method.
The reviewed studies reported 227 MIs in 3550 OA patients (incidence, 7.5%; 95% CI: 3.0-13.8%) and 616 MIs among 12,444 control subjects (incidence, 6.0%; 95% CI: 2.8-10.3%). Meta-analysis of the three longitudinal studies revealed a significantly increased MI risk among OA patients (RR=1.22; 95% CI: 1.02-1.45). We also found a significantly increased stroke risk in OA patients (RR=1.43; 95% CI: 1.38-1.48). Concerning cardiovascular risk factors, OA patients exhibited a pro-atherogenic lipid and glycemic profile including high levels of fasting glucose, total cholesterol, and LDL cholesterol and a high body mass index. Concerning atherosclerosis markers, OA patients exhibited a higher risk of metabolic syndrome, and increased pulse wave velocity.
Our meta-analysis results revealed higher cardiovascular risk in OA patients. This highlights the importance of cardiovascular risk factor management in OA.
类风湿关节炎或银屑病关节炎患者心血管风险较高，主要是由于全身炎症。在骨关节炎（OA）中，已经有报道称全身炎症的发生，但 OA 与心血管风险增加之间的可能关联仍不清楚。在这项荟萃分析中，我们旨在评估 OA 患者心肌梗死（MI）和中风的发生率以及心血管危险因素。
我们检索了 PubMed、EMBase 和 Cochrane 图书馆，以查找截至 2018 年 6 月的相关参考文献。使用荟萃比例分析计算 MI 和中风的发生率。使用方差倒数法表示 OA 患者与对照组之间心血管危险因素的差异，结果表示为标准化均数差。
综述研究报告了 3550 例 OA 患者中的 227 例 MI（发生率为 7.5%；95%CI：3.0-13.8%）和 12444 例对照者中的 616 例 MI（发生率为 6.0%；95%CI：2.8-10.3%）。对三项纵向研究的荟萃分析显示，OA 患者的 MI 风险显著增加（RR=1.22；95%CI：1.02-1.45）。我们还发现 OA 患者的中风风险显著增加（RR=1.43；95%CI：1.38-1.48）。在心血管危险因素方面，OA 患者表现出促动脉粥样硬化的脂质和血糖谱，包括空腹血糖、总胆固醇和 LDL 胆固醇水平升高以及体重指数升高。在动脉粥样硬化标志物方面，OA 患者的代谢综合征风险更高，脉搏波速度增加。
我们的荟萃分析结果显示 OA 患者存在更高的心血管风险。这凸显了在 OA 患者中管理心血管危险因素的重要性。
