From the Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
M. Loef, MD, Department of Rheumatology, Leiden University Medical Center; W. Damman, MD, PhD, Department of Rheumatology, Leiden University Medical Center; R. de Mutsert, PhD, Department of Clinical Epidemiology, Leiden University Medical Center; F.R. Rosendaal, MD, PhD, Professor, Department of Clinical Epidemiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Professor, Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Center.
J Rheumatol. 2020 Sep 1;47(9):1409-1415. doi: 10.3899/jrheum.190781. Epub 2019 Dec 1.
To investigate the association of hand osteoarthritis (OA) and concurrent hand and knee OA with health-related quality of life (HRQOL) in the general population, and in patients consulting a rheumatology outpatient clinic.
In the population-based Netherlands Epidemiology of Obesity (NEO) study, participants were recruited from the greater area of Leiden, the Netherlands. In the Hand OSTeoArthritis in Secondary care (HOSTAS) study, patients with a rheumatologist's diagnosis of hand OA were recruited from a Leiden-based hospital. In both cohorts, hand and knee OA were defined by the American College of Rheumatology clinical criteria. In NEO, self-reported hospital-based specialist consultation for OA was recorded. Physical and mental HRQOL was assessed with normalized Medical Outcomes Study Short Form-36 scores. Associations were analyzed using linear regression, adjusted for age, sex, education, ethnicity, and body mass index.
Hand OA alone and concurrent hand and knee OA was present in 8% and 4% of 6334 NEO participants, and in 57% and 32% of 538 HOSTAS patients. In NEO, hand OA alone, and concurrent hand and knee OA, were associated with lower physical component summary (PCS) scores [mean difference -2.4 (95% CI -3.6, -1.3) and -7.7 (95% CI -9.3, -6.2), respectively] compared with no OA. Consulting a specialist was associated with worse PCS scores. In the HOSTAS cohort, mean PCS scores were lower than norm values (-3.5 and -7.9 for hand OA and combined OA, respectively). Mental HRQOL was not clinically relevantly associated in either cohort.
Hand OA was associated with reduced physical, but not mental, HRQOL in the general population and hospital patients. Physical HRQOL was further reduced in hospital care, and with concurrent knee OA.
研究手部骨关节炎（OA）以及同时存在手部和膝部 OA 与普通人群和咨询风湿病门诊患者的健康相关生活质量（HRQOL）之间的关联。
在基于人群的荷兰肥胖症流行病学研究（NEO）中，参与者从荷兰莱顿市的更大区域招募。在手部骨关节炎二级护理研究（HOSTAS）中，从莱顿市的一家医院招募了被风湿病学家诊断为手部 OA 的患者。在这两个队列中，手部和膝部 OA 均通过美国风湿病学会临床标准定义。在 NEO 中，记录了自我报告的基于医院的 OA 专科咨询。身体和心理健康 HRQOL 通过标准化医疗结果研究简表 36 项评分进行评估。使用线性回归分析调整年龄、性别、教育程度、种族和体重指数后，分析了相关性。
在 6334 名 NEO 参与者中，单独的手部 OA 和同时存在的手部和膝部 OA 分别占 8%和 4%，在 538 名 HOSTAS 患者中分别占 57%和 32%。在 NEO 中，与无 OA 相比，单独的手部 OA 和同时存在的手部和膝部 OA 与较低的生理成分综合评分（PCS）相关[平均差异分别为-2.4（95%CI -3.6，-1.3）和-7.7（95%CI -9.3，-6.2）]。咨询专家与较差的 PCS 评分相关。在 HOSTAS 队列中，PCS 评分均低于正常值（手部 OA 和联合 OA 分别为-3.5 和-7.9）。在两个队列中，心理 HRQOL 均无显著相关性。
手部 OA 与普通人群和医院患者的身体功能下降有关，但与心理健康无关。在医院治疗中，手部 HRQOL 进一步下降，并且与同时存在的膝部 OA 相关。
