Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster St, Pawtucket, RI, 02860, USA.
BMC Musculoskelet Disord. 2020 Jan 31;21(1):60. doi: 10.1186/s12891-020-3073-3.
Prior research on accelerated knee osteoarthritis (AKOA) was primarily confined to the Osteoarthritis Initiative, which was enriched with people with risk factors for knee osteoarthritis (KOA). It is unclear how often AKOA develops in a community-based cohort and whether we can replicate prior findings from the Osteoarthritis Initiative in another cohort. Hence, we determined the incidence and characteristics of AKOA among women in the Chingford Study, which is a prospective community-based cohort.
The Chingford Study had 1003 women with quinquennial knee radiographs over 15 years. We divided the 15-year observation period into three consecutive 5-year phases. Within each 5-year phase, we selected 3 groups of participants among women who started a phase without KOA (Kellgren-Lawrence [KL] < 2): 1) incident AKOA developed KL grade ≥ 3, 2) typical KOA increased radiographic scoring (excluding AKOA), and 3) no KOA had the same KL grade over time. Study staff recorded each participant's age, body mass index (BMI), and blood pressure at baseline, 5-year, and 10-year study visits. We used multinomial logistic regression models to test the association between groups (outcome) and age, BMI, and blood pressure at the start of each phase. The cumulative incidences and odds ratios (OR) from each phase were pooled using a fixed-effect meta-analysis model.
The person-based cumulative incidence of AKOA was 3.9% over 5 years (pooled estimate across the three 5-year phases). Among incident cases of KOA, AKOA represented ~ 15% of women with incident KOA. Women with AKOA were older than those with typical (OR = 1.56, 95%CI = 1.16-2.11) or no KOA (OR = 1.84, 95%CI = 1.40-2.43). Women with AKOA had a greater BMI than those without KOA (OR = 1.52, 95%CI = 1.17-1.97). We observed no association between group and blood pressure.
In a community-based cohort, > 1 in 7 women with incident KOA had AKOA. Like the Osteoarthritis Initiative, people with AKOA were more likely to have greater age and BMI.
先前关于加速膝骨关节炎（AKOA）的研究主要局限于骨关节炎倡议，该倡议富含膝骨关节炎（KOA）的风险因素。目前尚不清楚在社区为基础的队列中 AKOA 的发生率如何，以及我们是否可以在另一个队列中复制骨关节炎倡议的先前发现。因此，我们确定了在 Chingford 研究中的女性中 AKOA 的发生率和特征，这是一个前瞻性的社区为基础的队列。
Chingford 研究中有 1003 名女性在 15 年内进行了每五年一次的膝关节放射照相检查。我们将 15 年的观察期分为三个连续的 5 年阶段。在每个 5 年阶段内，我们在开始阶段没有 KOA（Kellgren-Lawrence [KL] < 2）的女性中选择了 3 组参与者：1）出现 KL 分级≥3 的 AKOA；2）放射学评分增加的典型 KOA（不包括 AKOA）；3）随着时间的推移 KL 分级相同的无 KOA。研究人员在基线、5 年和 10 年的研究访问时记录每位参与者的年龄、体重指数（BMI）和血压。我们使用多项逻辑回归模型来检验每个阶段开始时组（结果）与年龄、BMI 和血压之间的关系。使用固定效应荟萃分析模型对各阶段的累积发生率和比值比（OR）进行汇总。
在 5 年内，基于人的累积 AKOA 发生率为 3.9%（三个 5 年阶段的汇总估计值）。在新发 KOA 患者中，AKOA 占新发 KOA 女性的~15%。患有 AKOA 的女性比患有典型 KOA（OR = 1.56，95%CI = 1.16-2.11）或无 KOA（OR = 1.84，95%CI = 1.40-2.43）的女性年龄更大。患有 AKOA 的女性的 BMI 大于没有 KOA 的女性（OR = 1.52，95%CI = 1.17-1.97）。我们没有观察到组与血压之间的关联。
在社区为基础的队列中，超过 1/7 的新发 KOA 女性患有 AKOA。与骨关节炎倡议一样，患有 AKOA 的人更有可能年龄更大、BMI 更高。
