Mathieu Sylvain, Naughton Geraldine, Descatha Alexis, Soubrier Martin, Dutheil Frédéric
Service de Rhumatologie, CHU Clermont-Ferrand, Université Clermont Auvergne, France.
Department of Educational Studies, Macquarie University, Sydney, New South Wales, Australia, and the Department of Health and Medical Sciences, Swinburne University of Technology, Melbourne, Australia.
Joint Bone Spine. 2020 May;87(3):203-207. doi: 10.1016/j.jbspin.2020.02.001. Epub 2020 Feb 12.
Dupuytren's Disease (DD) occurs frequently in the entire population. Several risk factors are well known, including diabetes, alcohol, and age. In this meta-analysis, we assessed the role of occupational vibration exposure in the risk of DD, an issue currently under debate.
We searched PubMed, Google Scholar, and the Cochrane Library to find references up to June 2019. DD prevalence was calculated using meta-proportion analysis. Differences in characteristics between DD patients and controls were expressed as standardized mean differences using the inverse of variance method or percentages using also meta-proportion analysis. We performed meta-regression analyses to assess the effects of alcohol, smoking, age, and sex on the DD incidence for the patients with DD that were exposed to vibrations.
We included 9 studies, comprising a total of 60,570 patients, including 1,804 DD patients. Prevalence of DD was 9.8% (95%CI: 5.9-14.4%). Compared with controls, patients with DD were older, more diabetic, more smokers and with a higher consumption of alcohol. Meta-analysis of the nine longitudinal studies comparing DD occurrence between patients exposed to vibration (626 of 6825) or not (1220 of 52,502) revealed a significantly increased DD incidence among patients with vibration exposure compared with controls (OR=2.87; 95%CI: 1.41-5.84). In metaregression we found no significant influence of all parameters on DD.
Age and environmental factors had no effect on DD prevalence among patients exposed to vibrations, despite a 10% prevalence in this group. Using vibration tools at work should be recognized as an important risk factor of developing DD.
杜普伊特伦挛缩病（DD）在整个人口中频繁发生。几个风险因素是众所周知的，包括糖尿病、酒精和年龄。在这项荟萃分析中，我们评估了职业性振动暴露在DD风险中的作用，这是一个目前正在争论的问题。
我们检索了PubMed、谷歌学术和考科蓝图书馆，以查找截至2019年6月的参考文献。使用荟萃比例分析计算DD患病率。DD患者和对照组之间特征的差异用方差倒数法表示为标准化平均差异，或也用荟萃比例分析表示为百分比。我们进行了荟萃回归分析，以评估酒精、吸烟、年龄和性别对接触振动的DD患者的DD发病率的影响。
我们纳入了9项研究，共60570名患者，其中包括1804名DD患者。DD的患病率为9.8%（95%CI：5.9 - 14.4%）。与对照组相比，DD患者年龄更大，糖尿病患者更多，吸烟者更多，饮酒量更高。对9项纵向研究进行荟萃分析，比较接触振动的患者（6825名中的626名）和未接触振动的患者（52502名中的1220名）之间DD的发生情况，结果显示与对照组相比，接触振动的患者DD发病率显著增加（OR = 2.87；95%CI：1.41 - 5.84）。在荟萃回归中，我们发现所有参数对DD均无显著影响。
尽管该组患病率为10%，但年龄和环境因素对接触振动的患者的DD患病率没有影响。在工作中使用振动工具应被视为发生DD的一个重要风险因素。
