McKevitt Sarah, Healey Emma, Jinks Clare, Rathod-Mistry Trishna, Quicke Jonathan
School of Primary, Community and Social Care, Primary Care Centre Versus Arthritis, Keele University, Keele, ST5 5BG, UK.
Osteoarthr Cartil Open. 2020 Jun;2(2):100057. doi: 10.1016/j.ocarto.2020.100057.
To determine whether comorbidity presence, frequency or type is associated with Physical Activity (PA) levels in people with Osteoarthritis (OA).
Secondary data analysis of adults aged ≥45, with OA related pain recruited to the BEEP trial (knee pain, n = 514) (ISRCTN93634563) and the MOSAICS trial (peripheral joint pain, n = 525) (ISRCTN06984617). Comorbidities considered were respiratory, cardiovascular diseases (CVD), depression, type 2 diabetes and obesity. Self-report PA was measured using the Physical Activity Scale for the Elderly (PASE). Linear regression models were used to estimate the mean change (β) in PA with comorbidity presence, frequency and type adjusting for potential confounding covariates.
In the BEEP trial comorbidity presence was associated with a decrease in PASE score (β = -32.25 [95% confidence interval (95% CI) -48.57, -15.93]). Each additional comorbidity was associated with an incrementally lower PASE score, one comorbidity (β = -24.42 [-42.45, -6.38]), two comorbidities β = -34.76 [-56.05, -13.48]), and three or more comorbidities β = -73.71 [-106.84, -40.58]) compared to those with no comorbidity. This pattern was similar in MOSAICS, but with a plateau in association from two comorbidities onward. In BEEP and MOSAICS, respiratory (β = -40.60 [-60.50, -20.35]; β = -11.82 [-34.95, 11.31]) and CVD (β = -27.15 [-53.25, -1.05]; β = -30.84 [-51.89, -9.80]) comorbidities were associated with the largest reduction in PASE scores respectively.
Comorbidity presence and frequency is associated with lower PA levels and respiratory and CVD comorbidities have the greatest impact. Future exploratory work needs to be done to understand how and why comorbidity is associated with PA levels in people with OA.
确定骨关节炎（OA）患者的合并症存在情况、频率或类型是否与身体活动（PA）水平相关。
对年龄≥45岁、因OA相关疼痛入选BEEP试验（膝关节疼痛，n = 514）（ISRCTN93634563）和MOSAICS试验（外周关节疼痛，n = 525）（ISRCTN06984617）的成年人进行二次数据分析。所考虑的合并症包括呼吸系统疾病、心血管疾病（CVD）、抑郁症、2型糖尿病和肥胖症。使用老年人身体活动量表（PASE）测量自我报告的PA。采用线性回归模型估计合并症存在、频率和类型对PA的平均变化（β），并对潜在的混杂协变量进行调整。
在BEEP试验中，合并症的存在与PASE评分降低相关（β = -32.25 [95%置信区间（95%CI）-48.57，-15.93]）。每增加一种合并症，PASE评分就会相应降低，与无合并症者相比，一种合并症（β = -24.42 [-42.45，-6.38]）、两种合并症（β = -34.76 [-56.05，-13.48]）、三种或更多合并症（β = -73.71 [-106.84，-40.58]）时的情况如此。MOSAICS试验中也有类似模式，但从两种合并症起相关性趋于平稳。在BEEP和MOSAICS试验中，呼吸系统疾病（β = -40.60 [-60.50，-20.35]；β = -11.82 [-34.95，11.31]）和CVD（β = -27.15 [-53.25，-1.05]；β = -30.84 [-51.89，-9.80]）合并症分别与PASE评分的最大降幅相关。
合并症的存在和频率与较低的PA水平相关，呼吸系统疾病和CVD合并症的影响最大。未来需要开展探索性工作，以了解合并症如何以及为何与OA患者的PA水平相关。
