Roux Christian Hubert, Coste Joël, Roger Coralie, Fontas Eric, Rat Anne-Christine, Guillemin Francis
Rheumatology Department, University Nice Sophia Antipolis, LAMHESS, EA 6312, CHU Nice, Nice, France.
Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France.
Joint Bone Spine. 2021 Mar;88(2):105077. doi: 10.1016/j.jbspin.2020.09.009. Epub 2020 Sep 17.
To evaluate the clinical and structural impact of smoking on knee and hip osteoarthritis at baseline and after 3years.
Observational data on the progressive effects of smoking at baseline and after 3years were collected from The Knee and Hip Osteoarthritis Long-Term Assessment cohort comprising a French population of patients aged 40-75years with symptomatic lower limb osteoarthritis. Clinical (the Western Ontario and McMaster Universities Arthritis Index and Harris scores) and structural (radiography for osteophyte detection and joint-space narrowing assessment) were conducted. The tobacco usage categories were 'never smoker', 'former smoker', and 'current smoker'.
Of the 873 subjects included, 215 (25%) were former smokers and 119 (14%) were current smokers. Multivariate analyses revealed that former and current smokers had fewer knee osteophytes in the medial compartment at baseline (odds ratio [OR]=0.64 [0.41-0.99] and 0.63 [0.36-1.11], respectively), lower osteophyte development in the lateral condyle after 3years (OR=011 [0.03-0.45] and 0.15 [0.03-0.97]), and lower osteophyte development in the lateral tibial plateau after 3years (OR=0.22 [0.06-0.75] and 0.68 [0.14-3.35]). Higher tobacco consumption and longer duration of consumption were significantly associated with fewer knee osteophytes at baseline and lower osteophyte development at 3years.
Although cigarette smoking did not influence knee function, pain, or the need for replacement surgery, current and former smokers developed fewer osteophytes. This relationship may be linked to the quantity and duration of consumption. Our results provide further insight into the smoking-related pathophysiology of osteoarthritis.
评估吸烟在基线期及3年后对膝关节和髋关节骨关节炎的临床及结构影响。
从膝关节和髋关节骨关节炎长期评估队列中收集关于吸烟在基线期及3年后的进展性影响的观察数据，该队列由40 - 75岁有症状的下肢骨关节炎法国患者组成。进行了临床评估（西安大略和麦克马斯特大学骨关节炎指数及哈里斯评分）和结构评估（通过X线摄影检测骨赘及评估关节间隙变窄情况）。烟草使用类别分为“从不吸烟者”“既往吸烟者”和“当前吸烟者”。
在纳入的873名受试者中，215名（25%）为既往吸烟者，119名（14%）为当前吸烟者。多变量分析显示，既往吸烟者和当前吸烟者在基线期内侧间室的膝关节骨赘较少（优势比[OR]分别为0.64[0.41 - 0.99]和0.63[0.36 - 1.11]），3年后外侧髁的骨赘生长较少（OR分别为0.11[0.03 - 0.45]和0.15[0.03 - 0.97]），3年后外侧胫骨平台的骨赘生长较少（OR分别为0.22[0.06 - 0.75]和0.68[0.14 - 3.35]）。较高的烟草消费量和较长的吸烟持续时间与基线期较少的膝关节骨赘及3年后较低的骨赘生长显著相关。
尽管吸烟不影响膝关节功能、疼痛或关节置换手术需求，但当前吸烟者和既往吸烟者形成的骨赘较少。这种关系可能与吸烟量和持续时间有关。我们的结果为骨关节炎与吸烟相关的病理生理学提供了进一步的见解。
