Meng Yan-Ting, Wang Yuan-Yuan, Zhou Yan-Hui, Fu Jing-Xia, Chen Ming-Zhu, Xu Chen, Qin Si, Luo Yang
Xiangya Nursing School of Central South University, Changsha, Hunan.
School of International Cultural Exchange of Fudan University, Shanghai, China.
Medicine (Baltimore). 2020 Oct 2;99(40):e22538. doi: 10.1097/MD.0000000000022538.
The current studies revealed inconsistent relationship between reproductive factors and osteoarthritis. Community-based research has not been conducted in China. The study was to examine the association of reproductive factors with the prevalence of knee osteoarthritis (OA).Through a multistage stratified random sampling method, 10 streets or villages from 5 cities in Hunan province were randomly selected, a total 2746 eligible women aged 50 to 83 were recruited in this cross-sectional study. A structured questionnaire including demographic factors, socio-economic status, reproductive factors, and knee OA was used. According to the criteria of American College of Rheumatology, clinical knee OA was assessed by doctors in community or village health clinics for knee pain, age, morning stiffness, crepitus on active motion or for knee pain, morning stiffness, crepitus on active motion, and tenderness of the bony navigation of the joint. Self-reported age of menarche, parity, abortion history, and menopausal status were collected.The prevalence of knee OA was 13.44%. Abortion is associated with knee OA (odds ratio [OR] = 1.271, 95% confidence interval [CI] = 1.007, 1.606), but age at menarche, parity, and menopausal status were not the factors. Furthermore, age (OR = 1.040, 95% CI = 1.020, 1.060), weight (OR = 1.019, 95% CI = 1.004, 1.035), higher education level (OR = 1.530, 95% CI = 1.121, 2.088), higher monthly household income (OR = .583, 95% CI = 0.441, 0.770 for 3000-4999 ¥ and OR = 0.599, 95% CI = 0.431, 0.833 for 5000 ¥ or more), and chronic gastritis (OR = 3.364, 95% CI = 2.548, 4.442) were associated with knee OA.Abortion may increase the risk of knee OA. Special attention should be paid to women with a history of abortion, and women who are planning to abort should be informed of the risk of knee OA later in life. The relationship between abortion and knee OA should be interpreted with caution and further confirmed.
目前的研究揭示了生殖因素与骨关节炎之间的关系并不一致。中国尚未开展基于社区的研究。本研究旨在探讨生殖因素与膝关节骨关节炎(OA)患病率之间的关联。通过多阶段分层随机抽样方法,从湖南省5个城市中随机选取10个街道或村庄,在这项横断面研究中,共招募了2746名年龄在50至83岁之间的符合条件的女性。使用了一份结构化问卷,内容包括人口统计学因素、社会经济状况、生殖因素和膝关节OA。根据美国风湿病学会的标准,由社区或村卫生室的医生对临床膝关节OA进行评估,评估内容包括膝关节疼痛、年龄、晨僵、主动活动时的摩擦音,或膝关节疼痛、晨僵、主动活动时的摩擦音以及关节骨突的压痛。收集了自我报告的初潮年龄、生育次数、流产史和绝经状态。膝关节OA的患病率为13.44%。流产与膝关节OA相关(优势比[OR]=1.271,95%置信区间[CI]=1.007,1.606),但初潮年龄、生育次数和绝经状态不是相关因素。此外,年龄(OR=1.040,95%CI=1.020,1.060)、体重(OR=1.019,95%CI=1.004,1.035)、高等教育水平(OR=1.530,95%CI=1.121,2.088)、较高的家庭月收入(3000 - 4999元时OR=0.583,95%CI=0.441,0.770;5000元及以上时OR=0.599,95%CI=0.431,0.833)以及慢性胃炎(OR=3.364,95%CI=2.548,4.442)与膝关节OA相关。流产可能会增加患膝关节OA的风险。应特别关注有流产史的女性,对于计划流产的女性,应告知其日后患膝关节OA的风险。流产与膝关节OA之间的关系应谨慎解读并进一步证实。