Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, 78180, France.
Epidemiology, IQVIA, Frankfurt, Germany.
Osteoarthritis Cartilage. 2021 Feb;29(2):215-221. doi: 10.1016/j.joca.2020.12.006. Epub 2020 Dec 21.
The goal of this study was to analyze the relationship between osteoarthritis and the incidence of fracture in men and women aged ≥18 years followed in general practices in the United Kingdom.
This study included patients aged ≥18 years who had received an initial diagnosis of osteoarthritis in one of 256 general practices in the United Kingdom between January 1997 and December 2016 (index date). Patients without osteoarthritis were matched (1:1) to those with osteoarthritis by sex, age, index year, diabetes, dementia, corticosteroid therapy, and practice. For patients without osteoarthritis, the index date was a randomly selected visit date between 1997 and 2016. The association between osteoarthritis and the incidence of fracture was investigated using Kaplan-Meier curves and conditional Cox regression analyses.
This retrospective cohort study included 129,348 patients with osteoarthritis and 129,348 patients without osteoarthritis [60.1% women; mean (standard deviation) age 63.7 (14.0) years]. After 10 years of follow-up, 12.1% of individuals with osteoarthritis and 7.7% of those without osteoarthritis had suffered at least one fracture (log-rank P-value<0.001). There was a positive and significant association between osteoarthritis and fracture in the overall sample [hazard ratio (HR) = 1.55, 95% confidence interval (CI) = 1.50-1.60]. These findings were corroborated in all sex, age, and osteoarthritis joint site subgroups.
Intervention is urgently needed to reduce the risk of fracture in adults with osteoarthritis, and further research is warranted in order to gain more of an insight into the mediators involved in the relationship between osteoarthritis and fracture.
本研究旨在分析英国普通诊所中≥18 岁男性和女性骨关节炎与骨折发生率之间的关系。
本研究纳入了 1997 年 1 月至 2016 年 12 月期间英国 256 家普通诊所中首次诊断为骨关节炎的年龄≥18 岁患者（索引日期）。无骨关节炎患者按性别、年龄、索引年、糖尿病、痴呆、皮质类固醇治疗和诊所与骨关节炎患者 1:1 匹配。对于无骨关节炎患者，索引日期为 1997 年至 2016 年之间随机选择的就诊日期。采用 Kaplan-Meier 曲线和条件 Cox 回归分析研究骨关节炎与骨折发生率之间的关系。
这项回顾性队列研究纳入了 129348 例骨关节炎患者和 129348 例无骨关节炎患者（60.1%为女性；平均[标准差]年龄 63.7[14.0]岁）。随访 10 年后，12.1%的骨关节炎患者和 7.7%的无骨关节炎患者至少发生过一次骨折（对数秩检验 P<0.001）。总体样本中，骨关节炎与骨折之间存在正相关且具有统计学意义[风险比（HR）=1.55，95%置信区间（CI）=1.50-1.60]。这些发现在所有性别、年龄和骨关节炎关节部位亚组中均得到证实。
迫切需要采取干预措施来降低骨关节炎成年患者骨折的风险，需要进一步研究以更深入地了解骨关节炎与骨折之间关系的中介因素。
