骨关节炎与合并症之间的时间关系：英国初级保健环境中的一项病例对照和队列研究的综合分析。

Temporal relationship between osteoarthritis and comorbidities: a combined case control and cohort study in the UK primary care setting.

机构信息

Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology.

Pain Centre and Versus Arthritis, University of Nottingham, Nottingham, UK.

出版信息

Rheumatology (Oxford). 2021 Sep 1;60(9):4327-4339. doi: 10.1093/rheumatology/keab067.

DOI:10.1093/rheumatology/keab067

PMID:33506862

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8410005/

Abstract

OBJECTIVE

To determine the burden of comorbidities in OA and their temporal relationships in the UK.

METHODS

The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidities (two or more comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aORs) and hazard ratios (aHRs), respectively.

RESULTS

During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to and following the diagnosis of OA and 2 (dementia and systemic lupus erythematosus) were associated with OA only following the diagnosis of OA. People with OA had a higher risk of developing heart failure [aHR 1.63 (95% CI 1.56, 1.71)], dementia [aHR 1.62 (95% CI 1.56, 1.68)], liver diseases [aHR 1.51 (95% CI 1.37, 1.67)], irritable bowel syndrome [aHR 1.51 (95% CI 1.45, 1.58)], gastrointestinal bleeding [aHR 1.49 (95% CI 1.39, 1.59)], 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95% CI 1.69, 1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95% CI 1.28, 1.30).

CONCLUSIONS

People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.

摘要

目的

确定英国 OA 患者的合并症负担及其时间关系。

方法

利用临床实践研究数据链接（CPRD）GOLD 数据库，从英国初级保健中确定患有 OA 的患者和年龄、性别及实践相匹配的非 OA 对照者。对照者的分配日期与匹配病例相同（OA 诊断日期）。使用比值比（aOR）和风险比（aHR），分别调整协变量后，估计 OA 与 49 种个体合并症和多重合并症（不包括 OA 的两种或多种合并症）之间的关联。

结果

在 1997 年至 2017 年期间，我们共确定了 221807 例 OA 新发病例和 221807 例匹配对照者。在所检查的 49 种合并症中，38 种在 OA 诊断前后与 OA 相关，2 种（痴呆和系统性红斑狼疮）仅在 OA 诊断后与 OA 相关。OA 患者发生心力衰竭的风险更高[aHR 1.63（95%CI 1.56，1.71）]、痴呆[aHR 1.62（95%CI 1.56，1.68）]、肝脏疾病[aHR 1.51（95%CI 1.37，1.67）]、肠易激综合征[aHR 1.51（95%CI 1.45，1.58）]、胃肠道出血[aHR 1.49（95%CI 1.39，1.59）]、10 种肌肉骨骼疾病和 25 种其他疾病的风险更高。在指数日期之前的多重合并症的 aOR 为 1.71（95%CI 1.69，1.74），而在指数日期之后的多重合并症的 aHR 为 1.29（95%CI 1.28，1.30）。