哮喘与骨关节炎的新关联：一项全国性的健康与营养调查研究。
Novel association between asthma and osteoarthritis: a nationwide health and nutrition examination survey.
机构信息
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea.
出版信息
BMC Pulm Med. 2021 Feb 16;21(1):59. doi: 10.1186/s12890-021-01425-6.
BACKGROUND
Asthma and osteoarthritis (OA) are medical conditions that inhibit physical activity and adversely affect quality of life. Despite the high prevalence, there are limited studies focusing on the comorbid condition and association between asthma and OA. The aim of this study was to assess the prevalence of OA co-occurring with asthma and to identify the relevant clinical considerations.
METHODS
Adult participants aged over 40 years who completed questionnaire assessments and spirometry tests were enrolled from the Korean National Health and Nutrition Examination Survey. Asthma and OA were defined based on the medical history of a diagnosis made by a doctor. Radiographic severities of OA were measured using the Kellgren-Lawrence grading system. Chronic obstructive pulmonary disease (COPD), as a comparative respiratory disease, was diagnosed based on the spirometric results.
RESULTS
A total of 9344 subjects were enrolled, and the prevalence of asthma and COPD were 4.6% ± 0.3% and 12.0% ± 0.5%, respectively. The prevalence of OA in the asthma group was 31.9% ± 2.8%, which was significantly higher than that in the COPD (17.8% ± 1.5%) or control (16.2% ± 0.6%) groups. OA was more prevalent in patients with asthma after adjusting for age, sex, body mass index, and smoking status (OR 1.65; 95% CI 1.27-2.13). Furthermore, after adjustment of this model for the prescription of OA medication, OA remained independently associated with asthma (OR 1.56; 95% CI 1.10-2.20). Conversely, the relationship of OA medication with asthma was not significant (P = 0.64). This relationship was evident in patients with asthma without airflow limitation measured by spirometry (OR 1.97; 95% CI 1.32-2.93). Moreover, the radiographic severity of knee OA correlated with asthma (OR 1.10; 95% CI 1.0-1.21).
CONCLUSIONS
OA shows a high prevalence in patients with asthma, higher than in patients with COPD or the controls. The comorbid characteristics of these two conditions need to be considered in clinical practice.
背景
哮喘和骨关节炎（OA）是抑制身体活动并对生活质量产生不利影响的医学病症。尽管发病率很高，但针对哮喘和 OA 的合并病症以及两者之间的关联，相关研究仍然有限。本研究旨在评估同时患有 OA 和哮喘的患者的患病率，并确定相关的临床注意事项。
方法
从韩国国家健康和营养检查调查中招募了年龄在 40 岁以上、完成问卷调查和肺功能检查的成年参与者。哮喘和 OA 是根据医生诊断的病史来定义的。OA 的放射学严重程度使用 Kellgren-Lawrence 分级系统进行测量。慢性阻塞性肺疾病（COPD）作为一种比较性呼吸道疾病，根据肺功能检查结果进行诊断。
结果
共纳入 9344 名受试者，哮喘和 COPD 的患病率分别为 4.6%±0.3%和 12.0%±0.5%。哮喘组中 OA 的患病率为 31.9%±2.8%，明显高于 COPD（17.8%±1.5%）或对照组（16.2%±0.6%）。调整年龄、性别、体重指数和吸烟状况后，哮喘患者中 OA 的患病率更高（OR 1.65；95%CI 1.27-2.13）。此外，在调整 OA 药物治疗模型后，OA 与哮喘仍呈独立相关（OR 1.56；95%CI 1.10-2.20）。相反，OA 药物与哮喘之间的关系不显著（P=0.64）。在通过肺功能检查测量无气流受限的哮喘患者中，这种关系更为明显（OR 1.97；95%CI 1.32-2.93）。此外，膝关节 OA 的放射学严重程度与哮喘呈正相关（OR 1.10；95%CI 1.0-1.21）。
结论
OA 在哮喘患者中的患病率较高，高于 COPD 患者或对照组。在临床实践中需要考虑这两种疾病的合并特征。
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