Division of Rheumatology, Department of Medicine, NYU Langone Health, 333 E. 38th St, 4th Floor, New York, NY, 10016, USA.
Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
Curr Rheumatol Rep. 2021 Jul 3;23(8):61. doi: 10.1007/s11926-021-01025-7.
Hand osteoarthritis (hand OA), the most common peripheral arthritis in the world, is less studied than osteoarthritis (OA) of the knee and hip. However, it is uniquely situated to offer novel insight into OA as a disease process by removing weight-bearing as a confounder of systemic disease mechanisms. Here we review the epidemiology of hand OA and key risk factors for its development.
Mounting evidence points to obesity as an important risk factor for hand OA development, with new evidence implicating a role for leptin and serum fatty acids. Disease progression in hand OA and specifically the erosive OA subtype may be associated with diabetes. New evidence supports an association between cardiovascular disease progression and symptomatic hand OA. Alcohol use may be associated with increased synovitis and erosive hand OA. Differences in ethnical distributions of hand OA have become more apparent, with a lower prevalence in Black patients compared to White patients. Novel genetic insights implicating the WNT gene pathway and IL-1β have led to novel potential targets in hand OA pathogenesis. Hand OA is a heterogeneous disease with many modifiable and non-modifiable risk factors that can determine disease severity and shed light on disease pathogenesis.
手骨关节炎（hand OA）是世界上最常见的外周关节炎，其研究不如膝关节炎和髋关节关节炎深入。然而，通过消除体重对系统性疾病机制的影响，手 OA 独特地为 OA 作为一种疾病过程提供了新的见解。本文综述了手 OA 的流行病学和发病的关键危险因素。
越来越多的证据表明肥胖是手 OA 发展的重要危险因素，新的证据表明瘦素和血清脂肪酸也起作用。手 OA 的疾病进展，特别是侵蚀性 OA 亚型，可能与糖尿病有关。新的证据支持心血管疾病进展与有症状的手 OA 之间存在关联。饮酒可能与滑膜炎症和侵蚀性手 OA 增加有关。手 OA 在不同种族中的分布差异变得更加明显，黑人患者的患病率低于白人患者。新的遗传研究表明 WNT 基因通路和 IL-1β 可能在手 OA 的发病机制中起作用。手 OA 是一种异质性疾病，有许多可改变和不可改变的危险因素，这些因素可以决定疾病的严重程度，并阐明疾病的发病机制。
