NOVA Medical School; Reumatologia, Faculdade de Ciências Médicas de Lisboa; Hospital CUF Descobertas, Lisboa.
EpiDoc Unit, CEDOC; Comprehensive Health Research Centre/ NOVA Medical School, Lisboa.
Acta Reumatol Port. 2021 Jul-Sep;46(3):208-217.
Hand osteoarthritis (HOA) is a highly prevalent rheumatic disease that predominates in females and causes pain and loss of functional capacity. Obesity and metabolic syndrome have been previously suggested to associate with the severity of HOA, but clarity on these associations is yet to be achieved.
Test the association between obesity and other components of the metabolic syndrome and disability in women with hand osteoarthritis (HOA).
Individuals from EpiReumaPt epidemiological community-based study (2011-2013) are representative of the Portuguese population. Women with diagnosis of primary HOA were included.
hand functional status, assessed by Cochin questionnaire.
hand pain, assessed by visual analogue scale and tender hand joint count (THJ). Explanatory variables: obesity, diabetes mellitus, arterial hypertension and hypercholesterolemia. Possible associations between obesity and the other components of metabolic syndrome with Cochin score, hand pain and THJ were tested in a multivariable linear regression model. Potential confounders considered: age, education level and countrywide distribution.
473 women with primary HOA were included. Forty percent were overweight and 29% obese. Ninety-three (19.8%) participants had diabetes, 261 (55.8%) reported hypertension and 261 (55.9%) hypercholesterolemia. Mean Cochin score was 15.5±14.8, mean pain VAS was 4.7±2.6 and mean THJ 1.4±3. In the multivariable analysis, obesity (β 4.6 CI 0.7;8.5) and diabetes (β 4.0 CI 0.4;7.6) were found to significantly associate with HOA functional disability. In addition, diabetes, but not obesity, associated with hand pain. There was no association between obesity or diabetes with THJ.
In a Portuguese female population with primary HOA, obesity and diabetes mellitus independently associated with a worse hand functional status. These data add to evidence suggesting a role of metabolic factors in the severity of HOA.
手部骨关节炎（HOA）是一种高发的风湿性疾病，多见于女性，可导致疼痛和功能丧失。肥胖和代谢综合征先前被认为与 HOA 的严重程度有关，但这些关联尚不清楚。
检验肥胖症和代谢综合征的其他成分与手部骨关节炎（HOA）女性患者残疾之间的相关性。
来自 EpiReumaPt 基于社区的流行病学研究（2011-2013 年）的个体具有葡萄牙人群的代表性。纳入了原发性 HOA 诊断的女性患者。
手部功能状态，采用科钦问卷进行评估。
手部疼痛，采用视觉模拟评分和压痛手部关节计数（THJ）进行评估。解释变量：肥胖症、糖尿病、动脉高血压和高胆固醇血症。在多变量线性回归模型中，检验了肥胖症与代谢综合征其他成分与科钦评分、手部疼痛和 THJ 之间的可能关联。考虑了潜在的混杂因素：年龄、教育水平和全国分布。
共纳入 473 名原发性 HOA 女性患者。40%超重，29%肥胖。93 名（19.8%）患者患有糖尿病，261 名（55.8%）报告高血压，261 名（55.9%）高胆固醇血症。平均科钦评分为 15.5±14.8，平均疼痛 VAS 为 4.7±2.6，平均 THJ 为 1.4±3。在多变量分析中，肥胖症（β 4.6，CI 0.7；8.5）和糖尿病（β 4.0，CI 0.4；7.6）与 HOA 功能障碍显著相关。此外，糖尿病与手部疼痛相关，但肥胖症与手部疼痛无关。肥胖症或糖尿病与 THJ 之间无关联。
在葡萄牙原发性 HOA 女性人群中，肥胖症和糖尿病独立与手部功能状态恶化相关。这些数据进一步证明了代谢因素在 HOA 严重程度中的作用。
