Perruccio Anthony V, Zahid Shatabdy, Yip Calvin, Power J Denise, Canizares Mayilee, Heckman George A, Badley Elizabeth M
Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Arthritis Community Research & Evaluation Unit, Dalla Lana School of Public Health, University of Toronto, and University of Toronto, Toronto, Ontario, Canada.
Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, and Arthritis Community Research & Evaluation Unit, Toronto, Ontario, Canada.
Arthritis Care Res (Hoboken). 2023 Apr;75(4):893-901. doi: 10.1002/acr.24826. Epub 2022 Nov 20.
The objective of this study was to investigate a profile of cardiovascular disease (CVD) risk factors by sex among individuals with and without osteoarthritis (OA) and to consider single-site and multisite joint OA.
Data were sourced from Cycle 1, Comprehensive Cohort, Canadian Longitudinal Study on Aging, a national sample of individuals ages 45 to 85 years. Systemic inflammatory/metabolic CVD risk factors collected were high-sensitivity C-reactive protein (hsCRP) level, high-density lipoprotein, triglycerides, total cholesterol, body mass index (BMI), systolic blood pressure, and hemoglobin A1c. Smoking history was also collected. Respondents indicated doctor-diagnosed OA in the knees, hips, and/or hands and were characterized as yes/no OA and single site/multisite OA. Individuals with OA were age- and sex-matched to non-OA controls. Covariates were age, sex, education, income, physical activity, timed up and go test findings, and comorbidities. A latent CVD risk variable was derived in women and men; standardized scores were categorized as follows: lowest, mid-low, mid-high, and highest risk. Associations with OA were quantified using ordinal logistic regressions.
A total of 6,098 respondents (3,049 with OA) had a median age of 63 years, and 55.8% were women. One-third of OA respondents were in the highest risk category versus one-fifth of non-OA respondents. Apart from BMI (the largest contributor in both sexes), hsCRP level (an inflammation marker) was predominant in women, and metabolic factors and smoking were predominant in men. Overall, OA was associated with worse CVD risk quartiles compared with non-OA. OA was increasingly associated with worse CVD risk quartiles with increasing risk thresholds among women with multisite OA, but not men.
Findings suggest unique CVD risks by sex/multisite subgroups and point to a potentially important role for inflammation in OA over and above traditional CVD risk factors.
本研究的目的是调查患骨关节炎（OA）和未患骨关节炎个体中按性别划分的心血管疾病（CVD）风险因素概况，并考虑单部位和多部位关节OA情况。
数据来源于加拿大老龄化纵向研究综合队列的第1轮，这是一个年龄在45至85岁的全国性个体样本。收集的全身性炎症/代谢性CVD风险因素包括高敏C反应蛋白（hsCRP）水平、高密度脂蛋白、甘油三酯、总胆固醇、体重指数（BMI）、收缩压和糖化血红蛋白A1c。还收集了吸烟史。受访者指出医生诊断的膝盖、臀部和/或手部OA情况，并被分类为有/无OA以及单部位/多部位OA。患有OA的个体按年龄和性别与无OA的对照组匹配。协变量包括年龄、性别、教育程度、收入、身体活动、计时起立行走测试结果和合并症。在男性和女性中得出一个潜在的CVD风险变量；标准化分数分类如下：最低、中低、中高和最高风险。使用有序逻辑回归对与OA的关联进行量化。
共有6098名受访者（3049名患有OA），中位年龄为63岁，55.8%为女性。三分之一的OA受访者处于最高风险类别，而无OA受访者中这一比例为五分之一。除BMI（男女中最大的影响因素）外，hsCRP水平（一种炎症标志物）在女性中占主导地位，而代谢因素和吸烟在男性中占主导地位。总体而言，与无OA相比，OA与更差的CVD风险四分位数相关。在多部位OA女性中，随着风险阈值增加，OA与更差的CVD风险四分位数的关联日益增加，但在男性中并非如此。
研究结果表明按性别/多部位亚组存在独特的CVD风险，并指出炎症在OA中可能发挥的潜在重要作用，其作用超出了传统CVD风险因素。
