Swain Subhashisa, Fernandes Gwen Sascha, Sarmanova Aliya, Valdes Ana M, Walsh David A, Coupland Carol, Doherty Michael, Zhang Weiya
Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham City Hospital.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.
Rheumatol Adv Pract. 2022 Jun 15;6(2):rkac049. doi: 10.1093/rap/rkac049. eCollection 2022.
The aims were to examine the prevalence of comorbidities and role of oral analgesic use in people with knee pain (KP) compared with those without.
The Knee Pain and related health In the Community (KPIC) cohort comprises community-derived adults aged ≥40 years, irrespective of knee pain. Thirty-six comorbidities across 10 systems were compared between people with KP and controls without KP or knee OA. Multivariable logistic regression analysis was used to determine the adjusted odds ratio (aOR) and 95% CI for multimorbidity (at least two chronic conditions) and each specific comorbidity. Both prescribed and over-the-counter analgesics were included in the model, and their interactions with KP for comorbidity outcomes were examined.
Two thousand eight hundred and thirty-two cases with KP and 2518 controls were selected from 9506 baseline participants. The mean age of KP cases was 62.2 years, and 57% were women. Overall, 29% of the total study population had multimorbidity (KP cases 34.4%; controls 23.8%). After adjustment for age, sex, BMI and analgesic use, KP was significantly associated with multimorbidity (aOR 1.35; 95% CI 1.17, 1.56) and with cardiovascular (aOR 1.25; 95% CI 1.08, 1.44), gastrointestinal (aOR 1.34; 95% CI 1.04, 1.92), chronic widespread pain (aOR 1.54; 95% CI 1.29, 1.86) and neurological (aOR 1.32; 95% CI 1.01, 1.76) comorbidities. For multimorbidity, the use of paracetamol and opioids interacted positively with KP, whereas the use of NSAIDs interacted negatively for seven comorbidities.
People with KP are more likely to have other chronic conditions. The long-term benefits and harms of this change remain to be investigated.
ClinicalTrials.gov, http://clinicaltrials.gov, NCT02098070.
旨在研究膝关节疼痛（KP）患者与无膝关节疼痛者相比，合并症的患病率以及口服镇痛药的作用。
社区膝关节疼痛及相关健康状况（KPIC）队列研究纳入了年龄≥40岁的社区成年人，无论其是否患有膝关节疼痛。比较了KP患者与无KP或膝关节骨关节炎的对照组在10个系统中的36种合并症。采用多变量逻辑回归分析来确定合并症（至少两种慢性病）及每种特定合并症的调整优势比（aOR）和95%置信区间（CI）。模型中纳入了处方药和非处方药，并研究了它们与KP在合并症结局方面的相互作用。
从9506名基线参与者中选取了2832例KP患者和2518例对照。KP患者的平均年龄为62.2岁，57%为女性。总体而言，研究总人群中29%患有合并症（KP患者为34.4%；对照为23.8%）。在调整年龄、性别、体重指数和镇痛药使用情况后，KP与合并症（aOR 1.35；95% CI 1.17，1.56）以及心血管疾病（aOR 1.25；95% CI 1.08，1.44）、胃肠道疾病（aOR 1.34；95% CI 1.04，1.92）、慢性广泛性疼痛（aOR 1.54；95% CI 1.29，1.86）和神经系统疾病（aOR 1.32；95% CI 1.01，1.76）显著相关。对于合并症，对乙酰氨基酚和阿片类药物的使用与KP呈正相互作用，而非甾体抗炎药的使用在7种合并症中呈负相互作用。
KP患者更有可能患有其他慢性病。这种变化的长期益处和危害仍有待研究。
ClinicalTrials.gov，http://clinicaltrials.gov，NCT02098070 。
