Department of Medical Education, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Department of Medical Imaging, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
BMC Musculoskelet Disord. 2022 Nov 8;23(1):961. doi: 10.1186/s12891-022-05929-y.
The reactivation of herpes zoster (HZ) is associated with disease stress. However, the relationship between chondromalacia patella (CMP) and HZ remains poorly understood. This study investigated the relationship between CMP and the risk of developing HZ.
Data were collected from the Taiwan's National Health Insurance Research Database. Patients with CMP diagnosed between 2000 and 2017 were assigned to the case group; patients without CMP were randomly selected from the same database and paired with controls matched by age and sex. The primary outcome was a diagnosis of HZ. All patients were followed until their diagnosis of HZ, their withdrawal from the NHI program, their death, or the end of 2017, whichever was earliest. The risk of developing HZ was compared between the case and control groups.
In total, 22,710 patients with CMP and 90,840 matched controls were enrolled. The overall incidence rates of HZ in the CMP and control cohorts were 7.94 and 7.35 per 1,000 person-years, respectively. After potential confounders were controlled for, the case group exhibited a higher risk of HZ than did the control group [adjusted hazard ratio (aHR) = 1.06, p < 0.05]. In a stratification analysis by age, patients over 65 years old in the CMP group exhibited a higher risk of HZ than did those in the control group (aHR = 1.22, p < 0.01). In a stratification analysis by sex, women with CMP were at greater risk of developing HZ than women without CMP (aHR = 1.18, p < 0.01).
Patients with CMP, especially elder adults and women, exhibited a higher risk of HZ. The HZ risk of patients with CMP should thus be assessed, and the necessity of HZ vaccination should be informed.
带状疱疹（HZ）的复发与疾病应激有关。然而，髌骨软化症（CMP）与 HZ 之间的关系仍知之甚少。本研究调查了 CMP 与发生 HZ 风险之间的关系。
数据来自台湾全民健康保险研究数据库。2000 年至 2017 年间诊断为 CMP 的患者被分配到病例组；从同一数据库中随机选择没有 CMP 的患者，并与年龄和性别相匹配的对照组进行配对。主要结局是诊断为 HZ。所有患者均随访至诊断为 HZ、退出全民健康保险计划、死亡或 2017 年底，以先发生者为准。比较病例组和对照组发生 HZ 的风险。
共纳入 22710 例 CMP 患者和 90840 例匹配对照组。CMP 和对照组队列的 HZ 总发生率分别为 7.94 和 7.35/1000 人年。在控制了潜在混杂因素后，病例组发生 HZ 的风险高于对照组[调整后的危险比（aHR）=1.06，p<0.05]。在按年龄分层分析中，CMP 组中年龄超过 65 岁的患者发生 HZ 的风险高于对照组（aHR=1.22，p<0.01）。在按性别分层分析中，患有 CMP 的女性发生 HZ 的风险高于未患有 CMP 的女性（aHR=1.18，p<0.01）。
患有 CMP 的患者，尤其是老年人和女性，发生 HZ 的风险更高。因此，应评估 CMP 患者的 HZ 风险，并告知其接种 HZ 疫苗的必要性。
