Department of Orthopedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyeonggi-do, Republic of Korea.
Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Sci Rep. 2023 Feb 16;13(1):2777. doi: 10.1038/s41598-023-29581-1.
We aimed to determine whether knee OA is associated with CVD risk and all-cause death and to evaluate whether the association differs by exercise behavior. We used Korea National Health Insurance Service (KNHIS) database and included 201,466 participants (7572 subjects diagnosed with knee OA) who underwent health screening between 2009 and 2015. Those who had been diagnosed with knee OA or CVD before the index year were excluded. Cox proportional hazard models were used after adjusting for sociodemographic and CVD risk factors to evaluate the association between knee OA and CVD risk and all-cause death. Stratification analysis was further performed to determine the effect of exercise behavior on this relationship. During a median follow-up of 7.06 ± 2.24 years, 8743 CVD (2510 MI and 6553 stroke) cases developed. Individuals with knee OA had increased risks of CVD [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.15-1.38], myocardial infarction (MI) (HR 1.20, 95% CI 1.00-1.44), and stroke (HR 1.29, 95% CI 1.16-1.43) compared with those without knee OA. Those with knee OA who did not exercise had an increased risk of CVD (HR 1.25, 95% CI 1.11-1.40), whereas no significant increased CVD risk was observed in those with knee OA who exercised at least once a week (HR 1.11, 95% CI 0.96-1.28). There was no association between knee osteoarthritis and all-cause death. Knee OA was independently associated with an increased risk of CVD. Lack of exercise might have a synergistic adverse effect on the association between knee OA and CVD.
我们旨在确定膝骨关节炎是否与心血管疾病风险和全因死亡相关，并评估这种关联是否因运动行为而异。我们使用了韩国国家健康保险服务（KNHIS）数据库，纳入了 2009 年至 2015 年间接受健康筛查的 201466 名参与者（7572 名被诊断为膝骨关节炎的患者）。那些在指数年前已被诊断为膝骨关节炎或心血管疾病的患者被排除在外。我们使用 Cox 比例风险模型，在调整了社会人口统计学和心血管疾病风险因素后，评估了膝骨关节炎与心血管疾病风险和全因死亡之间的关系。进一步进行分层分析，以确定运动行为对这种关系的影响。在中位随访 7.06±2.24 年后，有 8743 例心血管疾病（2510 例心肌梗死和 6553 例中风）发生。与没有膝骨关节炎的患者相比，患有膝骨关节炎的患者发生心血管疾病（风险比 [HR] 1.26，95%置信区间 [CI] 1.15-1.38）、心肌梗死（HR 1.20，95% CI 1.00-1.44）和中风（HR 1.29，95% CI 1.16-1.43）的风险增加。没有运动的膝骨关节炎患者发生心血管疾病的风险增加（HR 1.25，95% CI 1.11-1.40），而每周至少运动一次的膝骨关节炎患者发生心血管疾病的风险没有显著增加（HR 1.11，95% CI 0.96-1.28）。膝骨关节炎与全因死亡之间没有关联。膝骨关节炎与心血管疾病风险的增加独立相关。缺乏运动可能对膝骨关节炎与心血管疾病之间的关联产生协同的不利影响。
