Clinical Translational Science, Juntendo University School of Medicine Graduate School of Medicine, Tokyo, Japan.
Department of Hospital Pharmacy, Juntendo University Hospital, Tokyo, Japan.
BMJ Open. 2024 Mar 25;14(3):e080387. doi: 10.1136/bmjopen-2023-080387.
To investigate whether osteoarthritis (OA) is a risk factor for cardiovascular disease (CVD); whether there are differences concerning ischaemic heart disease (IHD), congestive heart failure (CHF) and stroke; and whether there are differences between OA sites (hips, knees and hand) in predicting CVD onset.
Population-based matched case-control study.
Health insurance claims data among Japanese patients.
Japanese patients aged ≥65 years with newly diagnosed CVD and hospitalised between January 2015 and December 2020 (cases) and age-matched and sex-matched 1:1 individuals (controls).
A conditional logistic regression model was used to estimate the adjusted ORs and their 95% CIs for CVD, IHD, CHF and stroke risk, adjusting for covariates.
A total of 79 296 patients were included, with respect to CVD (39 648 patients with newly diagnosed CVD and 39 648 controls). After adjustment for covariates, the exposure odds of knee OA (KOA), hip OA (HipOA) and hand OA (HandOA) for CVD were 1.192 (95% CI 1.115 to 1.274), 1.057 (95% CI 0.919 to 1.215) and 1.035 (95% CI 0.684 to 1.566), respectively, showing an association only for KOA. The exposure odds of KOA, HipOA and HandOA for IHD were 1.187 (95% CI 1.086 to 1.297), 1.078 (95% CI 0.891 to 1.306) and 1.099 (95% CI 0.677 to 1.784), respectively. The exposure odds of KOA, HipOA and HandOA for stroke were 1.221 (95% CI 1.099 to 1.356), 0.918 (95% CI 0.723 to 1.165) and 1.169 (95% CI 0.635 to 2.151), respectively. Similar to CVD, only KOA was associated with both. For CHF, neither KOA nor HipOA and HandOA were associated with CHF development.
This study confirms the association of KOA with CVD, particularly IHD and stroke, in the Japanese population. The finding that patients with KOA have a higher CVD risk can potentially assist in guiding future treatment strategies.
探讨骨关节炎(OA)是否是心血管疾病(CVD)的危险因素;OA 与缺血性心脏病(IHD)、充血性心力衰竭(CHF)和中风之间是否存在差异;以及 OA 部位(髋关节、膝关节和手部)在预测 CVD 发病方面是否存在差异。
基于人群的匹配病例对照研究。
日本患者的医疗保险索赔数据。
2015 年 1 月至 2020 年 12 月期间新诊断为 CVD 并住院的年龄≥65 岁的日本患者(病例),以及年龄和性别匹配的 1:1 个体(对照)。
采用条件逻辑回归模型,在调整协变量后,估计 CVD、IHD、CHF 和中风风险的调整比值比(OR)及其 95%置信区间(CI)。
共纳入 79296 例患者,其中 CVD 患者 39648 例(新诊断为 CVD 的患者 39648 例)。在调整协变量后,膝关节 OA(KOA)、髋关节 OA(HipOA)和手部 OA(HandOA)对 CVD 的暴露比值比(OR)分别为 1.192(95%CI 1.115-1.274)、1.057(95%CI 0.919-1.215)和 1.035(95%CI 0.684-1.566),仅 KOA 与 CVD 相关。KOA、HipOA 和 HandOA 对 IHD 的暴露比值比(OR)分别为 1.187(95%CI 1.086-1.297)、1.078(95%CI 0.891-1.306)和 1.099(95%CI 0.677-1.784)。KOA、HipOA 和 HandOA 对中风的暴露比值比(OR)分别为 1.221(95%CI 1.099-1.356)、0.918(95%CI 0.723-1.165)和 1.169(95%CI 0.635-2.151)。与 CVD 相似,仅 KOA 与两者均相关。对于 CHF,KOA 或 HipOA 和 HandOA 均与 CHF 发病无关。
本研究证实了 KOA 与日本人群 CVD、特别是 IHD 和中风之间的关联。KOA 患者 CVD 风险较高的发现,可能有助于指导未来的治疗策略。