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手部骨关节炎共病情况及心血管危险因素管理的患病率:一项横断面研究。

Prevalence of comorbidities and cardiovascular risk factor management in hand osteoarthritis: a cross-sectional study.

作者信息

Mathieu Sylvain, Fayet Françoise, Salembien Marie-Hélène, Rodere Malory, Soubrier Martin, Tournadre Anne

机构信息

Rheumatology Department, Gabriel Montpied Teaching Hospital, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, Neuro-Dol, Place H. Dunant, Clermont-Ferrand, Clermont-Ferrand, 63000, France.

Service de Rhumatologie, CHU Clermont-Ferrand, Clermont-Ferrand, 63000, France.

出版信息

Rheumatol Int. 2024 Dec 21;45(1):5. doi: 10.1007/s00296-024-05764-5.

Abstract

OBJECTIVES

To assess the prevalence of comorbidities and management of cardiovascular risk factors according to established guidelines for patients with hand osteoarthritis.

METHODS

A cross-sectional study was conducted that included 110 hand osteoarthritis patients. The clinical parameters (pain, function, grip strength, quality of life, sarcopenia, and comorbidities) were assessed along with cardiovascular (CV) risk factors (blood pressure, body mass index, and dyslipidaemia). CV risk was assessed using SCORE2 or SCORE2-OP algorithms. Comparisons of patient characteristics were performed using Student's or chi-squared tests.

RESULTS

Twenty-eight patients were identified with comorbidities, and they tended to be older, male, and with a lower quality of life. The median SCORE2 was 5.1%. SCORE2 was negatively associated with grip strength (r=-0.27, p = 0.02). There was no difference in SCORE2 between hand osteoarthritis patients with (n = 60) and without (n = 50) neuropathic-like pain (5.6 ± 3.7 versus 6.2 ± 3.3%; p = 0.38). Among the 40 patients with an intermediate or high CV risk, 33 (82.5%) were off target for low-density lipoproteins (LDL) level with no lipid-lowering treatment (n = 29) or an insufficient statin treatment (n = 4). Obesity was observed in 24 patients (21.8%) and 30 (27.3%) were overweight. Forty-two patients (41.2%) had blood hypertension (41 systolic and one diastolic patient) despite treatment for 9 patients.

CONCLUSIONS

We found an increased CV risk in hand osteoarthritis patients who had an insufficient LDL cholesterol target achievement. Hand osteoarthritis patients appear to have a pro-atherogenic profile. These results suggest that CV risk factors should be assessed in patients with hand osteoarthritis and managed according to recommended guidelines.

摘要

目的

根据既定指南评估手部骨关节炎患者的合并症患病率及心血管危险因素的管理情况。

方法

开展了一项横断面研究,纳入110例手部骨关节炎患者。评估了临床参数(疼痛、功能、握力、生活质量、肌肉减少症和合并症)以及心血管(CV)危险因素(血压、体重指数和血脂异常)。使用SCORE2或SCORE2-OP算法评估CV风险。采用Student's检验或卡方检验对患者特征进行比较。

结果

确定28例患者有合并症,他们往往年龄较大、为男性且生活质量较低。SCORE2中位数为5.1%。SCORE2与握力呈负相关(r = -0.27,p = 0.02)。有(n = 60)和无(n = 50)神经性疼痛的手部骨关节炎患者之间的SCORE2无差异(5.6±3.7对6.2±3.3%;p = 0.38)。在40例具有中度或高度CV风险的患者中,3)例(82.5%)低密度脂蛋白(LDL)水平未达目标,其中未接受降脂治疗的有29例,他汀类药物治疗不足的有4例。24例患者(21.8%)存在肥胖,30例(27.3%)超重。42例患者(41.2%)患有高血压(41例收缩期高血压患者和1例舒张期高血压患者),尽管有9例患者正在接受治疗。

结论

我们发现LDL胆固醇目标未充分达标的手部骨关节炎患者的CV风险增加。手部骨关节炎患者似乎具有促动脉粥样硬化特征。这些结果表明,应对手部骨关节炎患者的CV危险因素进行评估,并根据推荐指南进行管理。

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