人口统计学、生活方式和临床因素与掌腱膜挛缩症的相关性：生命线队列研究结果
Associations of Demographic, Lifestyle, and Clinical Factors With the Presence of Dupuytren Disease: Results from the Lifelines Cohort Study.
作者信息
Noordman Michel F N, Riesmeijer Sophie A, Werker Paul M N, Nolte Ilja M
机构信息
University of Groningen, University Medical Center Groningen, Department of Plastic Surgery, Groningen, The Netherlands.
University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
出版信息
J Hand Surg Glob Online. 2025 Jul 24;7(5):100786. doi: 10.1016/j.jhsg.2025.100786. eCollection 2025 Sep.
PURPOSE
Many risk factors have been associated with Dupuytren disease (DD), but their contribution is still unclear. Therefore, we aimed to investigate the associations of a wide range of risk factors with the presence of DD in Lifelines, an ongoing prospective population-based cohort study with >165,000 participants initiated in 2006.
METHODS
The presence of DD was determined through questionnaires by self-reported doctor's diagnosis. The association between demographic, lifestyle, and clinical factors and DD was analyzed using logistic regression adjusted for age, age, and sex. If < .25, the variable was selected for inclusion in multivariable logistic regression models. Related risk factors were grouped into blocks to overcome multicollinearity. Stepwise hierarchical modeling was applied. Nested models were compared using log-likelihood ratio tests. Sensitivity analysis using controls >55 years was performed to assess the robustness of the findings.
RESULTS
Overall, 1,320 (2.1%) Lifelines participants reported to have DD. Age, age, and sex accounted for 7.8% of the variability observed in DD risk. Other risk factors for DD were (osteo)arthritis, anti-inflammatory or antirheumatic products, high-density lipoprotein levels, triglyceride levels, alcohol use, and diabetes and diabetes medication, while anthropometric measures of adiposity were negatively associated with DD. Their contribution was relatively small, with the explained variance increasing only to 8.76%.
CONCLUSIONS
Older age and male sex were the predominant factors increasing DD risk, but anthropometric measures of adiposity, (osteo)arthritis, anti-inflammatory and antirheumatic drugs, high-density lipoprotein levels, triglyceride levels, alcohol use, diabetes and diabetes medication also contributed significantly to the final risk model for DD. In particular, the joint related factors are of interest because previous evidence for these risk factors was inconclusive.
CLINICAL RELEVANCE
Our risk model presents an opportunity for prevention of DD. Future studies should elucidate the role of rheumatoid arthritis in DD. Risk models may possibly enable the creation of accurate individual risk profiles of DD leading to optimization of care.
目的
许多风险因素与掌腱膜挛缩症（DD）相关，但其作用仍不明确。因此，我们旨在调查一系列风险因素与“生命线”研究中DD存在情况的关联，“生命线”是一项正在进行的基于人群的前瞻性队列研究，于2006年启动，参与者超过16.5万。
方法
通过问卷调查由自我报告的医生诊断来确定DD的存在情况。使用针对年龄、年龄和性别的逻辑回归分析人口统计学、生活方式和临床因素与DD之间的关联。如果P<0.25，则选择该变量纳入多变量逻辑回归模型。将相关风险因素分组以克服多重共线性。应用逐步分层建模。使用对数似然比检验比较嵌套模型。进行了使用55岁以上对照的敏感性分析以评估研究结果的稳健性。
结果
总体而言，1320名（2.1%）“生命线”参与者报告患有DD。年龄、年龄和性别占DD风险中观察到的变异性的7.8%。DD的其他风险因素包括（骨）关节炎、抗炎或抗风湿产品、高密度脂蛋白水平、甘油三酯水平、饮酒以及糖尿病和糖尿病药物治疗，而肥胖的人体测量指标与DD呈负相关。它们的作用相对较小，解释的方差仅增加到8.76%。
结论
年龄较大和男性是增加DD风险的主要因素，但肥胖的人体测量指标、（骨）关节炎、抗炎和抗风湿药物、高密度脂蛋白水平、甘油三酯水平、饮酒、糖尿病和糖尿病药物治疗对DD的最终风险模型也有显著贡献。特别是，与关节相关的因素值得关注，因为先前关于这些风险因素的证据尚无定论。
临床意义
我们的风险模型为预防DD提供了机会。未来的研究应阐明类风湿性关节炎在DD中的作用。风险模型可能有助于创建准确的DD个体风险概况，从而优化护理。
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