Wang Ning, Lu Na, Zhang Jian, Lu Cong, Sha Tingting, Wang Haochen
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Arthritis Research Canada, Richmond, BC, Canada.
BMJ Open. 2025 Aug 28;15(8):e092558. doi: 10.1136/bmjopen-2024-092558.
Osteoarthritis is common and often coexists with other chronic conditions, which may contribute to increased all-cause mortality. Maintaining a healthy lifestyle contributes to increased longevity; however, considering physical functions and physiological conditions of patients with osteoarthritis differ from the general population, the impact of maintaining a healthy lifestyle in these patients remains uncertain, which poses a challenge to implementing-related interventions in this population. This study aims to examine the association between healthy lifestyle factors and mortality in individuals with osteoarthritis.
This cohort study enrolled 52 973 participants from the UK Biobank who met the criteria for osteoarthritis as defined via hospitalisation or primary care records. Seven lifestyle factors, consisting of smoking, alcohol intake, physical activity, diet, television watching time, sleep duration and social connection, were included. HRs (with 95% CIs) for total and cause-specific mortality were estimated by Cox proportional hazards regression models.
A total of 4637 deaths were recorded during the follow-up period. Seven healthy lifestyle factors were all independently associated with a low mortality risk. When compared with participants meeting only 0-2 healthy lifestyle criteria, the adjusted HRs (95% CI) for those adhering to 3-7 factors were 0.70 (0.62 to 0.78), 0.60 (0.54 to 0.67), 0.49 (0.44 to 0.54), 0.46 (0.41 to 0.52) and 0.42 (0.36 to 0.49), respectively ( for trend <0.001). A dose-response pattern was also observed for mortality from cancer, cardiovascular, respiratory and digestive diseases (all for trend <0.001), whereas no significant trend emerged for mortality due to neurodegenerative diseases.
Adherence to a greater number of healthy lifestyle factors was associated with a significantly lower risk of mortality among individuals with osteoarthritis. Our findings hold important public health implications and provide empirical evidence that adhering to a healthy lifestyle could mitigate the burdens caused by osteoarthritis.
骨关节炎很常见，且常与其他慢性疾病共存，这可能导致全因死亡率增加。保持健康的生活方式有助于延长寿命；然而，考虑到骨关节炎患者的身体功能和生理状况与普通人群不同，保持健康生活方式对这些患者的影响仍不确定，这给在该人群中实施相关干预措施带来了挑战。本研究旨在探讨骨关节炎患者健康生活方式因素与死亡率之间的关联。
这项队列研究纳入了英国生物银行的52973名参与者，这些参与者符合通过住院或初级保健记录定义的骨关节炎标准。纳入了七个生活方式因素，包括吸烟、饮酒、身体活动、饮食、看电视时间、睡眠时间和社交联系。通过Cox比例风险回归模型估计全因死亡率和特定病因死亡率的风险比（HRs）及95%置信区间（CIs）。
随访期间共记录了4637例死亡。七个健康生活方式因素均与低死亡风险独立相关。与仅符合0 - 2项健康生活方式标准的参与者相比，坚持3 - 7项因素的参与者调整后的HRs（95%CI）分别为0.70（0.62至0.78）、0.60（0.54至0.67）、0.49（0.44至0.54）、0.46（0.41至0.52）和0.42（0.36至0.49）（趋势P< 0.001）。在癌症、心血管、呼吸和消化系统疾病导致的死亡率方面也观察到剂量反应模式（所有趋势P< 0.001），而神经退行性疾病导致的死亡率未出现显著趋势。
坚持更多的健康生活方式因素与骨关节炎患者的死亡风险显著降低相关。我们的研究结果具有重要的公共卫生意义，并提供了实证证据，即坚持健康的生活方式可以减轻骨关节炎带来的负担。
