Cerhan J R, Wallace R B, el-Khoury G Y, Moore T E, Long C R
Department of Preventive Medicine and Environmental Health, University of Iowa College of Medicine, Iowa City 52242.
Am J Epidemiol. 1995 Feb 1;141(3):225-34. doi: 10.1093/oxfordjournals.aje.a117424.
The relation between full-body, radiographically defined osteoarthritis and survival was examined in a cohort of 296 women aged 42-76 years (mean age, 57.1 years). These women were a random sample of women with very low body burdens of radium who were part of a larger cohort of women first employed in the US radium dial-painting industry between 1915 and 1945. At entry into the study between 1957 and 1982, these women had a clinical examination, and full-body radiographs were taken. Fifty-five joints (18 joint groups) of the hands, feet, cervical spine, lumbar spine, pelvis, and knees in each woman were graded for osteoarthritis by the method of J. H. Kellgren and J. S. Lawrence (Ann Rheum Dis 1957; 16:494-502). Through 1985, 18.6% (n = 55) of the women died. Cox regression showed a decreased survival for women with an increasing number of joint groups affected with osteoarthritis after adjusting for age at examination (hazard ratio = 1.45 for each increase in 3.1 joint groups (1 standard deviation) affected with osteoarthritis, 95% confidence interval 1.12-1.87). Further adjustment for a history of diabetes, smoking, alcohol use, and body mass index only slightly altered the risk. Similar results were obtained for the number of joints with osteoarthritis and the number of structures (e.g., left hand and right hand) with osteoarthritis. These results suggest that an increasing prevalence of full-body radiographic osteoarthritis is associated with decreased survival independent of age and several comorbid conditions related to osteoarthritis.
在一个由296名年龄在42至76岁（平均年龄57.1岁）的女性组成的队列中，研究了全身影像学定义的骨关节炎与生存率之间的关系。这些女性是镭身体负荷极低的女性的随机样本，她们是1915年至1945年间首次受雇于美国镭表盘绘画行业的更大女性队列的一部分。在1957年至1982年进入该研究时，这些女性接受了临床检查，并拍摄了全身X光片。采用J. H. 凯尔格伦和J. S. 劳伦斯的方法（《风湿病学年鉴》1957年；16:494 - 502）对每位女性的手、脚、颈椎、腰椎、骨盆和膝盖的55个关节（18个关节组）进行骨关节炎分级。到1985年，18.6%（n = 55）的女性死亡。Cox回归显示，在调整检查时的年龄后，受骨关节炎影响的关节组数量增加的女性生存率降低（骨关节炎每增加3.1个关节组（1个标准差），风险比 = 1.45，95%置信区间1.12 - 1.87）。进一步调整糖尿病史、吸烟、饮酒和体重指数后，风险仅略有改变。对于患有骨关节炎的关节数量和患有骨关节炎的结构数量（如左手和右手），也得到了类似的结果。这些结果表明，全身影像学骨关节炎患病率的增加与生存率降低相关，且独立于年龄以及与骨关节炎相关的几种合并症。
