Jordan J M, Linder G F, Renner J B, Fryer J G
Arthritis Care Res. 1995 Dec;8(4):242-50. doi: 10.1002/art.1790080407.
Rural residents may experience more arthritis and disability than urban dwellers. This paper reviews data on arthritis in rural areas and describes a new study, the Johnston County Osteoarthritis Project, a population-based study of osteoarthritis [OA] of the knee and hip in rural North Carolina.
Published reports of urban and rural comparisons of arthritis were reviewed. Data from the first 1,432 African-American and Caucasian participants in the Johnston County Osteoarthritis Project were analyzed. Radiographic knee and hip OA were defined as a Kellgren-Lawrence grade > or = 2. Functional ability was assessed by the Health Assessment Questionnaire, timed chair stands, and 8-foot walk time. Unweighted prevalences of knee and hip OA were calculated for age, sex, and racial groups. Associations between hip and knee OA, and hip and knee pain and functional ability were examined.
Hip OA was present in 27.9% and knee OA in 38.4% of participants. Both were strongly related to age (P < 0.0001), but only knee OA to female sex (odds ratio = 1.33, 95% confidence interval 1.05, 1.68). Neither hip OA nor knee OA was related to race. Hip OA, hip pain, knee OA, and knee pain was each associated with self-reported and observed functional ability.
Residents in rural areas may experience more arthritis and disability than previously expected. Contrary to other studies, African-American and Caucasian residents of rural Johnston County, North Carolina, have similar high rates of knee and hip OA. Further study is needed to address urban/rural differences in arthritis and its impact, with adequate control of confounders, standard definitions of rural/urban and of disease, and assessment of multiple arthritis outcomes.
农村居民可能比城市居民患关节炎及残疾的情况更多。本文回顾了农村地区关节炎的数据，并描述了一项新的研究——约翰斯顿县骨关节炎项目，这是一项基于人群的北卡罗来纳州农村地区膝和髋骨关节炎（OA）研究。
回顾了已发表的关于城市和农村关节炎比较的报告。对约翰斯顿县骨关节炎项目的前1432名非裔美国人和白人参与者的数据进行了分析。放射学上的膝和髋OA被定义为凯尔格伦 - 劳伦斯分级≥2级。通过健康评估问卷、定时从椅子上站起测试和8英尺步行时间来评估功能能力。计算了不同年龄、性别和种族组膝和髋OA的未加权患病率。研究了髋和膝OA之间以及髋和膝疼痛与功能能力之间的关联。
参与者中髋OA的患病率为27.9%，膝OA为38.4%。两者均与年龄密切相关（P < 0.0001），但只有膝OA与女性相关（优势比 = 1.33，95%置信区间1.05，1.68）。髋OA和膝OA均与种族无关。髋OA、髋疼痛、膝OA和膝疼痛均与自我报告及观察到的功能能力相关。
农村地区居民患关节炎及残疾的情况可能比之前预期的更多。与其他研究相反，北卡罗来纳州约翰斯顿县农村的非裔美国人和白人居民膝和髋OA的患病率都同样高。需要进一步研究以解决关节炎方面的城乡差异及其影响，要充分控制混杂因素，明确城乡及疾病的标准定义，并评估多种关节炎结局。
