Nevitt M C, Cummings S R, Lane N E, Hochberg M C, Scott J C, Pressman A R, Genant H K, Cauley J A
Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
Arch Intern Med. 1996 Oct 14;156(18):2073-80.
To determine whether postmenopausal estrogen replacement therapy is associated with a reduced risk of radiographic findings of osteoarthritis (OA) of the hip.
Cross-sectional study.
White women (N = 4366; age, > or = 65 years) who were participants in a cohort study of osteoporotic fractures.
Radiographs of the pelvis that were obtained in all subjects were assessed for radiographic features of OA of the hip on a summary scale of 0 (none) to 4 (severe OA). Postmenopausal estrogen use was assessed by interview. The association of current and past oral estrogen use with OA of the hip was analyzed by using logistic regression, adjusting for potential confounding variables (eg, indicators of osteoporosis and correlates of estrogen use).
Five hundred thirty-nine women (12.3%) had mild or greater radiographic findings of OA of the hip in at least 1 hip, and 214 women (4.9%) had moderate to severe findings; 17% and 24% of the women were current and past users of oral estrogen, respectively. Women who were currently using oral estrogen had a significantly reduced risk of any OA of the hip (adjusted odds ratio [OR], 0.62; 95% confidence interval [CI], 0.49-0.86) and moderate to severe manifestation of disease (OR, 0.54; 95% CI, 0.33-0.88). Current users who had taken estrogen for 10 years or longer had a greater reduction in the risk of any OA of the hip (OR, 0.57; 95% CI, 0.40-0.82) compared with that of users for less than 10 years (OR, 0.75; 95% CI, 0.47-1.24). Current estrogen use for 10 years or longer was associated with a nonsignificant trend for a reduced risk of moderate to severe symptomatic disease (OR, 0.59; 95% CI, 0.28-1.29).
Postmenopausal estrogen replacement therapy may protect against OA of the hip in elderly white women.
确定绝经后雌激素替代疗法是否与髋部骨关节炎（OA）影像学表现风险降低相关。
横断面研究。
参与骨质疏松性骨折队列研究的白人女性（N = 4366；年龄≥65岁）。
对所有受试者拍摄的骨盆X光片进行评估，根据0（无）至4（重度OA）的综合量表评估髋部OA的影像学特征。通过访谈评估绝经后雌激素的使用情况。采用逻辑回归分析当前和既往口服雌激素使用与髋部OA的关联，并对潜在混杂变量（如骨质疏松指标和雌激素使用相关因素）进行校正。
539名女性（12.3%）至少一侧髋部有轻度或更严重的髋部OA影像学表现，214名女性（4.9%）有中度至重度表现；分别有17%和24%的女性为当前和既往口服雌激素使用者。当前使用口服雌激素的女性髋部任何OA的风险显著降低（校正比值比[OR]为0.62；95%置信区间[CI]为0.49 - 0.86），疾病中度至重度表现的风险也降低（OR为0.54；95% CI为0.33 - 0.88）。与使用雌激素少于10年的使用者相比（OR为0.75；95% CI为0.47 - 1.24），使用雌激素10年或更长时间的当前使用者髋部任何OA的风险降低幅度更大（OR为0.57；95% CI为0.40 - 0.82）。当前使用雌激素10年或更长时间与中度至重度症状性疾病风险降低的趋势不显著相关（OR为0.59；95% CI为0.28 - 1.29）。
绝经后雌激素替代疗法可能预防老年白人女性的髋部OA。
