Philbin E F, Ries M D, Groff G D, Sheesley K A, French T S, Pearson T A
Department of Medicine, Columbia University College of Physicians & Surgeons, New York, USA.
J Cardiovasc Risk. 1996 Dec;3(6):529-33.
Osteoarthritis is associated with obesity, sedentary behavior and poor fitness. This study was conducted to test the hypothesis that risk factors for coronary heart disease (CHD) are more prevalent among patients with osteoarthritis than among non-arthritic adults of the same age and sex.
Forty-six patients with osteoarthritis of the hip and/or knee were evaluated; 23 non-arthritic subjects served as control group. A panel of metabolic risk factors were measured including body mass index (BMI), waist-hip ratio (WHR), blood pressure, fasting blood glucose, and serum lipids and apoproteins.
Measures of arthritis severity confirmed marked disability and deformity in the arthritis group. Patients reported the performance of less aerobic exercise than controls. Compared with controls, patients were noted to have greater mean BMI (31.2 +/0- 5.9 versus 24.6 +/- 3.2 kg/m2, P < 0.000005), WHR (0.88 +/- 0.07 versus 0.83 +/- 0.08, P < 0.05), systolic blood pressure (140.8 +/- 17.9 versus 131.3 +/- 15.3 mmHg, P < 0.05) and fasting blood glucose (105.0 +/- 24.6 versus 93.2 +/- 7.0 mg/dl, P < 0.01), and lower mean high-density-lipoprotein cholesterol (47.9 +/- 10.9 versus 56.7 +/- 17.1 mg/dl, P < 0.05). Nonsignificant trends for higher mean diastolic blood pressure and serum triglycerides were also noted in the arthritic group. Mean estimated risk for development of CHD within 10 years of evaluation was greater in the arthritic than in the control group (21.6 +/- 14.4% versus 15.2 +/- 11.7%, P < 0.05).
Patients with moderately severe to end-stage lower extremity osteoarthritis may be at advanced risk for the development of CHD by virtue of their unfavorable risk factor profile.
骨关节炎与肥胖、久坐行为及身体状况不佳相关。本研究旨在验证以下假设：与年龄和性别相同的非关节炎成年人相比，冠心病（CHD）的危险因素在骨关节炎患者中更为普遍。
对46例髋和/或膝关节骨关节炎患者进行评估；23例非关节炎受试者作为对照组。检测一系列代谢危险因素，包括体重指数（BMI）、腰臀比（WHR）、血压、空腹血糖以及血脂和载脂蛋白。
关节炎严重程度指标证实关节炎组存在明显残疾和畸形。患者报告的有氧运动表现低于对照组。与对照组相比，患者的平均BMI更高（31.2±5.9对24.6±3.2kg/m²，P<0.000005），WHR更高（0.88±0.07对0.83±0.08，P<0.05），收缩压更高（140.8±17.9对131.3±15.3mmHg，P<0.05），空腹血糖更高（105.0±24.6对93.2±7.0mg/dl，P<0.01），而平均高密度脂蛋白胆固醇更低（47.9±10.9对56.7±17.1mg/dl，P<0.05）。关节炎组舒张血压和血清甘油三酯平均水平也有升高趋势，但无统计学意义。评估后10年内冠心病发生的平均估计风险在关节炎组高于对照组（21.6±14.4%对15.2±11.7%，P<0.05）。
中度至重度下肢骨关节炎患者因其不利的危险因素谱，可能处于冠心病发生的高危状态。
