Cooper C, Inskip H, Croft P, Campbell L, Smith G, McLaren M, Coggon D
The MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, England.
Am J Epidemiol. 1998 Mar 15;147(6):516-22. doi: 10.1093/oxfordjournals.aje.a009482.
Hip osteoarthritis is a major cause of pain and disability. The authors explored individual risk factors for hip osteoarthritis in a population-based case-control study. The study was performed in two English health districts (Portsmouth and North Staffordshire) from 1993 to 1995. A total of 611 patients (210 men and 401 women) listed for hip replacement because of osteoarthritis over an 18-month period were compared with an equal number of controls selected from the general population and individually matched for age, sex, and family practitioner. Information about suspected risk factors was obtained by a questionnaire administered at interview and a short physical examination. Obesity (odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.3-2.4; highest vs. lowest third of body mass index), previous hip injury (OR = 4.3, 95% CI 2.2-8.4), and the presence of Heberden's nodes (OR = 1.6, 95% CI 1.2-2.2) were independent risk factors for hip osteoarthritis among men and women. Hip injury was more closely related to unilateral as compared with bilateral disease. There were a negative association between cigarette smoking and osteoarthritis among men and a weak positive association with prolonged regular sporting activity. Obesity and hip injury are important independent risk factors for hip osteoarthritis, which might be amenable to primary prevention. Hip osteoarthritis may also arise as part of the polyarticular involvement found in generalized osteoarthritis.
髋骨关节炎是疼痛和残疾的主要原因。作者在一项基于人群的病例对照研究中探讨了髋骨关节炎的个体危险因素。该研究于1993年至1995年在英国的两个卫生区（朴次茅斯和北斯塔福德郡）进行。在18个月期间，共有611名因骨关节炎而列入髋关节置换手术名单的患者（210名男性和401名女性）与从普通人群中选取的同等数量的对照者进行比较，这些对照者在年龄、性别和家庭医生方面进行了个体匹配。通过访谈时发放的问卷和简短的体格检查获取有关疑似危险因素的信息。肥胖（比值比（OR）=1.7，95%置信区间（CI）1.3 - 2.4；体重指数最高三分位与最低三分位相比）、既往髋部损伤（OR = 4.3，95% CI 2.2 - 8.4）以及赫伯登结节的存在（OR = 1.6，95% CI 1.2 - 2.2）是男性和女性髋骨关节炎的独立危险因素。与双侧疾病相比，髋部损伤与单侧疾病的关系更为密切。男性吸烟与骨关节炎之间存在负相关，而长期规律的体育活动与之存在微弱的正相关。肥胖和髋部损伤是髋骨关节炎重要的独立危险因素，可能适合进行一级预防。髋骨关节炎也可能作为全身性骨关节炎中多关节受累的一部分出现。
