鹿特丹研究中髋关节和膝关节放射性骨关节炎与运动功能障碍的关联。
Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam Study.
作者信息
Odding E, Valkenburg H A, Algra D, Vandenouweland F A, Grobbee D E, Hofman A
机构信息
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
出版信息
Ann Rheum Dis. 1998 Apr;57(4):203-8. doi: 10.1136/ard.57.4.203.
OBJECTIVE
To assess the contribution of radiological osteoarthritis of the hips and knees to disabilities in the activities of daily living related to lower limb function.
METHODS
During a home interview 1156 men and 1739 women, randomly chosen from the source population of all independently living residents aged 55 years and over living in a district of Rotterdam (the Rotterdam Study) were asked about locomotor disability by six questions of the Health Assessment Questionnaire (HAQ) and about pain in the hips and knees in the past month. Radiographs of hips and knees were scored according to the Kellgren grading system for osteoarthritis.
RESULTS
The prevalence of locomotor disability, defined as at least some difficulty with three or more out of six lower limb functions, was 20.2% for men and 31.9% for women; hip pain was present in 8.3% of the men and 16.6% of the women; knee pain in 12.6% of the men and 22.3% of the women. The prevalence of radiological osteoarthritis grade 2+ of the hip was 14.1% for men and 15.9% for women, and of the knee 16.3% and 29.1% respectively. The odds ratio (OR) (95% confidence intervals) of hip radiological osteoarthritis for locomotor disability adjusted for age and all other variables was for men: 1.4 (0.9, 2.1) and for women: 2.2 (1.6, 2.9). The ORs of knee radiological osteoarthritis adjusted for age and all other variables were 1.1 (0.9, 2.1) and 1.4 (1.1, 1.8) respectively. Severe radiological osteoarthritis (grade 3+) was stronger associated. The ORs of pain in the hips or knees and morning stiffness were much higher (between 2.7 and 5.5 for men and between 2.1 and 5.1 for women).
CONCLUSIONS
Radiological osteoarthritis of the hip and knee are only weak independent predictors of locomotor disability in women, and not at all independently associated with locomotor disability in men. Age, pain of the hips and knees, and morning stiffness seem to be the most important independent determinants of locomotor disability.
目的
评估髋部和膝部放射性骨关节炎对与下肢功能相关的日常生活活动障碍的影响。
方法
在一次家庭访谈中，从鹿特丹某区所有年龄在55岁及以上独立生活居民的源人群中随机选取1156名男性和1739名女性，通过健康评估问卷（HAQ）的六个问题询问其运动功能障碍情况，并询问过去一个月内髋部和膝部的疼痛情况。根据骨关节炎的凯尔格伦分级系统对髋部和膝部的X光片进行评分。
结果
运动功能障碍的患病率，定义为六项下肢功能中至少三项存在一定困难，男性为20.2%，女性为31.9%；男性中8.3%有髋部疼痛，女性中16.6%有髋部疼痛；男性中12.6%有膝部疼痛，女性中22.3%有膝部疼痛。髋部放射性骨关节炎2级及以上的患病率男性为14.1%，女性为15.9%，膝部分别为16.3%和29.1%。在对年龄和所有其他变量进行调整后，髋部放射性骨关节炎导致运动功能障碍的优势比（OR）（95%置信区间），男性为：1.4（0.9，2.1），女性为：2.2（1.6，2.9）。对年龄和所有其他变量进行调整后，膝部放射性骨关节炎的OR分别为1.1（0.9，2.1）和1.4（1.1，1.8）。严重放射性骨关节炎（3级及以上）的相关性更强。髋部或膝部疼痛以及晨僵的OR要高得多（男性在2.7至5.5之间，女性在2.1至5.1之间）。
结论
髋部和膝部放射性骨关节炎仅是女性运动功能障碍的弱独立预测因素，与男性的运动功能障碍完全无独立相关性。年龄、髋部和膝部疼痛以及晨僵似乎是运动功能障碍最重要的独立决定因素。
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