Stürmer T, Sun Y, Sauerland S, Zeissig I, Günther K P, Puhl W, Brenner H
Department of Epidemiology, University of Ulm, Germany.
J Rheumatol. 1998 Sep;25(9):1827-32.
To assess the association between serum cholesterol and osteoarthritis (OA).
OA patterns were studied in 809 patients with knee or hip joint replacement due to OA in 4 hospitals in southwest Germany. Participants had a standardized interview and examination. Radiographs of the contralateral joint as well as both hands and a blood sample were obtained. Serum cholesterol levels were divided into tertiles and hypercholesterolemia was defined as > or = 6.2 mmol/l or use of antihyperlipidemic drugs. According to the presence or absence of radiographic OA in the contralateral joint, participants were categorized as having bilateral or unilateral OA. If radiographic OA of different finger joints was present, participants were categorized as having generalized OA. Odds ratios and 95% confidence intervals for the association of serum cholesterol with OA patterns were calculated with logistic regression, adjusting for potential confounders.
Eighty-five percent of participants with radiographs had bilateral OA and 26% generalized OA. No association was observed between hypercholesterolemia and bilateral OA. Hypercholesterolemia (OR 1.61; 95% CI 1.06-2.47) and high serum cholesterol levels (3rd versus 1st tertile: OR 1.73; 95% CI 1.02-2.92) were independently associated with generalized OA. This association was almost exclusively due to participants with knee OA.
These data add to the evidence regarding the independent role of serum cholesterol as a systemic risk factor for OA. The discrepant associations observed for different OA patterns are likely due to the relative weight of other risk factors.
评估血清胆固醇与骨关节炎（OA）之间的关联。
在德国西南部4家医院对809例因OA行膝关节或髋关节置换术的患者的OA模式进行研究。参与者接受标准化访谈和检查。获取对侧关节以及双手的X线片和一份血样。血清胆固醇水平分为三分位数，高胆固醇血症定义为≥6.2 mmol/l或使用抗高血脂药物。根据对侧关节是否存在X线片显示的OA，将参与者分为双侧OA或单侧OA。如果存在不同手指关节的X线片显示的OA，则将参与者分类为患有全身性OA。采用逻辑回归计算血清胆固醇与OA模式关联的比值比和95%置信区间，并对潜在混杂因素进行校正。
有X线片的参与者中，85%患有双侧OA，26%患有全身性OA。未观察到高胆固醇血症与双侧OA之间存在关联。高胆固醇血症（比值比1.61；95%置信区间1.06 - 2.47）和高血清胆固醇水平（第三三分位数与第一三分位数相比：比值比1.73；95%置信区间1.02 - 2.92）与全身性OA独立相关。这种关联几乎完全归因于膝关节OA患者。
这些数据进一步证明了血清胆固醇作为OA全身性危险因素的独立作用。不同OA模式观察到的差异关联可能是由于其他危险因素的相对权重不同。
