The relation between progressive osteoarthritis of the knee and long term progression of osteoarthritis of the hand, hip, and lumbar spine
The relation between progressive osteoarthritis of the knee and long term progression of osteoarthritis of the hand, hip, and lumbar spine
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DOI：
10.1136/ard.2005.038414
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发表时间：
2006-05-01
影响因子：
27.4
通讯作者：
Spector, TD
中科院分区：
文献类型：
--
作者：
Hassett, G;Hart, DJ;Spector, TD
背景：由于缺乏多点纵向进展数据，膝关节骨关节炎的进展与远离膝关节部位的骨关节炎进展之间的关系尚不清楚。目的：在人群队列中检查膝关节骨关节炎的放射进展与手、髋部和腰椎的骨关节炎之间的关系。方法：914名女性接受了相隔10年的膝关节X光检查，检查是否存在骨赘和关节间隙变窄(JSN)。手部、髋部和腰椎X光片的进展状态在相同的8到10年内可用。在Logistic回归模型中，使用优势比(OR)和95%可信区间(CI)分析膝关节骨关节炎进展与其他部位骨关节炎的关系。结果：133名女性中有89名根据骨赘诊断为膝关节骨关节炎，其中51名根据JSN定义诊断为膝关节骨关节炎。通过腰椎间隙变窄(OR=2.9(95%可信区间1.2~7.5))和髋关节紊乱进展(OR=2.0(1.0~4.2))预测膝关节JSN的进展。对于手部骨关节炎，没有看到一致的效果。在调整了年龄和体重指数后，这种相关性仍然存在。结论：膝关节骨关节炎的进展与腰椎和髋骨关节炎的进展有关。这可能会对试验方法、骨关节炎研究患者的选择以及对骨关节炎患者预后的建议产生影响。
Background: The association between progression of knee osteoarthritis and progression of osteoarthritis at sites distant from the knee is unclear because of a lack of multisite longitudinal progression data.Objective: To examine the association between radiological progression of knee osteoarthritis and osteoarthritis of the hands, hips, and lumbar spine in a population based cohort.Methods: 914 women had knee x rays taken 10 years apart, which were read for the presence of osteophytes and joint space narrowing (JSN). Progression status was available for hand, hip, and lumbar spine x rays over the same 8 to 10 year period. The association between progression of knee osteoarthritis and osteoarthritis at other sites was analysed using odds ratios ( OR) and 95% confidence intervals (CI) in logistic regression models.Results: 89 of 133 women had progression of knee osteoarthritis based on osteophytes, and 51 of 148 based on JSN definition. Progression of JSN in the knee was predicted by progression in lumbar spine disc space narrowing ( OR = 2.9 ( 95% CI 1.2 to 7.5)) and hip JSN ( OR = 2.0 ( 1.0 to 4.2)). No consistent effects were seen for hand osteoarthritis. The associations remained after adjustment for age and body mass index.Conclusions: Progression of knee osteoarthritis is associated with progression of lumbar spine and hip osteoarthritis. This may have implications for trial methodology, the selection of patients for osteoarthritis research, and advice for patients on prognosis of osteoarthritis.