Pain Susceptibility Phenotypes in Those Free of Knee Pain With or at Risk of Knee Osteoarthritis: The Multicenter Osteoarthritis Study.
Pain Susceptibility Phenotypes in Those Free of Knee Pain With or at Risk of Knee Osteoarthritis: The Multicenter Osteoarthritis Study.
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DOI：
10.1002/art.40752
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发表时间：
2019-04
期刊：
影响因子：
--
通讯作者：
Neogi T
中科院分区：
文献类型：
--
作者：
Carlesso LC;Segal NA;Frey-Law L;Zhang Y;Na L;Nevitt M;Lewis CE;Neogi T
为什么有些人会出现膝骨性关节炎(OA)的疼痛，目前尚不清楚。我们试图确定疼痛易感性表型(PSP)及其与2年后发生的持续性膝痛(PKP)的关系。我们从多中心骨关节炎研究中确定了没有PKP的个体，这是一组患有或有膝骨性关节炎风险的老年人的纵向队列。潜在类分析被用来确定可能导致PKP发展的PSP，除了结构病理：广泛疼痛、睡眠不佳、心理因素和定量感觉测试(QST)(即压力痛阈值和时间总和(TS))。我们用Logistic回归分析了两年来社会人口学因素与PSP的相关性以及PSP与发展中的PKP的关系。852名参与者(平均年龄67岁；体重指数29.5公斤/平方米，55%为女性)。确定了四个PSP，主要特征是存在不同比例(低/无、中等或高)的压痛敏感性和易化TS，反映了不同的敏化措施。压痛敏感度高+易化TS比例适中的PSP在2年内发生PKP的可能性是两者均敏化比例低的PSP的2倍，OR为2.11(95%CI为1.06~4.22)。共鉴定出4个PSP，其中3个以致敏的QST证据为主，1个与2年后发生的PKP有关。预防或改善敏感化可能是预防骨性关节炎患者持续性膝关节疼痛的一种新方法。
Why some individuals develop pain with knee osteoarthritis (OA) is not clear. We sought to identify pain susceptibility phenotypes (PSPs) and their relation to incident persistent knee pain (PKP) 2 years later. We identified individuals free of PKP from the Multicenter Osteoarthritis Study, a longitudinal cohort of older adults with or at risk of knee OA. Latent class analysis was used to determine PSPs that may contribute to development of PKP apart from structural pathology: widespread pain, poor sleep, psychological factors and quantitative sensory tests (QST) (i.e., pressure pain threshold and temporal summation (TS)). We evaluated the association of sociodemographic factors with PSPs and the relation of PSPs to developing PKP over two years with logistic regression. 852 participants were included (mean age 67; BMI 29.5 kg/m2, 55% women). Four PSPs were identified, primarily characterized by varying proportions (low/absent, moderate, or high) of the presence of pressure pain sensitivity and of facilitated TS, reflecting different measures of sensitization. The PSP with high proportion of pressure pain sensitivity + moderate proportion of facilitated TS was twice as likely to develop incident PKP over 2 years OR 2.11 (95% CI 1.06 4.22) compared with the PSP having low proportion of sensitization by both measures. Four PSPs were identified, of which three were predominated by QST evidence of sensitization, and one was associated with developing PKP 2 years later. Prevention or amelioration of sensitization may be a novel approach to preventing onset of persistent knee pain in OA.
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影响因子：
4.7
作者：
Campbell CM;Buenaver LF;Finan P;Bounds SC;Redding M;McCauley L;Robinson M;Edwards RR;Smith MT
通讯作者：
Smith MT
影响因子：
3.7
作者：
Park, Sang Jun;Yoon, Duck Mi;Kim, Shin Hyung
通讯作者：
Kim, Shin Hyung
影响因子：
3.2
作者：
Lluch Girbes, Enrique;Duenas, Lirios;Nijs, Jo
通讯作者：
Nijs, Jo
影响因子：
7
作者：
Neogi, T.;Nevitt, M. C.;Felson, D. T.
通讯作者：
Felson, D. T.
影响因子：
7
作者：
Hawker, G. A.;Stewart, L.;Gooberman-Hill, R.
通讯作者：
Gooberman-Hill, R.