Hip Osteoarthritis and the Risk of All-Cause and Disease-Specific Mortality in Older Women: A Population-Based Cohort Study.
Hip Osteoarthritis and the Risk of All-Cause and Disease-Specific Mortality in Older Women: A Population-Based Cohort Study.
复制标题
DOI：
10.1002/art.39113
复制
发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Study of Osteoporotic Fractures Research Group
中科院分区：
文献类型：
--
作者：
Barbour KE;Lui LY;Nevitt MC;Murphy LB;Helmick CG;Theis KA;Hochberg MC;Lane NE;Hootman JM;Cauley JA;Study of Osteoporotic Fractures Research Group
确定髋关节骨性关节炎老年女性的全因和疾病特异性死亡风险，并确定因果通路中的介质。数据来自骨质疏松性骨折研究，这是一项在9704名年龄≥65岁的白色女性中开展的基于美国人群的队列研究。分析样本包括在基线（N= 7，889）和第8年（N= 5，749）进行髋关节X光检查的女性。通过死亡证明和出院总结确认死亡至2013年10月。影像学髋关节OA（RHOA）定义为至少1个髋关节Croft分级≥2（明确的关节间隙狭窄或骨赘加上1个其他影像学特征）。平均随访时间为16.1 ±6.2年。RHOA的基线和第8年患病率分别为8.0%和11.0%。全因死亡的累积发生率（研究期间死亡比例）为67.7%，心血管疾病（CVD）死亡率为26.3%，癌症死亡率为11.7%，胃肠道疾病死亡率为1.9%，所有其他死亡原因为27.8%。RHOA与经年龄、体重指数、教育、吸烟、健康状况、糖尿病和卒中校正后的全因死亡（风险比[HR]，1.14; 95%置信区间[CI]，1.05-1.24）和CVD（HR，1.24; 95% CI，1.09-1.41）风险增加相关。这些协会部分解释了身体功能（中介变量）。在随访16年的老年白色妇女中，RHOA与全因和心血管疾病死亡风险增加相关。在社区和临床环境中传播基于证据的身体活动和髋关节OA自我管理干预措施可以改善身体功能，也可能有助于降低死亡率。
Determine the risk of all-cause and disease-specific mortality among older women with hip OA and identify mediators in the causal pathway. Data were from the Study of Osteoporotic Fractures, a US population-based cohort study of 9704 white women, aged ≥65 years. The analytic sample included women with hip radiographs at baseline (N=7,889) and year 8 (N=5,749). Mortality was confirmed through October 2013 by death certificates and hospital discharge summaries. Radiographic hip OA (RHOA) was defined as having Croft grade ≥2 in at least 1 hip (definite joint space narrowing or osteophytes plus 1 other radiographic feature). Mean follow-up time was 16.1 ±6.2 years. Baseline and year 8 prevalence of RHOA was 8.0% and 11.0%, respectively. Cumulative incidence (proportion of deaths during study period) was 67.7% for all-cause mortality, 26.3% for cardiovascular disease (CVD) mortality, 11.7% for cancer mortality, 1.9% for gastrointestinal disease mortality, and 27.8% for all other mortality causes. RHOA was associated with an increased risk of all-cause (hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.05–1.24), and CVD (HR, 1.24; 95% CI, 1.09–1.41) mortality adjusted for age, body mass index, education, smoking, health status, diabetes, and stroke. These associations were partially explained by physical function (mediating variable). RHOA was associated with an increased risk of all-cause and CVD mortality among older white women followed for 16 years. Dissemination of evidence-based physical activity and self-management interventions for hip OA in community and clinical settings can improve physical function and might also contribute to lower mortality.