Association Between Race and Radiographic, Symptomatic, and Clinical Hand Osteoarthritis: A Propensity Score-Matched Study Using Osteoarthritis Initiative Data.
Association Between Race and Radiographic, Symptomatic, and Clinical Hand Osteoarthritis: A Propensity Score-Matched Study Using Osteoarthritis Initiative Data.
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种族与放射学、症状和临床手部骨关节炎之间的关联：使用骨关节炎倡议数据进行的倾向评分匹配研究。
DOI：
10.1002/art.41231
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Demehri,Shadpour
中科院分区：
文献类型：
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作者：
Pishgar,Farhad;Kwee,RobertM;Haj-Mirzaian,Arya;Guermazi,Ali;Haugen,IdaK;Demehri,Shadpour
目的确定黑人种族与放射学、症状和临床手部骨关节炎 (OA) 之间的关联。方法使用骨关节炎倡议队列中现有的手部 X 光照片（总共 4,699 名；n = 849 名黑人受试者 [18.1%]，n = 3,850 名非黑人受试者 [81.9%]），这是一种倾向评分匹配方法 用于将黑人受试者与非黑人受试者匹配，以了解手部 OA 的已知潜在危险因素（年龄、性别、体重指数、吸烟状况、心血管疾病、骨质疏松症、过度职业或娱乐相关的手部使用以及膝部 OA）。肌肉骨骼放射科医生以盲法方式检查了受试者惯用手的后前位X光片。为了评估手部 OA 的严重程度，使用改良的 Kellgren/Lawrence (K/L) 放射学 OA 评分量表（0-4 级），并记录手部关节是否存在糜烂性 OA。使用回归模型研究了种族与手 OA 严重程度（以修正 K/L 等级求和）、放射学手 OA 存在（修正 K/L 等级 ≥2）、糜烂性手 OA 存在、症状性手 OA（放射学 OA 伴有手痛）和临床手 OA（通过手部 Heberden 淋巴结的临床表现表明）之间的关联。在这些模型中，计算了黑人种族与任何这些放射学和症状性手部 OA 表型之间的关联的 β 系数或比值比 (OR)（95% 置信区间 (95% CI)）。结果黑人受试者的手部 OA 较轻 (β = –1.93 [95% CI –2.53, –1.34])，并且发生放射学手部 OA 的风险较低 (OR 0.79 [95% CI 0.66, 0.94])、糜烂性手 OA (OR 0.23 [95% CI 0.11, 0.47])、症状性手 OA (OR 0.63 [95% CI 0.49, 0.82]) 和临床手 OA (OR 0.49 [95% CI 0.41, 0.60]），与非黑人受试者相比。结论与 尽管黑人种族与膝关节或髋关节 OA 之间存在明确的关联，但本研究的结果表明，与非黑人受试者相比，黑人受试者患手部 OA 的风险较低，而这种风险并非由已知的手部 OA 危险因素介导。未来的研究有必要确定黑人受试者手部 OA 的调节保护因素。
ObjectiveTo determine the associations between Black race and the presence of radiographic, symptomatic, and clinical hand osteoarthritis (OA).MethodsUsing available hand radiographs from the Osteoarthritis Initiative cohort (total 4,699; n = 849 Black subjects [18.1%], n = 3,850 non‐Black subjects [81.9%]), a propensity score–matching method was used to match Black subjects with non‐Black subjects for known potential risk factors of hand OA (age, sex, body mass index, smoking status, cardiovascular disease, osteoporosis, excessive occupation‐ or recreation‐related hand use, and knee OA). Posteroanterior radiographs of subjects’ dominant hands were reviewed by a musculoskeletal radiologist in a blinded manner. To assess the severity of hand OA, the modified Kellgren/Lawrence (K/L) radiographic OA scoring scale (grades 0–4) was used, and the presence of erosive OA in the hand joints was recorded. Associations between race and the severity of hand OA (measured as the summed modified K/L grade), presence of radiographic hand OA (modified K/L grade ≥2), presence of erosive hand OA, presence of symptomatic hand OA (radiographic OA with hand pain), and presence of clinical hand OA (indicated by clinical findings of Heberden's nodes in the hands) were studied using regression models. In these models, beta coefficients or odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated for the associations between Black race and any of these radiographic and symptomatic hand OA phenotypes.ResultsBlack subjects had less severe hand OA (β = –1.93 [95% CI –2.53, –1.34]), as well as a lower risk of developing radiographic hand OA (OR 0.79 [95% CI 0.66, 0.94]), erosive hand OA (OR 0.23 [95% CI 0.11, 0.47]), symptomatic hand OA (OR 0.63 [95% CI 0.49, 0.82]), and clinical hand OA (OR 0.49 [95% CI 0.41, 0.60]), as compared to non‐Black subjects.ConclusionIn contrast to the well‐established association between Black race and knee or hip OA, the findings of this study suggest that the risk of hand OA is lower in Black subjects compared to non‐Black subjects, which is not mediated by known hand OA risk factors. Future studies are warranted to determine the mediating protective factors for hand OA among Black subjects.