Comorbidities and health-related quality of life in Koreans with knee osteoarthritis: Data from the Korean National Health and Nutrition Examination Survey (KNHANES).
Comorbidities and health-related quality of life in Koreans with knee osteoarthritis: Data from the Korean National Health and Nutrition Examination Survey (KNHANES).
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DOI：
10.1371/journal.pone.0186141
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Cha HS
中科院分区：
文献类型：
--
作者：
Jeong H;Baek SY;Kim SW;Eun YH;Kim IY;Lee J;Jeon CH;Koh EM;Cha HS
本研究旨在评价膝关节骨关节炎（OA）与合并症和健康相关生活质量（HRQOL）的相关性。从2010 - 2012年韩国国家健康和营养检查调查中选择了总计8，907名（加权n = 13，687，058）年龄≥ 50岁且接受过膝关节X线摄影的受试者。根据是否存在疼痛和影像学OA（罗阿），将OA分为4个亚组：非OA（疼痛-/罗阿-）、仅疼痛（疼痛+/罗阿-）、仅罗阿（疼痛-/罗阿+）和疼痛性罗阿（疼痛+/罗阿+）。罗阿定义为Kelling-Lawrence分级≥ 2级。同时分析HRQOL测量结果，包括EuroQOL视觉模拟量表（EQ-VAS）评分和EuroQOL-5维度的5个维度和汇总指数（EQ-5D指数）。进行多变量logistic回归和线性回归分析。调整社会经济和生活方式特征后，心血管疾病、恶性肿瘤和其他合并症与OA无显著相关性。单纯疼痛和疼痛性罗阿均与体力活动受限显著相关（比值比（OR）分别为2.66，95% CI 2.07 - 3.44，p <0.001和OR 2.83，95% CI 2.25 - 3.58，p <0.001），EQ-VAS较低（分别为β系数=-10.95，p <0.001和β系数=-9.75，p <0.001）和EQ-5D指数（β系数=-0.10，p <0.001和β系数=-0.13，p <0.001），而仅罗阿与体力活动受限或HRQOL评分较低无关。调整后，合并症与膝关节OA无显著相关性。膝关节OA与体力活动和HRQOL相关。与无疼痛的罗阿相比，疼痛性膝关节OA（伴或不伴罗阿）与体力活动减少和生活质量降低的相关性更强。
This study aimed to evaluate the association of knee osteoarthritis (OA) with comorbidities and health-related quality of life (HRQOL). A total of 8,907 (weighted n = 13,687,058) participants aged ≥50 years who had undergone knee radiography were selected from the 2010–2012 Korea National Health and Nutrition Examination Survey. OA was classified into four subgroups based on the presence or absence of pain and radiographic OA (ROA): non-OA (Pain-/ROA-), pain only (Pain+/ROA-), ROA only (Pain-/ROA+), and painful ROA (Pain+/ROA+). ROA was defined as Kellgren–Lawrence grade ≥ 2. HRQOL measurements including EuroQOL visual analogue scale (EQ-VAS) scores and the five dimensions and summary index of the EuroQOL-5 dimension (EQ-5D index) were also analyzed. Multivariable logistic regression and linear regression analyses were performed. After adjustment for socioeconomic and lifestyle characteristics, cardiovascular disease, malignancy, and other comorbidities were not significantly associated with OA. Pain only and painful ROA were each significantly associated with limitations in physical activity (odds ratio (OR) 2.66, 95% CI 2.07–3.44, p < 0.001 and OR 2.83, 95% CI 2.25–3.58, p < 0.001, respectively), lower EQ-VAS (β-coefficient = -10.95, p < 0.001 and β-coefficient = -9.75, p < 0.001, respectively), and EQ-5D index (β-coefficient = -0.10, p < 0.001 and β-coefficient = -0.13, p < 0.001) compared with the non-OA group, whereas ROA only was not associated with limitations in physical activity or lower HRQOL score. Comorbidities were not significantly associated with knee OA after adjustment. Knee OA was associated with physical activity and HRQOL. Painful knee OA, with or without ROA, was more strongly associated with decreased physical activity and lower quality of life than ROA without pain.