Statin use is associated with reduced incidence and progression of knee osteoarthritis in the Rotterdam study
Statin use is associated with reduced incidence and progression of knee osteoarthritis in the Rotterdam study
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DOI：
10.1136/annrheumdis-2011-200092
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发表时间：
2012-05-01
影响因子：
27.4
通讯作者：
Bierma-Zeinstra, S. M.
中科院分区：
文献类型：
--
作者：
Clockaerts, S.;Van Osch, G. J. V. M.;Bierma-Zeinstra, S. M.
骨关节炎是最常见的慢性关节疾病，可引起疼痛和残疾。除了生物力学机制外，骨关节炎的发病机制可能涉及炎症、血管改变和脂质代谢失调。由于他汀类药物能够调节这些过程中的许多，本研究探讨他汀类药物的使用是否与发病率降低和/或进展的osteoarthritis.Methods参与者在一个前瞻性的人群为基础的队列研究，年龄在55岁及以上（n=2921）。在基线和平均6.5年后获得膝关节/髋关节的X线片，并使用Kellgren和Lawrence骨关节炎评分进行评分。任何评分增加均定义为总体进展（发生率和进展）。在基线时收集协变量数据。随访期间他汀类药物使用的信息来自计算机化药房数据库。比较了他汀类药物使用者和非使用者之间骨关节炎的总体进展。采用多因素Logistic回归模型，调整混杂变量后计算OR和95% CI。结果膝关节和髋关节骨关节炎的总体进展率分别为6. 9%和4. 7%。他汀类药物使用者膝关节骨关节炎总体进展的校正OR为0.43（95%CI 0.25 - 0.77，p=0.01）。他汀类药物的使用与髋关节骨性关节炎的总体进展无关。结论他汀类药物的使用与膝关节骨性关节炎总体进展减少50%以上相关，但与髋关节无关。
Background Osteoarthritis is the most frequent chronic joint disease causing pain and disability. Besides biomechanical mechanisms, the pathogenesis of osteoarthritis may involve inflammation, vascular alterations and dysregulation of lipid metabolism. As statins are able to modulate many of these processes, this study examines whether statin use is associated with a decreased incidence and/or progression of osteoarthritis.Methods Participants in a prospective population-based cohort study aged 55 years and older (n=2921) were included. x-Rays of the knee/hip were obtained at baseline and after on average 6.5 years, and scored using the Kellgren and Lawrence score for osteoarthritis. Any increase in score was defined as overall progression (incidence and progression). Data on covariables were collected at baseline. Information on statin use during follow-up was obtained from computerised pharmacy databases. The overall progression of osteoarthritis was compared between users and non-users of statins. Using a multivariate logistic regression model with generalised estimating equation, OR and 95% CI were calculated after adjusting for confounding variables.Results Overall progression of knee and hip osteoarthritis occurred in 6.9% and 4.7% of cases, respectively. The adjusted OR for overall progression of knee osteoarthritis in statin users was 0.43 (95% CI 0.25 to 0.77, p=0.01). The use of statins was not associated with overall progression of hip osteoarthritis.Conclusions Statin use is associated with more than a 50% reduction in overall progression of osteoarthritis of the knee, but not of the hip.