Retinal arteriolar narrowing and incidence of knee replacement for osteoarthritis: a prospective cohort study
Retinal arteriolar narrowing and incidence of knee replacement for osteoarthritis: a prospective cohort study
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DOI：
10.1016/j.joca.2015.01.007
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发表时间：
2015-04-01
影响因子：
7
通讯作者：
Cicuttini, Flavia M.
中科院分区：
文献类型：
--
作者：
Hussain, S. M.;Wang, Y.;Cicuttini, Flavia M.
目的：微循环在骨关节炎发病机制中的作用尚不清楚。这项前瞻性队列研究考察了视网膜血管直径与OA患者膝关节置换术发生率之间的关系。设计：澳大利亚糖尿病、肥胖和生活方式研究（AusDiab）的1838名参与者在1999-2000年间使用无散瞳眼底数码相机测量视网膜血管直径，在关节置换术数据收集开始时年龄为>= 40岁。通过将队列记录与澳大利亚骨科协会国家关节置换术登记处（AOANJRR）联系起来，确定了2002-2011年OA膝关节置换术的发生率。结果：77名参与者接受了OA膝关节置换术。与未进行膝关节置换术的患者相比，他们的视网膜小动脉直径更窄（166.1 +/- 24.8 μ m vs 174.3 +/- 24.5 μ m, P = 0.004）。视网膜小动脉直径每减少一个标准差，膝关节置换术的发生率增加25% （HR 1.25, 95%可信区间（CI） 1.00-1.56）。在调整性别、身体质量指数（BMI）、身体活动和糖化血红蛋白（HbA1c）后，动脉直径较窄的三分之二的参与者发生膝关节置换手术的风险是动脉直径较宽的三分之一的参与者的两倍（HR 2.00, 95% CI 1.07-3.74, P = 0.03）。与视网膜静脉直径无关联。结论：视网膜小动脉狭窄与OA患者膝关节置换术风险增加相关，表明微循环在OA发病机制中的作用有待进一步研究。(C) 2015年国际骨关节炎学会。Elsevier Ltd.出版。版权所有。
Objectives: The role of the microcirculation in the pathogenesis of osteoarthritis (OA) remains unclear. This prospective cohort study examined the association between retinal vascular calibre and incidence of knee replacement for OA.Design: 1838 participants of the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study had retinal vascular calibre measured using a nonmydriatic digital fundus camera in 1999-2000 and were aged >= 40 years at joint replacement data collection commencement. The incidence of knee replacement for OA during 2002-2011 was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).Results: 77 participants underwent knee replacement for OA. They had narrower retinal arteriolar calibre compared with those without knee replacement (166.1 +/- 24.8 mu m vs 174.3 +/- 24.5 mu m, P = 0.004). For every one standard deviation reduction in retinal arteriolar calibre, the incidence of knee replacement increased by 25% (HR 1.25, 95% confidence interval (CI) 1.00-1.56). Participants in the narrower two-thirds of arteriolar calibre had twice the risk of knee replacement compared with those in the widest one-third (HR 2.00, 95% CI 1.07-3.74, P = 0.03) after adjustment for sex, body mass index (BMI), physical activity and HbA1c. There was no association for retinal venular calibre.Conclusions: Retinal arteriolar narrowing is associated with increased risk of knee replacement for OA suggesting that further work is warranted to determine the role of the microcirculation in the pathogenesis of knee OA. (C) 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.