An investigation of risk factors for symptomatic osteoarthritis of the knee in women using a life course approach
An investigation of risk factors for symptomatic osteoarthritis of the knee in women using a life course approach
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DOI：
10.1136/jech.57.10.823
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发表时间：
2003-10-01
影响因子：
6.3
通讯作者：
Fitzpatrick, R
中科院分区：
文献类型：
--
作者：
Dawson, J;Juszczak, E;Fitzpatrick, R
研究目的：探讨女性症状性膝骨关节炎 (OAK) 的危险因素，其中包括穿高跟鞋。设计：匹配病例对照研究。通过采访获得的暴露信息，包括有关过去鞋类的详细信息。自我报告的体重和身高数据代表女性离开学校时、年龄在 36 - 40 岁和年龄 51 - 55 岁之间。使用生活网格收集定期工作活动（包括家庭主妇或看护者的时期）、吸烟和激素相关数据。设置：在参与者家中进行访谈。从骨科医院手术等候名单中确定的病例，由全科医生 (GP) 确定的对照参与者：50 至 70 岁的女性。等待膝关节置换手术的病例。对照组过去没有做过膝盖手术，过去三年也没有膝盖疼痛，他们的年龄和全科医生都匹配。共有 111 名符合条件的女性接受了采访（29 例，82 名对照）。 主要结果：单变量分析确定了与 OAK 的几个显着关联，包括既往膝关节损伤、脚关节炎、大量吸烟、超重（BMI 25 或以上）和各种职业活动。事实上，所有使用高跟鞋的措施都与降低 OAK 风险相关，尽管这些发现均不具有统计学意义。在多变量分析中，只有 36 - 40 岁时 BMI 25 或以上仍与 OAK 显着相关（OR 36.4，95% CI 3.07 至 432，p = 0.004），尽管弱证据表明某些职业活动可能会增加风险。成年早期的体重增加在病例中尤其明显。结论：40 岁之前超重会显着增加女性随后出现症状性 OAK 的风险。穿高跟鞋就没有。
Study objective: To explore risk factors for symptomatic knee osteoarthritis ( OAK) in women, which included wearing high heeled shoes.Design: Matched case-control study. Exposure information obtained by interview, included details about past footwear. Self reported weight and height data obtained representing when women left school, were aged 36 - 40 and were aged 51 - 55. Regular work activities ( including periods when homemaker or carer), smoking, and hormone related data gathered using a life-grid.Setting: Interviews in participants' homes. Cases identified from orthopaedic hospital surgical waiting list, controls identified by general practitioners (GPs)Participants: Women aged 50 to 70 years. Cases awaiting knee replacement surgery. Controls, who had no past knee surgery and no knee pain in the past three years, were matched for age and GP. Altogether 111 eligible women were interviewed ( 29 cases, 82 controls).Main results: Univariate analyses identified several significant associations with OAK including past knee injury, arthritis of the feet, heavy smoking, being overweight (BMI 25 or above) and various occupational activities. Virtually all measures of high heeled shoes use were associated with reduced risk of OAK, although none of these findings were statistically significant. In multivariate analysis only BMI 25 or above at age 36 - 40 remained significantly associated with OAK ( OR 36.4, 95% CI 3.07 to 432, p = 0.004), although weak evidence suggested certain occupational activities might increase risk. Weight gain in early adult life was particularly pronounced among cases.Conclusions: Being overweight before the age of 40 considerably increased the risk of subsequent symptomatic OAK in women. Wearing high heeled shoes did not.