Osteoarthritis in the carpometacarpal joint of the thumb -: Prevalence and associations with disability and mortality
Osteoarthritis in the carpometacarpal joint of the thumb -: Prevalence and associations with disability and mortality
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DOI：
10.2106/00004623-200407000-00013
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发表时间：
2004-07-01
影响因子：
5.3
通讯作者：
Aromaa, A
中科院分区：
文献类型：
--
作者：
Haara, MM;Heliovaara, M;Aromaa, A
背景：本研究旨在调查芬兰30岁以上成人拇指掌关节骨关节炎的患病率。方法：在1978年至1980年期间，邀请8000名30岁或以上的芬兰人进行全面健康检查；90%的接受。手x线片共拍摄3595名受试者。自审查以来，对这些对象进行了系统的跟踪，通过审查覆盖全体人口的登记册来评估工作残疾和死亡率。结果：年龄调整后的Kellgren 2级、3级或4级拇指腕掌骨关节炎患病率男性为7%，女性为15%。在调整了年龄、性别和其他所谓的危险因素后，体重指数被发现与男女拇指腕掌骨关节炎的患病率成正比。体重指数每增加5 kg/m(2)，调整后的优势比为1.29（95%可信区间为1.15 ~ 1.43）。体力劳动史与拇指腕骨关节炎之间没有明显的联系。拇指活动受限，局部压痛和肿胀常被发现与拇指腕掌骨关节炎的x线证据。晚期（3级或4级）拇指腕掌骨关节炎可预测男性的总死亡率（校正相对危险度，1.32；95%可信区间，1.03 - 1.69）。拇指腕掌骨关节炎的影像学征象不能预测工作残疾。结论和临床意义：肥胖是两性拇指腕掌骨关节炎的重要决定因素。拇指腕掌骨关节炎对一般人群致残和死亡率的影响不大。由于罕见的后续残疾，拇指腕骨关节炎很可能在临床实践中被误诊。证据等级：预后研究，II-1级（回顾性研究）。有关证据水平的完整描述，请参见作者说明。
Background: This study was designed to investigate the prevalence of osteoarthritis in the carpometacarpal joint of the thumb in adults thirty years of age or older in Finland.Methods: Between 1978 and 1980, a representative population sample of 8000 Finns thirty years of age or older were invited to have a comprehensive health examination; 90% accepted. Hand radiographs were made of 3595 subjects. Since the examination, the subjects have been followed systematically to assess work disability and mortality by reviewing registers covering the whole population.Results: The age-adjusted prevalence of thumb carpometacarpal osteoarthritis of Kellgren grade 2, 3, or 4 was 7% for men and 15% for women. After adjustment for age, sex, and other alleged risk factors, body mass index was found to be directly proportional to the prevalence of thumb carpometacarpal osteoarthritis in both sexes. The adjusted odds ratio was 1.29 (95% confidence interval, 1.15 to 1.43) per 5-kg/m(2) increment in body mass index. No significant association was found between the physical workload history and thumb carpometacarpal osteoarthritis. Restricted mobility of the thumb and local tenderness and swelling were frequently found in conjunction with radiographic evidence of thumb carpometacarpal osteoarthritis. Advanced (grade-3 or 4) thumb carpometacarpal osteoarthritis predicted the total mortality rate in men (adjusted relative risk, 1.32; 95% confidence interval, 1.03 to 1.69). Radiographic signs of thumb carpometacarpal osteoarthritis did not predict work disability.Conclusions and Clinical Relevance: Obesity is a strong determinant of thumb carpometacarpal osteoarthritis in both sexes. The effect of thumb carpometacarpal osteoarthritis on disability and mortality in the general population is modest. Because of the rarity of ensuing disability, carpometacarpal osteoarthritis of the thumb is likely to be underdiagnosed in clinical practice.Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.