Are Bone Mineral Density and Fractures Related to the Incidence and Progression of Radiographic Osteoarthritis of the Knee, Hip, and Hand in Elderly Men and Women? The Rotterdam Study
Are Bone Mineral Density and Fractures Related to the Incidence and Progression of Radiographic Osteoarthritis of the Knee, Hip, and Hand in Elderly Men and Women? The Rotterdam Study
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DOI：
10.1002/art.40735
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发表时间：
2019-03-01
影响因子：
13.3
通讯作者：
van Meurs, Joyce B. J.
中科院分区：
文献类型：
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作者：
Bergink, Arjan P.;Rivadeneira, Fernando;van Meurs, Joyce B. J.
目的探讨骨密度（BMD）与膝、髋、手骨关节炎（OA）发病率和进展之间的纵向关系，并探讨鹿特丹研究中老年男性和女性中普遍存在的椎骨和非椎骨骨折与OA发病率和进展之间的关系。方法对4,154名受试者的股骨颈BMD数据进行年龄和性别四分位数分析。X线片对膝关节和髋关节OA的发生率和进展以及手部OA的发生率进行评分。采用McCloskey/Kanis方法对椎体骨折的发生率进行评分，通过基线访谈报告非椎体骨折的发生率。结果与最低四分位数相比，股骨颈BMD最高四分位数的受试者发生放射学膝关节OA（罗阿）的风险增加（比值比[OR] 1.58 [95%可信区间（95%CI）1.14-2.18]），发生髋关节罗阿的风险增加（OR 1.57 [95%CI 1.06-2.32]）。高股骨颈BMD与膝、髋关节罗阿的进展及手部罗阿的发生率之间无明显关系。普遍的椎骨和非椎骨骨折与膝关节或髋关节罗阿的发生率增加或进展无关。然而，椎骨骨折与手部罗阿事件相关（OR 1.74 [95% CI 1.02-2.98]）。结论本研究的结果证实了早期的研究结果，从而提供了强有力的证据表明，高股骨颈BMD是膝关节和髋关节罗阿发展的预后危险因素。发现椎骨骨折是手部罗阿事件的风险因素。
Objective To examine the longitudinal relationship between bone mineral density (BMD) and the incidence and progression of knee, hip, and hand osteoarthritis (OA), and to examine the relationship between prevalent vertebral and nonvertebral fractures and the incidence and progression of OA in elderly men and women in the Rotterdam Study. Methods Age- and sex-specific quartiles of baseline femoral neck BMD data were constructed for 4,154 subjects. Radiographs were scored for incidence and progression of knee and hip OA, and for incidence of hand OA. Prevalent vertebral fractures were scored using the McCloskey/Kanis method, and prevalent nonvertebral fractures were reported by baseline interview. Results Subjects in the highest quartile of femoral neck BMD had an increased risk of incident radiographic knee OA (ROA) (odds ratio [OR] 1.58 [95% confidence interval (95% CI) 1.14-2.18]), and an increased risk of incident hip ROA (OR 1.57 [95% CI 1.06-2.32]), compared to the lowest quartile. No significant relationship was found between high femoral neck BMD and progression of knee or hip ROA or the incidence of hand ROA. Prevalent vertebral and nonvertebral fractures were not related to an increase in the incidence or progression of knee or hip ROA. However, vertebral fractures were associated with incident hand ROA (OR 1.74 [95% CI 1.02-2.98]). ConclusionResults from the present study confirm earlier findings and thus provide strong evidence that high femoral neck BMD is a prognostic risk factor for the development of knee and hip ROA. Vertebral fractures were found to be a risk factor for incident hand ROA.