Racial differences in self-reported pain and function among individuals with radiographic hip and knee osteoarthritis: the Johnston County Osteoarthritis Project
Racial differences in self-reported pain and function among individuals with radiographic hip and knee osteoarthritis: the Johnston County Osteoarthritis Project
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DOI：
10.1016/j.joca.2009.03.003
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发表时间：
2009-09-01
影响因子：
7
通讯作者：
Jordan, J. M.
中科院分区：
文献类型：
--
作者：
Allen, K. D.;Helmick, C. G.;Jordan, J. M.
目的：本研究比较了疼痛和功能的非裔美国人和白人与放射学髋关节和/或膝关节骨关节炎（OA），控制放射学的严重程度和其他patient characteristics.Methods：参与者是1368人（32%非洲裔美国人）从约翰斯顿县骨关节炎项目，只有膝关节OA，只有髋关节OA，膝关节和髋关节OA。线性回归模型检查了西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）总评分和疼痛与功能分量表的种族差异，调整了放射学严重程度、年龄、性别、教育、体重指数（BMI）、抑郁症状和WOMAC疼痛（函数模型中的最后一个变量）。在仅有膝关节OA的患者中，非裔美国人的平均WOMAC总分显著低于白人（32.8 vs24.3，P <0.001），疼痛和功能评分更差（P <0.001）。当控制影像学严重程度和人口统计学因素时，WOMAC总分、疼痛和功能评分的种族差异持续存在，但当控制BMI和抑郁症状时，差异不显著。在WOMAC功能模型中，疼痛是最强相关的变量，并显著降低了种族与功能的相关性。只有髋关节OA或膝关节和髋关节OA之间的WOMAC评分没有种族差异。结论：在膝关节OA的参与者中，种族差异的疼痛和功能可以解释BMI和抑郁症状，种族差异的功能也可能在很大程度上受到疼痛的影响。改善体重和抑郁症状的管理可能是减少膝关节OA症状种族差异的关键步骤。由Elsevier Ltd代表国际骨关节炎研究协会出版。
Objective: This study compared pain and function among African Americans and Caucasian with radiographic hip and/or knee osteoarthritis (OA), controlling for radiographic severity and other patient characteristics.Methods: Participants were 1368 individuals (32% African American) from the Johnston County Osteoarthritis Project with only knee OA, only hip OA, and both knee and hip OA. Linear regression models examined racial differences in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores and pain and function subscales, adjusting for radiographic severity, age, gender, education, body mass index (BMI), depressive symptoms, and WOMAC pain (last variable in models of function).Results: Among those with only knee OA, African Americans had significantly worse mean WOMAC total scores than Caucasian (32.8 vs 24.3, P< 0.001), and worse pain and function scores (P < 0.001). Racial differences in WOMAC total, pain, and function scores persisted when controlling for radiographic severity and demographic factors but were not significant when also controlling for BMI and depressive symptoms. In models of WOMAC function, pain was the most strongly associated variable and substantially reduced the association of race with function. There were no racial differences in WOMAC scores among those with only hip OA or with both knee and hip OA.Conclusion: Among participants with knee OA, racial differences in pain and function may be explained by BMI and depressive symptoms, and racial differences in function may also be largely influenced by pain. Improving management of weight and depressive symptoms may be key steps toward reducing racial disparities in knee OA symptoms. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.