The relationship between smoking and knee osteoarthritis in the Osteoarthritis Initiative.
The relationship between smoking and knee osteoarthritis in the Osteoarthritis Initiative.
复制标题
骨关节炎倡议中吸烟与膝关节骨关节炎之间的关系。
DOI：
10.1016/j.joca.2015.09.015
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发表时间：
2016-03
影响因子：
7
通讯作者：
Lapane KL
中科院分区：
文献类型：
--
作者：
Dubé CE;Liu SH;Driban JB;McAlindon TE;Eaton CB;Lapane KL
评估经影像学证实的膝关节OA患者中吸烟史与症状和疾病进展的相关程度。横断面（基线）和纵向研究均采用来自骨关节炎倡议的数据（n= 2，250名参与者）。在基线时评估了44%的当前或既往吸烟者的吸烟史。使用西安大略和麦克马斯特大学关节炎指数（WOMAC）测量膝关节疼痛、僵硬和身体功能。使用关节间隙宽度（JSW）测量疾病进展。我们使用调整后的多变量线性模型来检查吸烟状态与暴露（PY）与基线症状和JSW之间的关系。进一步评估症状和JSW随时间的变化。在横断面分析中，与从不吸烟者相比，高PY（≥15 PY）与疼痛（β 0.36，95% CI：0.01-0.71）和僵硬（β 0.20，95% CI：0.03-0.37）略大相关;低PY（<15 PY）与JSW更好相关（β 0.15，95% CI：0.02-0.28）。与从不吸烟者相比，目前吸烟与更大的疼痛相关（β 0.59，95% CI：0.04-1.15）。这些关联在纵向研究中未得到证实。纵向上，高或低PY或基线吸烟状态与症状（72个月时）或JSW（48个月时）的变化之间没有相关性。横断面结果可能是由于残留混杂。更强有力的纵向分析发现，吸烟状况与症状或JSW之间没有关联。长期吸烟对膝关节骨性关节炎患者没有任何益处，同时使他们暴露于其他有据可查的严重健康风险。
To estimate the extent that smoking history is associated with symptoms and disease progression among individuals with radiographically confirmed knee OA. Both cross-sectional (baseline) and longitudinal studies employed data from the Osteoarthritis Initiative (n= 2,250 participants). Smoking history was assessed at baseline with 44% current or former smokers. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to measure knee pain, stiffness, and physical function. Disease progression was measured using joint space width (JSW). We used adjusted multivariable linear models to examine the relationship between smoking status and exposure in pack years (PY) with symptoms and JSW at baseline. Changes in symptoms and JSW over time were further assessed. In cross-sectional analyses, compared to never-smokers high PY (≥15 PY) was associated with slightly greater pain (beta 0.36, 95% CI: 0.01–0.71) and stiffness (beta 0.20, 95% CI: 0.03–0.37); and low PY (<15 PY) was associated with better JSW (beta 0.15, 95% CI: 0.02–0.28). Current smoking was associated with greater pain (beta 0.59, 95% CI: 0.04–1.15) compared to never-smokers. These associations were not confirmed in the longitudinal study. Longitudinally, no associations were found between high or low PY or baseline smoking status with changes in symptoms (at 72 months) or JSW (at 48 months). Cross-sectional findings are likely due residual confounding. The more robust longitudinal analysis found no associations between smoking status and symptoms or JSW. Long-term smoking provides no benefits to knee OA patients while exposing them to other well-documented serious health risks.