Osteoarthrosis of the knee in men and women in association with overweight, smoking, and hormone therapy
Osteoarthrosis of the knee in men and women in association with overweight, smoking, and hormone therapy
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DOI：
10.1136/ard.58.3.151
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发表时间：
1999-03-01
影响因子：
27.4
通讯作者：
Vingård, E
中科院分区：
文献类型：
--
作者：
Sandmark, H;Hogstedt, C;Vingård, E
目的：研究膝关节骨关节病导致假体手术的男性和女性与超重、吸烟和激素治疗之间的关系。方法：采用病例对照研究，研究对象为1921-1938年出生于瑞典14个县的所有男性和女性。这些病例(n=625)是通过瑞典膝关节置换术登记簿确定的。参照对象(n=548)是通过中央人口登记中心从同一县随机抽取的。通过电话采访和邮寄问卷收集了关于一般健康状况、身高、体重、吸烟习惯、药物使用、激素使用、职业和家务的特定体力负荷以及体育活动的详细信息。结果：40岁体重指数(BMI)高的女性晚年患严重膝关节骨关节病的相对风险为9.2(95%CI 5.3，16.0)，而同龄男性的相对风险为3.9(95%CI 2.3，6.4)。与不吸烟者相比，吸烟者患严重膝关节骨关节病的可能性较小。50岁以上女性接受雌激素治疗的相对风险增加1.8(95%可信区间1.2，2.6)，而口服避孕药的使用不影响风险。结论超重是导致男性和女性膝关节骨关节病假体手术的危险因素，其中女性的相关性最强。50岁后接受雌激素治疗会增加相对风险，而吸烟则会降低相对风险。
Objectives-The aim was to examine the relation between osteoarthrosis of the knee leading to prosthetic surgery among men and women and overweight, smoking, and hormone therapy.Methods-A case-referent study was performed with a study base of all men and women, born 1921-1938, living in 14 counties in Sweden during 1991-95. The cases (n=625) were identified through the Swedish Knee Arthroplasty Register. The referents (n=548) were randomly selected through the central population register from the same counties. Detailed information on general health status, height, weight, smoking habits, medication, use of hormones, specific physical loads from occupation and housework, and sports activities was collected by a telephone interview and a postal questionnaire. The cases were classified in terms of high, medium or low/non-exposure to the factors studied, according to the distribution of variables among the referents.Results-Women with high body mass index (BMI) at the age of 40 had a relative risk of 9.2 (95%CI 5.3, 16.0) of developing severe knee osteoarthrosis later in life, and for men at the same age the relative risk was 3.9 (95%CI 2.3, 6.4). Smokers were less likely to develop severe knee osteoarthrosis compared with nonsmokers. Oestrogen therapy for women over 50 showed an increased relative risk of 1.8 (95%CI 1.2, 2.6), while use of oral contraceptives did not influence the risk.Conclusion-Overweight is a risk factor for knee osteoarthrosis leading to prosthetic surgery in men and women, with the strongest relation for women. Oestrogen therapy after 50 increased the relative risk, while smoking decreased it.