Racial and Ethnic Differences in Older Adults With Knee Osteoarthritis
Racial and Ethnic Differences in Older Adults With Knee Osteoarthritis
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DOI：
10.1002/art.38620
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发表时间：
2014-07-01
影响因子：
13.3
通讯作者：
Fillingim, Roger B.
中科院分区：
文献类型：
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作者：
Cruz-Almeida, Yenisel;Sibille, Kimberly T.;Fillingim, Roger B.
Objective.膝关节骨关节炎（OA）对老年人的残疾有很大影响，少数种族/民族受到的影响不成比例。本研究旨在描述老年非裔美国人（AA）和非西班牙裔白色（NHW）膝关节OA受试者的临床和实验性疼痛（包括疼痛抑制）的差异。AA和NHW膝关节OA受试者（n = 267）完成了临床和功能性疼痛评估，包括定量感觉测试（QST）。我们假设，当与NHW受试者相比时，AA受试者将显示1）较低的疼痛耐受性和较高的热、机械和冷诱导疼痛评分，2）更大的疼痛时间总和，3）疼痛抑制降低，和4）更大的临床疼痛和更差的功能。此外，我们假设QST的结果将显着预测临床疼痛的严重程度在每个种族/ethnicity.Results.与膝关节OA的NHW受试者相比，膝关节OA的AA受试者表现出疼痛敏感性增加、时间总和增加和疼痛抑制减少。此外，AA受试者报告了更大的临床疼痛和更差的功能。当分析控制了教育和年收入时，临床疼痛的种族/民族差异变得不显著，而QST结果的差异仍然非常显著。尽管疼痛抑制程度可以预测两组临床疼痛的严重程度，但不同的QST测量值还可以预测各组内的临床疼痛。结论。本研究的结果表明，老年膝关节骨性关节炎患者在实验和临床疼痛和功能方面存在种族/民族差异。我们的研究结果表明，不同的QST措施与2个种族/民族的临床疼痛，而减少疼痛抑制是重要的，在所有的参与者，值得进一步研究，以阐明共同的和组特异性的病理生理机制，有助于临床疼痛的OA。
Objective. Knee osteoarthritis (OA) contributes significantly to disability in older individuals, and racial/ethnic minorities are disproportionately affected. The present study aimed to characterize differences in clinical and experimental pain, including pain inhibition, among older African American (AA) and non-Hispanic white (NHW) subjects with knee OA.Methods. AA and NHW subjects with knee OA (n = 267) completed clinical and functional pain assessments, including quantitative sensory testing (QST). We hypothesized that, when compared to NHW subjects, AA subjects would display 1) lower pain tolerance and higher ratings of heat-, mechanical-, and cold-induced pain, 2) greater temporal summation of pain, 3) reduced pain inhibition, and 4) greater clinical pain and poorer function. In addition, we hypothesized that the findings from QST would significantly predict the severity of clinical pain within each race/ethnicity.Results. AA subjects with knee OA displayed increased pain sensitivity, greater temporal summation, and reduced pain inhibition when compared to NHW subjects with knee OA. Moreover, AA subjects reported greater clinical pain and poorer function. Racial/ethnic differences in clinical pain became nonsignificant when the analyses were controlled for education and annual income, whereas differences in QST findings remained highly significant. Although the extent of pain inhibition predicted the severity of clinical pain in both groups, different QST measures were additionally predictive of clinical pain within each group.Conclusion. The results of this study establish that there are racial/ethnic differences in experimental and clinical pain and function in older individuals with knee OA. Our findings indicating that different QST measures were associated with clinical pain within the 2 racial/ethnic groups, whereas reduced pain inhibition was important in all participants, warrant further study in order to elucidate the common and group-specific pathophysiologic mechanisms contributing to clinical pain in OA.