Statin use and clinical osteoarthritis in the general population: a longitudinal study.
Statin use and clinical osteoarthritis in the general population: a longitudinal study.
复制标题
DOI：
10.1007/s11606-013-2382-8
复制
发表时间：
2013-07
影响因子：
5.7
通讯作者：
Belcher, J.
中科院分区：
文献类型：
--
作者：
Kadam, U. T.;Blagojevic, M.;Belcher, J.
有一种假说认为，脂代谢异常是否可能是骨关节炎（OA）发病机制中的一个致病因素。他汀类药物在临床实践中的常规使用为检验这一假设的自然实验提供了基础。检验他汀类药物降低临床定义的OA长期发生率的假设。队列设计，随访10年。来自英国全科医学研究数据库的16，609例年龄在40岁及以上的成人心血管疾病队列，数据截至2006年12月31日。他汀类药物总结为两年时间段内的年平均日剂量和剂量变化。采用考克斯和离散时间生存分析，评估2年内、4年和10年随访期内临床定义的骨关节炎的发病情况。协变量包括年龄、性别、剥夺、体重指数、胆固醇水平、疼痛缓解药物联合治疗以及心血管疾病的持续时间和严重程度。在随访期间，与非他汀类药物使用者相比，更高治疗剂量的他汀类药物，治疗持续时间至少为2年，与临床OA显著减少相关。估计的校正率比如下：最低他汀类药物剂量四分位数1：2.5（95% CI 2.3，2.9）;四分位数2：1.3（1.1，1.5）;四分位数3：0.8（0.7，0.95）;最高他汀类药物剂量四分位数4：0.4（0.3，0.5）。与非他汀类药物使用者相比，最大他汀类药物剂量增量与2年内OA结局的显著降低相关，估计为18%，4年后为40%。这项来自国家临床实践环境的纵向研究提供了证据，证明较高的他汀类药物剂量和较大的他汀类药物剂量增量与临床定义的OA结局降低相关。
One hypothesis has posited whether abnormal lipid metabolism might be a causal factor in the pathogenesis of osteoarthritis (OA). Routine statin use in clinical practice provides the basis for a natural experiment in testing this hypothesis. To test the hypothesis that statins reduce the long-term occurrence of clinically defined OA. Cohort design with a 10-year follow-up. 16,609 adults cardiovascular disease cohorts aged 40 years and over from the UK General Practice Research Database with data available to 31 December 2006. Statins were summarised as annual mean daily dose and dose change over two-year time periods. Incident episode of clinically defined osteoarthritis was assessed within 2 years, and at 4-year and 10-year follow-up time periods, using Cox and discrete time survival analysis. Covariates included age, gender, deprivation, body mass index, cholesterol level, pain-modifying drug co-therapies, and duration and severity of cardiovascular disease. Higher therapeutic dose of statin, with a treatment duration of at least 2 years was associated with a significant reduction in clinical OA compared to non-statin users in the follow-up time period. The estimated adjusted rate ratios were as follows: lowest statin dose quartile 1: 2.5 (95 % CI 2.3, 2.9); quartile 2: 1.3 (1.1, 1.5); quartile 3: 0.8 (0.7, 0.95); and highest statin dose quartile 4: 0.4 (0.3, 0.5). The largest statin dose increments were associated with significant reductions estimated at 18 % in OA outcome within 2 years and 40 % after 4 years, compared to non-statin users. This longitudinal study from a national clinical practice setting provides evidence that higher statin dose and larger statin dose increments were associated with a reduction in clinically defined OA outcome.
登录
查看更多内容
影响因子：
27.4
作者：
Clockaerts, S.;Van Osch, G. J. V. M.;Bierma-Zeinstra, S. M.
通讯作者：
Bierma-Zeinstra, S. M.
影响因子：
3.4
作者：
Herrett, Emily;Thomas, Sara L.;Hall, Andrew J.
通讯作者：
Hall, Andrew J.
影响因子：
3
作者：
Bavry, Anthony A.;Mood, Girish R.;Bhatt, Deepak L.
通讯作者：
Bhatt, Deepak L.
影响因子：
6.2
作者：
Diascro, DD;Vogel, RL;Schmidt, A
通讯作者：
Schmidt, A
DOI：
10.1097/01.blo.0000144854.66565.8f
发表时间：
2004-10-01
影响因子：
4.2
作者：
Goldring, SR;Goldring, MB
通讯作者：
Goldring, MB