Cross-Sectional and Longitudinal Associations of Comorbidities with Knee Symptoms and Radiographic Abnormalities of Osteoarthritis.

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2024-02-01 Epub Date: 2023-11-18 DOI:10.1007/s40744-023-00625-2

Xiaoxi Li, Feng Pan, Rui Zhu, Liru Ge, Xiaoyue Zhang, Xiangrui Wen, Jiantao Zhou, Jiale Cheng, Faming Pan, Guoqi Cai

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Abstract

Introduction: This study aimed to investigate the associations of comorbidities with knee symptoms and radiographic abnormalities of osteoarthritis (OA).

Methods: Participants were from the Osteoarthritis Initiative. Comorbidities were identified at baseline using the modified Charlson Comorbidity Index. For both knees, symptoms were assessed annually from baseline to 48 months using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores (rescaled range 0-100), and radiographic abnormalities using the Kellgren-Lawrence (KL, 0-4) grades. The presence of significant pain and functional disability was defined as a WOMAC score of ≥ 25 and ≥ 22, respectively, and radiographic OA (ROA) as KL ≥ 2. An increase of ≥ 9 in WOMAC scores and ≥ 1 in KL grades were defined as symptomatic and radiographic progression, respectively.

Results: Of 3337 participants, 28% and 9% had one and ≥ 2 comorbidities, respectively. The number of comorbidities was associated with the presence of significant functional disability (odds ratios [ORs] 1.15; 1.46) and predicted the progression of both knee pain and functional disability (ORs 1.11; 1.51). For the type of comorbidities, non-OA musculoskeletal diseases were associated with the presence of ROA and significant functional disability (ORs 1.63; 1.82) and showed a trend to predict incident ROA (OR 1.84, 95% confidence interval 1.00-3.38 p = 0.051). Diabetes and kidney diseases were associated with symptomatic progression of OA (ORs 1.38; 2.72).

Conclusions: Having more comorbidities, especially diabetes and kidney diseases, is associated with symptomatic progression of knee OA. Moreover, non-OA musculoskeletal diseases may be associated with the presence and onset of ROA.

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骨关节炎共病与膝关节症状和影像学异常的横断面和纵向关联。

本研究旨在探讨骨关节炎(OA)的膝关节症状和影像学异常的合并症的相关性。方法:参与者来自骨关节炎倡议。在基线时使用改良的Charlson合并症指数确定合并症。对于双膝，从基线到48个月，每年使用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛和功能评分(重新调整范围0-100)评估症状，并使用kellgreen - lawrence (KL, 0-4)分级评估影像学异常。存在明显疼痛和功能障碍的定义为WOMAC评分分别≥25和≥22，放射学OA (ROA)为KL≥2。WOMAC评分≥9分和KL评分≥1分分别被定义为症状进展和影像学进展。结果:在3337名参与者中，28%和9%分别有一种和≥2种合并症。合并症的数量与显著功能障碍的存在相关(优势比[or] 1.15;1.46)并预测膝关节疼痛和功能障碍的进展(or 1.11;1.51)。对于合并症的类型，非oa肌肉骨骼疾病与ROA的存在和显著的功能残疾相关(or为1.63;1.82)，并有趋势预测事件ROA (OR 1.84, 95%可信区间1.00-3.38 p = 0.051)。糖尿病和肾脏疾病与OA症状进展相关(or 1.38;2.72)。结论:有更多的合并症，尤其是糖尿病和肾脏疾病，与膝关节炎的症状进展有关。此外，非骨性关节炎肌肉骨骼疾病可能与骨性关节炎的存在和发病有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. 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