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Liu T, Xu C, Driban JB, McAlindon T, Eaton CB, Lu B. Excessive alcohol consumption and the risk of knee osteoarthritis: a prospective study from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2022; 30:697-701. [PMID: 35150844 PMCID: PMC9038654 DOI: 10.1016/j.joca.2022.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the association of alcohol consumption with risk of incident knee osteoarthritis (OA) in a large prospective cohort study. DESIGN In the Osteoarthritis Initiative, 2,846 participants aged 45-79 years and free from radiographic knee OA in at least one knee at baseline were followed up to 96 months. Information on baseline alcohol consumption was obtained from the Block Brief Food Frequency Questionnaire. Incident cases of radiographic knee OA (ROA) were defined as Kellgren-Lawrence grade changing from zero or one to ≥ two during the follow-up time. Incident symptomatic OA (SxOA) was defined as ROA with knee pain worsening. The Cox proportional hazards models were used to assess the independent association between alcohol consumption and risk of knee. RESULTS During 96 months' follow-up, we identified 691 knees with incident ROA, and 496 knees with incident SxOA among 2,846 subjects. Compared to non-drinkers, excessive alcohol consumption was significantly associated with increased risk of ROA (HR ≥ 30 g/d vs none = 1.93, 95% CI: 1.28-2.89) and SxOA (HR ≥ 30 g/d vs none = 1.61, 95% CI: 1.04-2.48). Similar association was observed for liquor consumption (HR liquor≥15 g/d vs none = 1.71, 95% CI: 1.16-2.52 for ROA; HR liquor≥15 g/d vs none = 1.59, 95% CI: 1.04-2.39 for SxOA). Light to moderate alcohol consumption was not associated with knee OA risk. CONCLUSION Our results suggest that excessive alcohol drinking was associated with an increased risk of knee OA. Further studies are needed in other populations.
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Affiliation(s)
- Tong Liu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Chang Xu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA,Rutgers University, School of Public Health, Department of Biostatistics and Epidemiology, New Brunswick, NJ
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Timothy McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Charles B. Eaton
- Brown University Center for Primary Care and Prevention, Pawtucket, RI,Departments of Family Medicine and Epidemiology, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Bing Lu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA,Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
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Fang KH, Lai CH, Hsu CM, Huang E, Tsai MS, Chang GH, Lee YC, Tsai YT. A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma. PeerJ 2020; 8:e9361. [PMID: 32587804 PMCID: PMC7304427 DOI: 10.7717/peerj.9361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/25/2020] [Indexed: 12/18/2022] Open
Abstract
Background Although the C-reactive protein-to-albumin ratio (CAR) can predict poor outcomes in assorted cancers, its prognostic value in oral cavity squamous cell carcinoma (OSCC) remains unclear. We explored the value of preoperative CAR in predicting clinical outcomes in OSCC patients treated with radical surgery. Methods All the recommended cutoff values were defined analyzing receiver operating characteristic curves or overall survival (OS). Dichotomization was performed on the basis of optimal CAR cutoff, and we compared the clinicopathological features between groups. Kaplan-Meier analysis was also performed to compare OS curves between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to find the clinical characteristics that were most closely correlated with disease free survival (DFS) and overall survival (OS). A nomogram incorporated CAR and several clinicopathological factors was established to predict prognosis and its accuracy was evaluated using concordance index (c-index). Results In this retrospective study, a total of 326 patients with newly diagnosis of OSCC and received primary surgery between 2008 and 2017 were enrolled. Through the executed ROC curve analyses, the optimal CAR cutoff derived was 0.195 (area under the curve = 0.718, p < 0.001), with this cutoff exhibiting a discrimination ability superior to that of other inflammation-based prognostic scores after comparing the area under curves. Multivariate analysis demonstrated that CAR (≥0.195/<0.195) was associated with OS (hazard ratio 3.614; 95% CI [1.629-8.018]; p = 0.002) and DFS (hazard ratio 1.917; 95% CI [1.051-3.863]; p = 0.029). Kaplan-Meier analysis and log rank test revealed a significant difference in DFS and OS curves between patients with low CAR (<0.195) and those with high CAR (≥0.195; both p < 0.001). The c-index of the nomogram based on TNM system alone was 0.684 and could be increased to 0.801 if CAR and other clinicopathological factors were included. Conclusions Preoperative CAR could constitute an independent prognostic indicator for OS and DFS prediction in OSCC patients treated with curative surgery. The established nomogram that incorporated CAR and prognostic factors might increase the accuracy of prognostic prediction for patients with OSCC.
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Affiliation(s)
- Ku-Hao Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ethan Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
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Kang AH, Kim MR, Shin JS, Lee J, Lee YJ, Park Y, Nam D, Kim EJ, Ha IH. Association between alcohol consumption and osteoarthritis prevalence in Korea as assessed by the alcohol use disorders identification test (AUDIT): a cross-sectional study. BMC Public Health 2020; 20:227. [PMID: 32054481 PMCID: PMC7020542 DOI: 10.1186/s12889-020-8326-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/05/2020] [Indexed: 12/11/2022] Open
Abstract
Background Osteoarthritis (OA) holds significance as a highly prevalent disorder in elderly populations. Various studies have been conducted on the association between alcohol consumption and OA, but the results have often been conflicting. The aim of this study was to investigate the relationship between alcohol consumption and OA in a large-scale sample representative of the Korean population. Methods Among the 25,534 participants surveyed in the fifth Korean National Health and Nutrition Examination Survey (2010–2012), 7165 individuals aged ≥50 who responded to drinking-related items were analyzed. The Alcohol Use Disorders Identification Test (AUDIT) grade was calculated, and radiologic examination analysis included the Kellgren-Lawrence (KL) grade of the lumbar spine, hip, and knee joints. Logistic regression analysis was performed to evaluate the association between AUDIT grades and OA through estimation of odds ratios (ORs). Results In crude analyses, OA (KL grade ≥ 2) of the lumbar spine and knee was more prevalent towards Zone I, but following adjustment, knee OA prevalence significantly increased in Zone III and IV compared to Zone I (Zone III: OR 1.464, 95% confidence interval (CI) 1.027–2.088; Zone IV: OR 1.543, 95% CI 1.028–2.317, respectively). Meanwhile, adjusted hip and lumbar OA values showed positive associations towards Zone IV, but did not reach statistical significance. Additional analyses of the association between alcohol consumption and pain severity of knee OA patients were nonsignificant. Conclusions These results imply that radiological knee OA, rather than symptomatic knee OA, is associated with alcohol consumption.
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Affiliation(s)
- Ah Hyun Kang
- Incheon Jaseng Hospital of Korean Medicine, Incheon, Republic of Korea
| | - Me-Riong Kim
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yeoncheol Park
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
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Ito A, Hayashi K, Suzuki S, Ideno Y, Kurabayashi T, Ogata T, Seichi A, Akai M, Iwaya T. Association of trajectory of body mass index with knee pain risk in Japanese middle-aged women in a prospective cohort study: the Japan Nurses' Health Study. BMJ Open 2020; 10:e033853. [PMID: 32034025 PMCID: PMC7045261 DOI: 10.1136/bmjopen-2019-033853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 12/27/2019] [Accepted: 01/09/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To investigate whether body mass index (BMI) trajectory, lifestyle and reproductive factors are associated with knee pain risk among middle-aged women. DESIGN Prospective study of the Japan Nurses' Health Study (JNHS). SETTING The JNHS investigates the health of female nurses in Japan. Biennial follow-up questionnaires are mailed to the participants. PARTICIPANTS The 7434 women aged over 40 years who responded to the 10-year self-administered follow-up questionnaire. PRIMARY OUTCOME MEASURE Self-reported knee pain at the 10-year follow-up was the primary outcome. We analysed BMI (normal or overweight) trajectory data from a baseline survey to the 10-year follow-up survey using group-based trajectory modelling. Exposure measurements were BMI trajectory, BMI at age 18 years, lifestyle variables and reproductive history. RESULTS BMI trajectories from baseline to the 10-year follow-up were divided into four groups: remained normal, remained overweight, gained weight or lost weight. At the 10-year follow-up, 1281 women (17.2%) reported knee pain. Multivariable logistic regression analysis revealed that compared with the remained normal group, multivariable-adjusted ORs (95% CI) of knee pain were 1.93 (1.60 to 2.33) for the remained overweight group, 1.60 (1.23 to 2.08) for the gained weight group and 1.40 (0.88 to 2.21) for the lost weight group. The attributable risk percent (95% CI) of the remained overweight group was 48.1% (37.3% to 57.0%) compared with the reference group of remained normal. Alcohol intake at baseline was significantly associated with knee pain. CONCLUSIONS The lost weight group had a lower risk than the remained overweight group and the gained weight group and did not carry statistically significant risks for knee pain. Weight reduction and maintaining a normal BMI in middle age was important for preventing knee pain in women.
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Affiliation(s)
- Ayumi Ito
- Unit of International and Community Health Sciences, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Kunihiko Hayashi
- Unit of International and Community Health Sciences, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Shosuke Suzuki
- Faculty of Medicine, Gunma University, Maebashi, Japan
- Eco-Health Research Group, Isesaki, Japan
| | - Yuki Ideno
- Center for Mathematics and Data Science, Gunma University, Maebashi, Japan
| | - Takumi Kurabayashi
- Department of Obstetrics & Gynecology, Niigata City General Hospital, Niigata, Japan
| | - Toru Ogata
- Center for Sport Science and Health Promotion, Department of Rehabilitaion for the Movement Functions, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Atsushi Seichi
- Department of Orthopaedic Surgery, Mitsui Memorial Hospital, Chiyoda-ku, Japan
| | - Masami Akai
- Graduate School, International University of Health and Welfare Kohokai Group, Minato-ku, Japan
| | - Tsutomu Iwaya
- Nagano University of Health and Medicine, Nagano, Japan
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Wang C, Luo L, Tian F, An N, Zhang Y, Hao R, Li D, Zhou Z, Xiao P, Guo L. Effects of receptor activator nuclear factor κB gene polymorphisms on the susceptibility to knee osteoarthritis: A case-control study. Medicine (Baltimore) 2019; 98:e14933. [PMID: 30921190 PMCID: PMC6456093 DOI: 10.1097/md.0000000000014933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 01/16/2019] [Accepted: 02/28/2019] [Indexed: 02/07/2023] Open
Abstract
The present study aimed to explore genetic association of receptor activator nuclear factor κB (RANK) polymorphisms with individual susceptibility to knee osteoarthritis (OA) in different Kellgren-Lawrence (KL) grades.This case-control study included 138 knee OA patients and 145 healthy individuals. RANK rs1805034 and rs8086340 polymorphisms were genotyped through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The effects of RANK polymorphisms on knee OA risk were analyzed via χ test or Fisher exact test, and the results were expressed using odds ratios (ORs) with corresponding 95% confidence intervals (CIs).The C allele of rs1805034 polymorphism had significantly higher frequency in knee OA patients than in controls (P = .044), indicating that this allele could increase the risk of knee OA (OR = 1.424, 95% CI = 1.010-2.008). Besides, the CC genotype and C allele of the rs1805034 polymorphism were significantly associated with elevated risk of knee OA in moderate grade (CC vs TT: P = .018, OR = 3.071, 95% CI = 1.187-7.941; C vs T: P = .012, OR = 1.787, 95% CI = 1.131-2.823). However, rs8086340 polymorphism had no significant association with knee OA riskThe C allele of RANK rs1805034 polymorphism is closely correlated with increased risk of knee OA, especially for moderate grade.
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Affiliation(s)
| | - Li Luo
- Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | | | - Ning An
- Department II of Orthopedics
| | | | | | | | | | | | - Lin Guo
- Department II of Orthopedics
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Prevalence of osteoarthritis and association between smoking patterns and osteoarthritis in China: a cross-sectional study. FRONTIERS OF NURSING 2018. [DOI: 10.2478/fon-2018-0015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Abstract
Objective
The aims of this study were to estimate the prevalence of radiographic osteoarthritis (OA) and to assess the association between smoking patterns and OA prevalence in adults aged 50 years or older belonging to the Shanxi province of China.
Methods
A cross-sectional study in the rural regions of the Shanxi province was conducted among 2638 Chinese adults (aged ≥50 years). Demographic characteristics and behavioral information were collected through epidemiological surveys. All participants with joint pain underwent plain radiographic examination and were diagnosed by a professional orthopedist. Associations between smoking patterns and the prevalence of OA were assessed using binary logistic regression modeling.
Results
Among 2638 individuals (men, 50.3% and women, 49.7%; mean age, 61.5 years) included in the analysis, 49.8% had radiographic OA and 27.5% had knee OA. The prevalence of radiographic OA was higher in women than in men (P<0.001). After adjusting for potential confounding factors, there was a nonsignificant correlation between smoking and OA prevalence in the multivariate model. Odds ratios (ORs) for all types of OA and knee OA were higher in active and passive smokers than in nonsmoking individuals after adjustments (OR 1.374; 95% confidence interval [CI] 1.049–1.802; OR 1.440; 95% CI 1.059–1.958, respectively).
Conclusions
This study showed that smoking may not be an independent risk factor for OA; however, there was a positive correlation between active and passive smoking and OA.
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Meta-analysis of serum C-reactive protein and cartilage oligomeric matrix protein levels as biomarkers for clinical knee osteoarthritis. BMC Musculoskelet Disord 2018; 19:22. [PMID: 29351749 PMCID: PMC5775565 DOI: 10.1186/s12891-018-1932-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 01/10/2018] [Indexed: 12/26/2022] Open
Abstract
Background The roles of C-reactive protein (CRP) and cartilage oligomeric matrix protein (COMP) in knee osteoarthritis (KOA) remain controversial, thus the present study is aimed to explore the relationships between CRP, COMP, and the incidence/progression of KOA. Methods A systematic search was conducted on PubMed and Embase until September, 2016 for all the relevant studies. The pooled mean difference (MD) with its 95% confidence interval (95% CI) based on fixed effects model or random effects model was calculated to assess the potential role of CRP and COMP in the incidence or progression of KOA. Heterogeneity was evaluated by Cochran’s Q and I2 tests. When P < 0.05 or I2 > 50%, a random effects model was chosen, otherwise, a fixed effects model was used. Moreover, the role of CRP in different degrees of pain was also analyzed. Sensitivity analysis was performed to evaluate the strength of the meta-analysis. Results Fourteen studies were enrolled in the meta-analysis. No difference was found between baseline CRP and CRP levels in the last follow-up period of KOA (MD = − 0.09, 95% CI: -0.30, 0.13). Pooled data showed higher CRP concentration in patients with incident KOA when compared with controls (MD = 0.33, 95% CI: 0.04, 0.63). Moreover, higher serum COMP levels were found in patients with incident KOA (MD = 1.69, 95% CI: 0.61, 2.76) Additionally, significant higher CRP concentration was observed in KOA patients with highest degree of pain (MD = 1.60, 95% CI: 0.52, 2.67). Conclusion CRP and COMP serum levels were both associated with the incidence of KOA. Patients with a higher CRP and COMP concentration might have an increased probability of developing KOA. However, higher CRP serum levels was not related with KOA progression. Furthermore, KOA patients with more pain had higher CRP concentrations.
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Yang T, Zhang Y, Wei J, Zeng C, Li LJ, Xie X, Wang YL, Xie DX, Li H, Yang C, Lei GH. Relationship between cigarette smoking and hyperuricemia in middle-aged and elderly population: a cross-sectional study. Rheumatol Int 2016; 37:131-136. [PMID: 27704161 DOI: 10.1007/s00296-016-3574-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 09/28/2016] [Indexed: 12/14/2022]
Abstract
The aim of the study was to estimate the cross-sectional association between cigarette smoking and the prevalence of hyperuricemia (HU) in the middle-aged and elderly males and females. A total of 3415 males and 2932 females were included in this study. HU was defined as SUA≥ 416 mmol/L for males and ≥360 mmol/L for females. The smoking status was classified into four categories based on daily smoking habit: (1) 0/day; (2) 1-10/day; (3) 11-20/day; and (4) >20/day. Multivariable logistic regressions were conducted to examine the aforementioned association. The prevalence of HU in the male and female sample was 25.0 and 10.0 %, respectively. In male subjects, the prevalence of HU in smokers (22.8 %) was significantly lower than that in non-smokers (26.5 %) (p = 0.016). Meanwhile, with adjustment for potential confounding factors, the prevalence of HU in smokers was still lower (OR = 0.83, 95 % CI 0.70-0.98, P = 0.033). Furthermore, a significantly inverse association between smoking status and HU was observed in the multivariable model. The multivariable-adjusted OR (95 % CI) for HU in the second, third and fourth category of smoking status was 0.84 (95 % CI 0.66-1.06), 0.90 (95 % CI 0.69-1.18) and 0.76 (95 % CI 0.58-0.99), respectively, compared with that in the first category. A clear trend (P for trend was 0.036) was observed. However, there was no significant association between cigarette smoking and HU in female subjects (P for trend was 0.739). This study indicated an inverse association between cigarette smoking and the prevalence of HU in the middle-aged and elderly male population, independent of some major confounding factors. The findings of this study expect further prospective studies to confirm the causal relationship.
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Affiliation(s)
- Tuo Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan Province, China.,Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, 410008, Hunan Province, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Liang-Jun Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Xi Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Yi-Lun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Dong-Xing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Cui Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China.
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