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Li X, Pan F, Zhu R, Ge L, Zhang X, Wen X, Zhou J, Cheng J, Pan F, Cai G. Cross-Sectional and Longitudinal Associations of Comorbidities with Knee Symptoms and Radiographic Abnormalities of Osteoarthritis. Rheumatol Ther 2024; 11:129-142. [PMID: 37980309 PMCID: PMC10796852 DOI: 10.1007/s40744-023-00625-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/27/2023] [Indexed: 11/20/2023] Open
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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Affiliation(s)
- Xiaoxi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases, Laboratory of Anhui Province, Hefei, 230032, Anhui, China
| | - Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Rui Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases, Laboratory of Anhui Province, Hefei, 230032, Anhui, China
| | - Liru Ge
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases, Laboratory of Anhui Province, Hefei, 230032, Anhui, China
| | - Xiaoyue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases, Laboratory of Anhui Province, Hefei, 230032, Anhui, China
| | - Xiangrui Wen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Second Clinical Medical College, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Jiantao Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Second Clinical Medical College, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Jiale Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Second Clinical Medical College, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases, Laboratory of Anhui Province, Hefei, 230032, Anhui, China
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
- Inflammation and Immune Mediated Diseases, Laboratory of Anhui Province, Hefei, 230032, Anhui, China.
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
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Zhang H, Xie J, Lu B, Chen Y, Ding Y, Zhang Y, Xu S, Li X. Premature death patterns and trends in diseases of the musculoskeletal system and connective tissue in Shanghai China from 1973 to 2019. Am J Transl Res 2023; 15:6832-6840. [PMID: 38186973 PMCID: PMC10767530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/24/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES The long-term trends in crude mortality rates (CMRs) and age-standardized mortality rates characterized by Segi's world standard population (ASMRWs) of DMSCT in Pudong New Area (PNA), Shanghai, were evaluated from 1973 to 2019, and the role of demographic and non-demographic factors in the mortality of diseases of the musculoskeletal system and connective tissue (DMSCT) was explored. METHODS The PNA district has the largest population and area in Shanghai. Therefore, the mortality registration system of the PNA district was used to calculate and verify the number of deaths. Then, the Joinpoint Regression Program was used to analyze the time trend of mortality. The difference decomposition method was used to visualize the mortality of population and non-population factors, and GraphPad Prism was used for image visualization. RESULTS A total of 2260 deaths from DMSCT occurred from 1973 to 2019. The CMR and ASMRW of DMSCT were 2.56/105 person-years and 1.57/105 person-years, respectively. The number of people aged ≥80 (696 deaths) who died of DMSCT was the highest among total deaths, the highest number of years of life lost (YLL) was observed in the 45-59 age group, and the YLL rate in the ≥80 age group was the highest. The CMR and YLL rates of DMSCT showed upward trends in the total population from 1973 to 2019. CONCLUSION The CMR and YLL rates of DMSCT showed upward trends in the total population from 1973 to 2019 in PNA, Shanghai, and age was closely related to the occurrence of DMSCT. Similarly, demographic factors played a role in this process.
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Affiliation(s)
- Hongyue Zhang
- Department of Orthopedics, First Affiliated Hospital of Naval Medical UniversityShanghai 200433, China
| | - Jiaxin Xie
- Department of High-Altitude Operational Medicine, Army Medical UniversityChongqing 400038, China
| | - Bo Lu
- Department of Orthopedics, Hebei Petrochina Central HospitalLangfang 065000, Hebei, China
| | - Yichen Chen
- Center for Disease Control and PreventionPudong New Area, Shanghai 200136, China
- Fudan University Pudong Institute of Preventive MedicinePudong New Area, Shanghai 200136, China
| | - Yibo Ding
- Department of Epidemiology, Naval Medical UniversityShanghai 200433, China
| | - Yue Zhang
- School of Public Health, Department of Epidemiology, Shanxi Medical UniversityTaiyuan 030001, Shanxi, China
| | - Shuogui Xu
- Department of Orthopedics, First Affiliated Hospital of Naval Medical UniversityShanghai 200433, China
| | - Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan UniversityShanghai 200032, China
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Vincent HK, Sharififar S, McLaren C, May J, Vincent KR. Acute and chronic cardiovascular responses to concentric and eccentric exercise in older adults with knee osteoarthritis. BMC Sports Sci Med Rehabil 2023; 15:95. [PMID: 37528468 PMCID: PMC10394881 DOI: 10.1186/s13102-023-00708-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Muscle contraction type in resistance exercise training may confer benefits besides strength in individuals with osteoarthritis and cardiovascular disease (CVD) risks. The purpose of the study was to explore whether Eccentric-resistance training (RT) improved hemodynamic responses to acute walking exercise stress compared to Concentric-RT among individuals with knee OA over four months. METHODS This was a secondary analysis from a randomized, controlled, single-blinded study. Participants (N = 88; 68.3 ± 6.4 yrs; 67.4% female) were randomized to one of two work-matched resistance training (RT) programs against a non-RT control group. Pre-training and month four, participants completed a self-paced Six-Minute Walk Test (6MWT) and progressive treadmill exercise test. Heart rates, blood pressures and mean arterial pressures (MAP) were captured during each test. Antihypertensive medications use was documented at each time point. RESULTS Leg strength improved in both training groups by month four (p < .05). Changes in 6MWT distance and progressive treadmill test time were not different across groups over four months. Neither Concentric or Eccentric RT produced different hemodyamic responses during the 6MWT compared to the control group post-training. However, Concentric RT was associated with 6.0%-7.4% reductions in systolic blood pressure during the graded treadmill walking test at 50%, 75% and 100% of the test time compared to Eccentric RT and the controls (p = .045). MAP values were lower at 75% and 100% of the treadmill test after Concentric RT (5.7%-6.0% reductions) compared to Eccentric RT (1.0%-2.4% reductions) and controls (1.5% and 4.0% elevations) post-training (p = .024). Antihypertensive medication use did not change in any group. CONCLUSIONS The repeated, progressive exposures of Concentric RT-induced blunted the hypertensive responses to acute exercise compared to Eccentric-RT. Among people with knee OA, Concentric-RT may confer strength benefits to manage OA and possibly reduce cardiovascular stress during exercise.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA.
| | - Sharareh Sharififar
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - Christian McLaren
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - James May
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
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