膝骨关节炎患者血清铜水平与高血压患病的相关性
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摘要
目的:明确膝骨关节炎患者血清铜水平与高血压患病之间的相关性。方法:纳入2013年10月至2014年11月在湘雅医院健康管理中心体检的年龄≥40岁,且通过双膝负重站立前后位X线片诊断为膝骨关节炎的患者935例。使用化学发光法测定血清铜水平,电子血压计测量血压。采用多因素logistic回归分析研究血清铜水平与高血压患病之间的相关性。结果:多因素校正后的模型显示,与血清铜水平最低分类组相比,总人群与女性亚组人群中血清铜水平最高分类组高血压患病风险比值比(odds ratio,OR)分别为1.46(95%CI:1.02～2.09,趋势性P=0.035)和1.47(95%CI:0.77～2.78,趋势性P=0.032);男性亚组人群中,血清铜水平与高血压患病之间的相关性不显著(OR=1.21,95%CI:0.76～1.93,趋势性P=0.354)。结论:骨关节炎患者中血清铜水平与高血压患病呈正相关,该相关性仅在总人群和女性亚组人群中成立,在男性亚组人群中可能不成立。
Objective:To examine the association between serum copper concentration and the prevalence of hypertension in patients with knee osteoarthritis(OA).Methods:A total of 935 patients who were aged ≥40 years and underwent routine checkups from October 2013 to November 2014 at the Health Management Center of Xiangya Hospital,Central South University were included.They were diagnosed as knee OA by weight-bearing bilateral anteroposterior radiography.Serum copper concentration was measured using the chemiluminescence method.Blood pressure was measured by an electronic sphygmomanometer.The association between serum copper concentration and hypertension was evaluated by conducting multivariable adjusted logistic regression.Results:Compared with the lowest quintile,the multivariable-adjusted odds ratio(OR) and related 95% confidence interval(95% CI) of hypertension were 1.46(95% CI 1.02 to 2.09,P for trend=0.035) and 1.47(95% CI 0.77 to 2.78,P for trend=0.032) in the total population and female subgroup of the highestest quintile,respectively.There was no significant association between serum copper and hypertension in male subgroup among OA patients(OR=1.21,95% CI 0.76 to 1.93,P for trend=0.354).Conclusion:The serum copper concentration was significantly associated with the prevalence of hypertension in total population and female subgroup,but may not in male subgroup among patients with knee OA.
Objective:To examine the association between serum copper concentration and the prevalence of hypertension in patients with knee osteoarthritis(OA).Methods:A total of 935 patients who were aged ≥40 years and underwent routine checkups from October 2013 to November 2014 at the Health Management Center of Xiangya Hospital,Central South University were included.They were diagnosed as knee OA by weight-bearing bilateral anteroposterior radiography.Serum copper concentration was measured using the chemiluminescence method.Blood pressure was measured by an electronic sphygmomanometer.The association between serum copper concentration and hypertension was evaluated by conducting multivariable adjusted logistic regression.Results:Compared with the lowest quintile,the multivariable-adjusted odds ratio(OR) and related 95% confidence interval(95% CI) of hypertension were 1.46(95% CI 1.02 to 2.09,P for trend=0.035) and 1.47(95% CI 0.77 to 2.78,P for trend=0.032) in the total population and female subgroup of the highestest quintile,respectively.There was no significant association between serum copper and hypertension in male subgroup among OA patients(OR=1.21,95% CI 0.76 to 1.93,P for trend=0.354).Conclusion:The serum copper concentration was significantly associated with the prevalence of hypertension in total population and female subgroup,but may not in male subgroup among patients with knee OA.
引文
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[15]Hart DJ,Doyle DV,Spector TD.Association between metabolic factors and knee osteoarthritis in women:the Chingford Study[J].JRheumatol,1995,22(6):1118-1123.
[16]Zang X,Huang H,Zhuang Z,et al.The association between serum copper concentrations and cardiovascular disease risk factors in children and adolescents in NHANES[J].Environ Sci Pollut Res Int2018,25(17):16951-16958.
[17]Zeng C,Wei J,Terkeltaub R,et al.Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis[J].Arthritis Res Ther,2017,19(1):236.
[18]Zeng C,Wei J,Li H.Relationship between serum magnesium concentration and radiographic knee osteoarthritis[J].J Rheumatol2015,42(7):1231-1236.
[19]Wang YL,Zeng C,Wei J,et al.Association between dietar y magnesium intake and hyperuricemia[J].PLoS One,2015,10(11):e141079.
[20]Wei J,Zeng C,Gong QY,et al.The association between dietary selenium intake and diabetes:a cross-sectional study among middleaged and older adults[J].Nutr J,2015,14:18.
[21]Zeng C,Wang YL,Wei J,et al.Association between low serum magnesium concentration and hyperuricemia[J].Magnes Res,201528(2):56-63.
[22]Kellgren JH,Lawrence JS.Radiological assessment of osteoarthrosis[J].Ann Rheum Dis,1957,16(4):494-502.
[23]Bergomi M,Rovesti S,Vinceti M,et al.Zinc and copper status and blood pressure[J].J Trace Elem Med Biol,1997,11(3):166-169.
[24]Duda G,Suliburska J,Wójciak R,et al.Analysis of dietary intake of iron,copper and zinc and their serum and hair levels in hypertensive adults[C].International Symposium on Trace Elem,2006:252.
[25]Duda G,Suliburska J,Wójciak R,et al.Levels of selected microelements in hypertensive subjects[C].Macro and Trace Elements,2004:930-934.
[26]Chiplonkar SA,Agte VV,Tar wadi KV,et al.Micronutrient deficiencies as predisposing factors for hypertension in lactovegetarian Indian adults[J].J Am Coll Nutr,2004,23(3):239-247.
[27]Li Y,Ma A,Sun Y,et al.Magnesium status and dietary intake of midold people in a rural area of China[J].Magnes Res,2009,22(2):66-71.
[28]Grennan DM,Knudson JM,Dunckley J,et al.Serum copper and zinc in rheumatoid arthritis and osteoarthritis.[J].N Z Med J,198091(652):47-50.
[29]Chang CS,Choi JB,Kim HJ,et al.Correlation between serum testosterone level and concentrations of copper and zinc in hair tissue[J].Biol Trace Elem Res,2011,144(1/2/3):264-271.
[2]GBD 2016 DALYs and HALE Collaborators.Global,regional,and national incidence,prevalence,and years lived with disability for 328diseases and injuries for 195 countries,1990-2016:A systematic analysis for the global burden of disease study 2016[J].Lancet,2017390(10100):1211-1259.
[3]Woolf AD,Pfleger B.Burden of major musculoskeletal conditions[J]Bull World Health Organ,2003,81(9):646-656.
[4]Puig-Junoy J,Ruiz ZA.Socio-economic costs of osteoarthritis:a systematic review of cost-of-illness studies[J].Semin Arthritis Rheum,2015,44(5):531-541.
[5]Cross M,Smith E,Hoy D,et al.The global burden of hip and knee osteoarthritis:estimates from the global burden of disease 2010study[J].Ann Rheum Dis,2014,73(7):1323-1330.
[6]Institute for Health Metrics and Evaluation.The global burden of disease:Generating evidence,guiding policy[M].Washington:Institute for Health Metrics and Evaluation,2013:1-70.
[7]Sellam J,Berenbaum F.Is osteoarthritis a metabolic disease?[J].Joint Bone Spine,2013,80(6):568-573.
[8]Puenpatom RA,Victor TW.Increased prevalence of metabolic syndrome in individuals with osteoarthritis:an analysis of NHANESIII data[J].Postgrad Med,2009,121(6):9-20.
[9]Calvet J,Orellana C,Larrosa M,et al.High prevalence of cardiovascular co-morbidities in patients with symptomatic knee or hand osteoarthritis[J].Scand J Rheumatol,2016,45(1):41-44.
[10]Rahman MM,Kopec JA,Cibere J,et al.The relationship between osteoarthritis and cardiovascular disease in a population health survey:a cross-sectional study[J].BMJ Open,2013,3(5):e2624.
[11]Inoue R,Ishibashi Y,Tsuda E,et al.Medical problems and risk factors of metabolic syndrome among radiographic knee osteoarthritis patients in the Japanese general population[J].J Orthop Sci,201116(6):704-709.
[12]Jungmann PM,Kraus MS,Alizai H,et al.Association of metabolic risk factors with cartilage degradation assessed by T2 relaxation time at the knee:data from the osteoarthritis initiative[J].Arthritis Care Res(Hoboken),2013,65(12):1942-1950.
[13]Yoshimura N,Muraki S,Oka H,et al.Accumulation of metabolic risk factors such as overweight,hypertension,dyslipidaemia and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis:a 3-year follow-up of the ROADstudy[J].Osteoarthritis Cartilage,2012,20(11):1217-1226.
[14]Monira HS,Wang Y,Cicuttini FM,et al.Incidence of total knee and hip replacement for osteoarthritis in relation to the metabolic syndrome and its components:a prospective cohort study[J].Semin Arthritis Rheum,2014,43(4):429-436.
[15]Hart DJ,Doyle DV,Spector TD.Association between metabolic factors and knee osteoarthritis in women:the Chingford Study[J].JRheumatol,1995,22(6):1118-1123.
[16]Zang X,Huang H,Zhuang Z,et al.The association between serum copper concentrations and cardiovascular disease risk factors in children and adolescents in NHANES[J].Environ Sci Pollut Res Int2018,25(17):16951-16958.
[17]Zeng C,Wei J,Terkeltaub R,et al.Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis[J].Arthritis Res Ther,2017,19(1):236.
[18]Zeng C,Wei J,Li H.Relationship between serum magnesium concentration and radiographic knee osteoarthritis[J].J Rheumatol2015,42(7):1231-1236.
[19]Wang YL,Zeng C,Wei J,et al.Association between dietar y magnesium intake and hyperuricemia[J].PLoS One,2015,10(11):e141079.
[20]Wei J,Zeng C,Gong QY,et al.The association between dietary selenium intake and diabetes:a cross-sectional study among middleaged and older adults[J].Nutr J,2015,14:18.
[21]Zeng C,Wang YL,Wei J,et al.Association between low serum magnesium concentration and hyperuricemia[J].Magnes Res,201528(2):56-63.
[22]Kellgren JH,Lawrence JS.Radiological assessment of osteoarthrosis[J].Ann Rheum Dis,1957,16(4):494-502.
[23]Bergomi M,Rovesti S,Vinceti M,et al.Zinc and copper status and blood pressure[J].J Trace Elem Med Biol,1997,11(3):166-169.
[24]Duda G,Suliburska J,Wójciak R,et al.Analysis of dietary intake of iron,copper and zinc and their serum and hair levels in hypertensive adults[C].International Symposium on Trace Elem,2006:252.
[25]Duda G,Suliburska J,Wójciak R,et al.Levels of selected microelements in hypertensive subjects[C].Macro and Trace Elements,2004:930-934.
[26]Chiplonkar SA,Agte VV,Tar wadi KV,et al.Micronutrient deficiencies as predisposing factors for hypertension in lactovegetarian Indian adults[J].J Am Coll Nutr,2004,23(3):239-247.
[27]Li Y,Ma A,Sun Y,et al.Magnesium status and dietary intake of midold people in a rural area of China[J].Magnes Res,2009,22(2):66-71.
[28]Grennan DM,Knudson JM,Dunckley J,et al.Serum copper and zinc in rheumatoid arthritis and osteoarthritis.[J].N Z Med J,198091(652):47-50.
[29]Chang CS,Choi JB,Kim HJ,et al.Correlation between serum testosterone level and concentrations of copper and zinc in hair tissue[J].Biol Trace Elem Res,2011,144(1/2/3):264-271.