Assessment of Arterial Stiffness and Related Affecting Factors in Patients with Osteoarthritis
1.Department of Orthopedics,General Hospital of Qinhuai Medical Area,Eastern Theater Command
2.Department of Ultrasound Diagnostics,General of Qinhuai Medical Area,Hospital of Eastern Theater Command
3.School of Aerospace Medicine,Airforce Military Medical University
4.Unit 96784,the People’s Liberation Army
Abstract:Objective To evaluate the carotid-femoral pulse wave velocity (cfPWV),the “gold standard” of arterial stiffness in patients with osteoarthritis (OA)and explore the related influencing factors.Methods 82 subjects were studied.41 patients with knee OA admitted to the Qinhuai Medical Area of General Hospital of Eastern Theater Command from May to December,2021 were included in the OA group and 41 age,height and weight matched non-OA volunteers were included in the control group.There were 23 males and 18 females in the patient group.The patients aged from 45 to 70 years old,with an average age of (60.54±7.01)years.The control group included 22 males and 19 females,and aged from 45 to 70 years old,with an average age of (59.57±7.57)years.The cfPWV of each subject was measured by a non-invasive automatic measurement technology based on ultrasound doppler.Results The cfPWV measurements of the OA patients were (9.24±1.84)m/s,the cfPWV of the control group were (8.25±1.25)m/s.Compared with the control group,the OA patients had significantly higher cfPWV (P=0.006).The patient group showed significantly higher total cholesterol and systolic blood pressure than the control group (P<0.05).After adjustment for age,systolic blood pressure and total cholesterol,the multifactor linear regression model showed cfPWV was still significantly increased in OA patients (P=0.024).In addition,age and systolic blood pressure were also independent influencing factors for the increased arterial stiffness.Conclusion The arterial stiffness of knee OA patients was significantly increased,independently affected by OA,age and systolic blood pressure.The increased arterial stiffness may play an important role in the increased cardiovascular diseases in OA patients.
[1]中华医学会骨科学分会关节外科学组.中国骨关节炎诊疗指南(2021年版)[J].中华骨科杂志,2021,41(18):1291-1314.
[2]Rahman MM,Kopec JA,Anis AH,et al.Risk of cardiovascular disease in patients with osteoarthritis:a prospective longitudinal study [J].Arthritis Care Res (Hoboken),2013,65 (12):1951-1958.
[3]Matsunaga M,Chen JJ,Jijiwa M,et al.The impact of diabetes and osteoarthritis on the occurrence of stroke,acute myocardial infarction,and heart failure among older adults with nonvalvular atrial fibrillation in Hawaii:a retrospective observational cohort study [J].BMC Public Health,2021,21 (1):1183.
[4]Cardoso CRL,Salles GC,Salles GF.Prognostic impact of aortic stiffness in patients with resistant hypertension [J].Hypertension,2019,73 (3):728-735.
[5]Laurent S,Cockcroft J,van Bortel L,et al.Expert consensus document on arterial stiffness:methodological issues and clinical applications [J].Eur Heart J,2006,27 (21):2588-2605.
[6]Kusunoki H,Iwashima Y,Kawano Y,et al.Associations between arterial stiffness indices and chronic kidney disease categories in essential hypertensive patients [J].Am J Hypertens,2021,34 (5):484-493.
[7]Altman R,Asch E,Bloch D,et al.Development of criteria for the classification and reporting of osteoarthritis.Classification of osteoarthritis of the knee.Diagnostic and therapeutic criteria committee of the american rheumatism association[J].Arthritis Rheum,1986,29 (8):1039-1049.
[8]Wang Z,Wang D,Han M,et al.A novel methodology for semi-automatic measurement of arterial stiffness by doppler ultrasound:clinical feasibility and reproducibility [J].Ultrasound Med Biol,2021,47 (7):1725-1736.
[9]Hawker GA,Croxford R,Bierman AS,et al.All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis:a population based cohort study [J].PLoS One,2014,9 (3):e91286.
[10]Belen E,Karaman O,Caliskan G,et al.Impaired aortic elastic properties in primary osteoarthritis [J].Vascular,2016,24 (1):70-77.
[11]Tootsi K,Kals J,Zilmer M,et al.Severity of Osteoarthritis Is Associated with Increased Arterial Stiffness [J].Int J Rheumatol,2016(2016):6402963.
[12]Kapoor M,MartelPelletier J,Lajeunesse D,et al.Role of proinflammatory cytokines in the pathophysiology of osteoarthritis [J].Nat Rev Rheumatol,2011,7 (1):33-42.
[13]周炎,刘世清.天然免疫介导凋亡-炎症途径参与骨关节炎发病的研究进展 [J].实用骨科杂志,2019,25 (5):434-459.
[14]Claridge M,Hobbs S,Quick C,et al.Nonsteroidal antiinflammatory drugs are associated with increased aortic stiffness [J].Vasc Health Risk Manag,2005,1 (2):149-153.
[15]Chirinos JA,Segers P,Hughes T,et al.Large-artery stiffness in health and disease:JACC state of the art review [J].J Am Coll Cardiol,2019,74 (9):1237-1263.