Osteoarthritis-related difficulty walking and risk for diabetes complications

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• 作者：G.A. Hawker^&dagger ; ; ^&Dagger ; ; ^§ ; ; ^‖ ; ^{g.hawker@utoronto.ca} ; R. Croxford^§ ; ; A.S. Bierman^&Dagger ; ; ^§ ; ; ^‖ ; ^¶ ; ; ^# ; P. Harvey^&dagger ; ; ^‖ ; B. Ravi^&dagger ; &dagger ; ; T. Kendzerska^&dagger ; ; ^§ ; ; ^‖ ; I. Stanaitis^&dagger ; ; L.K. King^‖ ; L. Lipscombe^&dagger ; ; ^&Dagger ; ; ^§ ; ; ^‖
• 关键词：Osteoarthritis ; Walking disability ; Chronic conditions ; Diabetes ; Comorbidity
• 刊名：Osteoarthritis and Cartilage
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：25
• 期：1
• 页码：67-75
• 全文大小：355 K
• 卷排序：25

文摘

To examine the effect of Osteoarthritis (OA)-related difficulty walking on risk for diabetes complications in persons with diabetes and OA.DesignA population cohort aged 55+ years with symptomatic hip and knee OA was recruited 1996–98 and followed through provincial administrative data to 2015 (n = 2,225). In those with confirmed OA (examination and radiographs) and self-reported diabetes at baseline (n = 359), multivariate Cox regression modeling was used to examine the relationship between baseline difficulty walking (Health Assessment Questionnaire (HAQ) difficulty walking score; use of walking aid) and time to first diabetes-specific complication (hospitalization for hypo- or hyperglycemia, infection, amputation, retinopathy, or initiation of chronic renal dialysis) and cardiovascular (CV) events.ResultsParticipants’ mean baseline age was 71.4 years; 66.9% were female, 77.7% had hypertension, 54.0% had pre-existing CV disease, 42.9% were obese and 15.3% were smokers. Median HAQ difficulty walking score was 2/3 indicating moderate to severe walking disability; 54.9% used a walking aid. Over a median 6.1 years, 184 (51.3%) experienced one or more diabetes-specific complications; 191 (53.2%) experienced a CV event over a median 5.7 years. Greater baseline difficulty walking was associated with shorter time to the first diabetes-specific complication (adjusted HR per unit increase in HAQ walking 1.24, 95% CI 1.04–1.47, P = 0.02) and CV event (adjusted HR for those using a walking aid 1.35, 95% CI 1.00–1.83, P = 0.04).ConclusionsIn a population cohort with OA and diabetes, OA-related difficulty walking was a significant – and potentially modifiable – risk factor for diabetes complications.