Osteoarthritis (OA) is the most common form of arthritis worldwide, affecting millions of patients. Not only does it pose a significant risk of disability, but it also leads to widespread use of health care resources and an increased economic burden. However, many people may not know that osteoarthritis is not just a problem with the joints, it is also closely related to various comorbidities. In recent years, this association has attracted increasing attention. Today, we're going to delve into this topic, revealing the full health implications of osteoarthritis and its comorbidities.
The basics of osteoarthritis
What is Osteoarthritis?
Osteoarthritis is a chronic joint disease characterized by degeneration of articular cartilage and bone hyperplasia. This degeneration often results in joint pain, stiffness, swelling, and limited mobility. Osteoarthritis most commonly affects the knee, hip and hand joints, but it can also affect any joint in the body.
Risk factors for osteoarthritis
Although the exact cause of osteoarthritis is not fully understood, several factors are thought to increase the risk:
- Age: Increasing age is the most significant risk factor.
- Obesity: Being overweight increases the pressure on the joints, especially those that bear weight.
- Joint injuries: Past joint injuries, such as sports injuries or accident injuries, can lead to osteoarthritis.
- Genetic factors: Family history may increase the risk.
- Gender: Women have a higher risk of osteoarthritis than men.
Epidemiology of osteoarthritis
The prevalence of osteoarthritis is increasing worldwide, especially in ageing societies. According to the latest data, about 10% of the world's population is affected by osteoarthritis, and this number is expected to continue to climb in the future. Osteoarthritis not only affects the daily life of patients, but also places a huge financial burden on society and the healthcare system.
Relationship between osteoarthritis and comorbidities
What are comorbidities?
Comorbidities refer to other diseases or symptoms that coexist with the predominant disease (in this case, osteoarthritis). These comorbidities may occur at the same time as osteoarthritis or after it, further increasing the health burden of the patient.
Background and data analysis
To delve deeper into the relationship between osteoarthritis and comorbidities, the ComOA research team conducted extensive case-control and cohort studies covering more than 3 million primary care patients in the UK, the Netherlands, Sweden and Spain. The findings, presented at the 2024 EULAR Congress in Vienna, demonstrate an association between osteoarthritis and 61 different comorbidities.
Research data show that several disorders are more common in patients with osteoarthritis than in controls. These conditions include chronic back pain, high blood pressure, allergies, cataracts, vertigo, depression, and diabetes.
Data results and interpretation
Of the 33 comorbidities studied, 10 showed consistent evidence of association during the diagnosis of osteoarthritis. These comorbidities include fibromyalgia, polymyalgia, and chronic back pain. The three most common comorbidities after diagnosis of osteoarthritis are fibromyalgia, rheumatoid arthritis, and polymyalgia.
However, in 14 chronic diseases, including heart failure, diabetes, dementia, and chronic obstructive pulmonary disease, studies found no consistent evidence of a relationship with osteoarthritis before and after diagnosis. These findings have important implications for planning the treatment of patients with osteoarthritis, suggesting that further research is warranted to determine the causal relationship between osteoarthritis and its comorbidities.
Case Study: Mr. Zhang's Story
Mr. Zhang, a 55-year-old company manager, has long suffered from knee pain. A few years ago, he was diagnosed with osteoarthritis and began regular medication and physical therapy. However, in recent months, he has found himself constantly experiencing fatigue and pain all over his body. Doctors found that he also had fibromyalgia and high blood pressure. These comorbidities not only aggravated his condition, but also made his daily life more difficult.
With the help of comprehensive treatment, Mr. Zhang's symptoms improved. He began regular physical therapy and made lifestyle adjustments, including eating a healthy diet and exercising moderately. His story reminds us that while focusing on patients with osteoarthritis, we should not ignore the presence of comorbidities, and that only a comprehensive treatment plan can lead to the best health outcomes.
Management of comorbidities
Chronic back pain
Chronic back pain is one of the most common comorbidities in patients with osteoarthritis. Physical therapy, exercise, and medication are common methods of management. Proper exercises, such as swimming, walking, and yoga, can help strengthen the back muscles and reduce pain.
hypertension
High blood pressure is also common in people with osteoarthritis. The key to controlling high blood pressure is a healthy diet, regular exercise and medication. Reducing salt intake and maintaining a healthy weight can help control blood pressure.
Depression
Chronic diseases such as osteoarthritis are often accompanied by depression. Counselling, medication, and social support are effective interventions. Through confiding and communication, patients can receive emotional support and relieve psychological stress.
diabetes
People with diabetes should keep their blood sugar levels under tight control, maintain a healthy diet, and exercise regularly. Monitoring your blood sugar regularly and following your doctor's treatment plan can help prevent complications.
Development of a comprehensive treatment plan
For osteoarthritis and its comorbidities, it is important to develop a comprehensive treatment plan. Here are some suggestions:
- Individualized treatment: Individualized treatment plan is developed according to the specific situation of the patient. Considering the patient's age, severity of illness, comorbidities and other factors, drugs, physical therapy and surgery are comprehensively used.
- Multidisciplinary collaboration: The treatment of osteoarthritis and its comorbidities requires a multidisciplinary team effort. Rheumatology, orthopedics, cardiology, psychology and other departments work together to provide a full range of medical services.
- Patient education: Raise patients' health awareness and enhance self-management skills. Through health education, patients can learn about the disease, master self-care skills, and actively participate in the treatment process.
- Regular follow-up: Regular follow-up can help detect and deal with changes in the condition and adjust the treatment plan. Patients should have regular follow-up visits and maintain good communication with their doctors to ensure the effectiveness of treatment.
Future research directions
Although studies have revealed an association between osteoarthritis and multiple comorbidities, these studies are largely based on observational data, and causal relationships are not yet clear. Future research should further explore the following aspects:
- Causal study: A longitudinal study design was used to explore the causal relationship between osteoarthritis and comorbidities, and to clarify the pathway and mechanism of disease development.
- Biomarker research: Finding biomarkers for osteoarthritis and its comorbidities to facilitate early diagnosis and individualized treatment.
- Novel treatment strategies: developing new therapeutic agents and therapeutics to provide more effective treatment options for osteoarthritis and its comorbidities.
- Big data and artificial intelligence applications: use big data and artificial intelligence technology to analyze massive medical data and explore the potential laws and prediction models of osteoarthritis and its comorbidities.
epilogue
As a common chronic disease, osteoarthritis not only affects the joint function of patients, but is also closely related to a variety of comorbidities. Through comprehensive treatment and scientific management, the symptoms of patients can be effectively alleviated and the quality of life can be improved. Future research will further reveal the causal relationship between osteoarthritis and comorbidities, and provide patients with more personalized and accurate medical care. We look forward to more medical breakthroughs that will bring hope and good news to patients with osteoarthritis.
参考文献：Swain, S., et al. (2024) Comorbidities in people with osteoarthritis in four European primary care settings - comprehensive evidence from the ComOA study. Annals of the Rheumatic Diseases. doi.org/10.1136/annrheumdis-2024-eular.3327.