50세 이상 한국 성인에서 무릎 골관절염의 방사선적 소견에 따른 무릎 통증과 관련된 요인
Factors Associated with Knee Pain with Different Grades of Knee Osteoarthritis among Korean Adults Aged 50 Years or More
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연구배경: 무릎 통증과 무릎 골관절염의 방사선 소견은일치하지 않은 것으로 알려져 있다. 본 연구는 50세 이상한국 성인에서 무릎 골관절염의 방사선적 소견의 정도에따라 무릎 통증에 영향을 주는 요인에 차이가 있는지를 파악하고자 한다. 방법:2010년과 2011년 시행된 국민건강영양조사에서 무릎 방사선 촬영을 시행한 50세 이상의 성인 5,978명 대상으로 하였으며, 무릎 골관절염의 방사선적 소견은 K‐L 등급으로 구분하였다. 모든 통계 분석은 가중치를 고려하였으며, 다중회귀로짓분석을 시행하여 각 등급별로 무릎 통증에 영향을 미치는 인구사회학적인 요인(성별, 연령, 교육, 결혼상태, 직업), 생활습관요인(음주, 흡연, 규칙적인 운동), 동반질환(고혈압, 당뇨병), 건강상태(우울 여부, 체질량지수) 요인에 차이가 있는지를 살펴보았다. 결과: 무릎 통증의 유병률은 여성에서 남성보다 유의하게 유병률이 높았으며(P<0.001), K‐L 등급이 증가함에 따라 증가하였다(Ptrend<0.001). 여성은 무릎 골관절염의 방사선적 소견 모두에서 무릎 통증의 위험을 유의하게 증가시키는 요인이었으며, 우울증은 방사선적 소견 대부분에서무릎 통증의 위험 증가와 고등학교 이상의 교육을 받은 경우는 무릎 통증의 위험 감소와 관련되어 있었다. 무릎 골관절염의 방사선적 소견 등급에 따라 연령, 체질량지수, 비음주 등의 요인도 무릎 통증의 위험 증가와 관련되어 있었다. 결론: 무릎 골관절염의 방사선적 소견이 악화될수록 무릎 통증의 유병률은 증가하였다. 무릎 골관절염의 방사선적 소견에 따라 무릎 통증에 영향을 주는 요인이 다소 차이가 있었으나, 무릎 골관절염의 방사선적 소견 대부분에서여성과 우울증은 무릎 통증의 위험 증가와 관련되어 있었고, 고등학교 이상의 교육을 받은 경우 무릎 통증의 위험감소와 관련되어 있었다
Abstract
Background:Discordance between knee pain and radiologic osteoarthritis is well‐known. This study was to investigate factors associated with knee pain with different grades of knee osteoarthritis among Korean adults aged 50 years or more. Methods:Total 5,978 Korean aged 50 years or more who underwent the radiographs of the knees were analyzed from Korean National Nutrition and Health Examination Survey conducted in 2010‐11. Radiographs of the knees were scored for osteoarthritis using the Kellgren‐Lawrence scale. Multivariate logistic regression analysis adjusting for sociodemographic factors, lifestyle factors, comorbidity and health status was used for analysis. Results:The prevalence of knee pain was higher in female compared to that of male (P<0.001), and increased as increasing severity of radiologic knee osteoarthritis. Female was associated with increased risk of knee pain in all of Kellgren‐Lawrence degrees. In most of Kellgren‐Lawrence degrees, depression was associated with increased risk of knee pain, and those with high school diploma or higher were associated with decreased risk of knee pain. A few factors (age, body mass index, and no alcohol drinking) were also associated with increased risk of knee pain for particular grades of radiographic knee osteoarthritis. Conclusions:Knee pain increased as increasing severity of radiologic knee osteoarthritis. Although there were differences of risk factors associated with knee pain with different grades of knee osteoarthritis, female, depression were associated with increased of knee pain, and those with high school diploma or higher were associated with decreased risk of knee pain in most of Kellgren‐Lawrence degrees.
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