骨关节炎是一种常见的肌肉骨骼疾病，但特定血清生物标志物（例如钙、维生素 D 和 C 反应蛋白 (CRP)）在预测骨关节炎患者死亡率方面的作用仍不清楚。这项观察性研究分析了超过 500,000 名患者的纵向数据英国生物银行的参与者使用 ICD-9/10 代码或自我报告的病史来识别骨关节炎患者。我们采用多变量 cox 回归和灵活参数生存模型 (FPSM) 进行生存分析，并通过有向无环图 (DAG) 识别的基线协变量的治疗权重逆概率 (IPTW) 进行调整。在 49,082 名骨关节炎人群中，平均年龄60.69岁，其中女性占58.7%。在超过15年的随访期间，共有5522名骨关节炎患者死亡。与正常血清钙水平相比，高血清钙水平与全因死亡率（风险比 (HR) 1.33，95% 置信区间 (CI) 1.11、1.59）、心血管疾病 (CVD) 相关死亡 (HR) 显着相关1.55，95% CI 1.05，2.29），以及其他死亡（HR 1.59，95% CI 1.20，2.11）。与正常血清钙水平相比，低血清钙水平与 CVD 相关死亡相关（HR 2.06，95% CI 1.02，4.14）。与足够的维生素 D 水平相比，维生素 D 不足与全因死亡率（HR 1.22，95% CI 1.13，1.33）、CVD 相关死亡（HR 1.43，95% CI 1.20，1.72）和其他死亡（HR 1.43，95% CI 1.20，1.72）相关。 HR 1.26，95% CI 1.09，1.45），但与癌症相关死亡无关。与正常 CRP 水平相比，高血清 CRP 水平与所有结局相关（全因死亡率：HR 1.22，95% CI 1.12，1.33；CVD 相关死亡：HR 1.24，95% CI 1.03，1.49；癌症相关死亡死亡：HR 1.23，95% CI 1.09，1.40；其他死亡：HR 1.19，95% CI 1.03，1.38）。高和低血清钙水平、升高的 CRP 和维生素 D 缺乏都是死亡风险增加的潜在预测因素。骨关节炎人群。这些发现强调了监测并可能解决骨关节炎人群中这些血清生物标志物以改善长期结果的重要性。需要进一步研究以了解潜在机制并提出治疗干预措施。© 2024。作者。

Osteoarthritis is a prevalent musculoskeletal condition, but the role of specific serum biomarkers, such as calcium, vitamin D, and C-reactive protein (CRP), in predicting mortality among individuals with osteoarthritis remains unclear.This observational study analyzed longitudinal data from over 500,000 participants in the UK Biobank, identifying those with osteoarthritis using ICD-9/10 codes or self-reported history. We performed multivariable cox-regression and flexible parametric survival model (FPSM) for survival analysis, with adjustments made through the inverse probability of treatment weight (IPTW) for baseline covariates identified by directed acyclic graphs (DAGs).Of the 49,082 osteoarthritis population, the average age was 60.69 years, with 58.7% being female. During the follow-up period exceeding 15 years, a total of 5,522 people with osteoarthritis died. High serum calcium levels, compared to normal serum calcium levels, were significantly associated with all-cause mortality (hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.11, 1.59), cardiovascular diseases (CVD)-related deaths (HR 1.55, 95% CI 1.05, 2.29), and other deaths (HR 1.59, 95% CI 1.20, 2.11). Low serum calcium levels, compared to normal serum calcium levels, was linked with CVD-related deaths (HR 2.06, 95% CI 1.02, 4.14). Vitamin D insufficiency, compared to sufficient vitamin D levels, was correlated with all-cause mortality (HR 1.22, 95% CI 1.13, 1.33), CVD-related deaths (HR 1.43, 95% CI 1.20, 1.72), and other deaths (HR 1.26, 95% CI 1.09, 1.45) but not with cancer-related deaths. High serum CRP levels, compared to normal CRP levels, were associated with all outcomes (all-cause mortality: HR 1.22, 95% CI 1.12, 1.33; CVD-related death: HR 1.24, 95%CI 1.03, 1.49; cancer-related death: HR 1.23, 95% CI 1.09, 1.40; other deaths: HR 1.19, 95%CI 1.03, 1.38).Both high and low serum calcium levels, elevated CRP, and vitamin D insufficiency are potential predictors of increased mortality risk in the osteoarthritis population. These findings emphasize the importance of monitoring and possibly addressing these serum biomarkers in osteoarthritis populations to improve long-term outcomes. Further studies are needed to understand the underlying mechanisms and to propose therapeutic interventions.© 2024. The Author(s).