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Yuqing Zhang

Publications and source records attributed to Yuqing Zhang.

53 records · Page 3Linked to original sources
PubMed2004

The effect of body weight on progression of knee osteoarthritis is dependent on alignment.

OBJECTIVE: Whereas obesity increases overall loading of the knee, limb malalignment concentrates that loading on a focal area, to the level at which cartilage damage may occur. This study evaluated whether the effect of body weight on progression of knee osteoarthritis (OA) differs depending on the degree of limb malalignment. METHODS: The study population comprised 228 veterans and community recruits with symptomatic knee OA (pain on most days and radiographic disease) who volunteered to participate in a natural history study and from whom baseline radiographs were obtained to assess alignment; 227 (99.6%) completed a 30-month followup. Of 403 knees assessed at baseline, 394 (97.8%) were followed up. Participants' body mass index (BMI) was assessed at each examination. The main outcome measure was progression of knee OA, defined as narrowing of the tibiofemoral joint space by 1 grade (semiquantitative scale 0-3) on radiographs of the fluoroscopically positioned knee. The association between BMI and the risk of knee OA progression was assessed after adjusting for age, sex, and limb alignment, using logistic regression and generalized estimating equations. RESULTS: Of 394 knees, 90 (22.8%) showed disease progression, and limb alignment was strongly associated with progression risk. The risk of progression increased with increasing weight (for each 2-unit increase in BMI, odds ratio [OR] for progression 1.08, 95% confidence interval [95% CI] 1.00-1.16). However, among those knees with neutral alignment (0-2 degrees ), increases in BMI had no effect on risk of progression (OR 1.00), and in those with severe malalignment (> or =7 degrees ), the effect was similarly null (OR 0.93). The effect of BMI on progression was limited to knees in which there was moderate malalignment (OR per 2-unit increase in BMI 1.23, 95% CI 1.05-1.45). CONCLUSION: Although elevated BMI increases the risk of knee OA progression, the effect of BMI is limited to knees in which moderate malalignment exists, presumably because of the combined focus of load from malalignment and the excess load from increased weight. This has implications for clinical recommendations and for trials testing weight loss in those with knee OA.

Aged↗
PubMed2004

Lifestyle determinants of high-density lipoprotein cholesterol: the National Heart, Lung, and Blood Institute Family Heart Study.

BACKGROUND: While genetic factors are major determinants of high-density lipoprotein cholesterol (HDL-C), environmental factors also play a role. The latter include 3 modifiable lifestyle factors: alcohol consumption, physical activity, and smoking. METHODS: We compared the relative effects of alcohol, physical activity, and smoking on HDL-C levels, using data from 2309 subjects (1226 women and 1083 men), aged 25 to 91 years, from randomly selected families participating in the National Heart, Lung, and Blood Institute Family Heart Study. RESULTS: Alcohol consumption was associated with the largest increment in HDL-C (an increase of 9.0-13.1 mg/dL from nondrinker to highest categories); physical activity with a more modest increment (an increase of 3.0-3.3 mg/dL from lowest to highest categories); and cigarette smoking with a large decrement in women (a decrease of 9.9 mg/dL) and a modest one in men (a decrease of 2.6 mg/dL) between nonsmoker and > or =20 cigarettes per day categories. The 3 lifestyle behaviors plus age, body mass index, education, and current estrogen use explained 22.4% and 18.2% of the total variance of HDL-C for women and men, respectively. Alcohol accounted for 28.6% of this variance among women and 50.1% among men; smoking accounted for 6.7% and 3.3%, respectively, and physical activity for 2.7% and 3.6%, respectively, among women and men. Age, body mass index, education, and current estrogen use explained the remaining 62.0% and 43.0%, respectively, of the variance attributed to environmental factors. CONCLUSIONS: This study suggests that, among lifestyle behaviors, alcohol consumption is the more important correlate of HDL-cholesterol.

Alcohol Drinking↗
PubMed2004

Long-term effects of serum cholesterol on bone mineral density in women and men: the Framingham Osteoporosis Study.

Laboratory studies have suggested a role for cholesterol in the pathogenesis of both osteoporosis and atherosclerosis. The purpose of this prospective study was to assess whether cholesterol levels, repeatedly measured over three decades in young and middle-aged adult women and men, predicted bone mineral density (BMD) at advanced age. Study participants included 712 women and 450 men enrolled in the Framingham Osteoporosis Study, aged 32-61 years at baseline (1953-55) who underwent bone densitometry 34 years later (1988-1989). BMD was measured at the proximal femur (neck, trochanter, and Ward's triangle) and lumbar spine using dual-photon absorptiometry and at the one-third radial shaft and ultradistal radius using single-photon absorptiometry. Sex-specific multivariable linear regression was used to model each BMD site as a function of total cholesterol level, adjusted for age, cigarette smoking, alcohol consumption, body mass index, systolic blood pressure, diabetes, and estrogen use (women). No significant association between total cholesterol and BMD was found in women for any of the bone sites considered. For example, adjusted mean BMD at the lumbar spine was similar in women from the lowest to highest quartile of total cholesterol, respectively, 1.07, 1.08, 1.06, 1.07 g/cm2; P for trend=0.98. Similarly, the findings in men largely showed no association between cholesterol and BMD, although there was an isolated finding of a statistically significant trend in decreasing mean radial shaft BMD with increasing total cholesterol, 0.73, 0.72, 0.72, 0.70 g/cm2, lowest to highest quartile, P for trend=0.02. Cholesterol levels in women and men from young adulthood to middle age years do not appear to have long-term clinical implications for osteoporosis later in life.

Adult↗
PubMed2004

Effect of medical conditions on improvement in self-reported and observed functional performance of elders.

OBJECTIVES: To evaluate the effect of nine disabling medical conditions upon recovery from functional limitations by elders. DESIGN: Retrospective analysis of prospective longitudinal cohort. SETTING: Community. PARTICIPANTS: Persons aged 65 and older in Framingham Heart Study. MEASUREMENTS: Change in function in elders from biennial Examinations 18 (1983-85; baseline) through 23 (1994-96). At each examination, subjects reported limitations in heavy household work, walking up and down stairs, walking half a mile, bathing, toileting, and continence. They were also directly observed for performance of transferring in and out of a chair, dressing, walking 50 feet, and carrying a 10-pound object 10 feet. The prevalence of functional limitations and the incidence of recovery from functional limitation by the subsequent examination for each task were calculated. The effects of congestive heart failure, cognitive impairment, diabetes mellitus, stroke, depressive symptoms, hip fracture, knee pain, claudication, and chronic obstructive pulmonary disease were evaluated. The relationship between the total number of comorbid conditions present (0, 1, 2, 3 or more), the presence of each individual condition at the start of each examination cycle, and the incidence of recovery from functional limitations were examined using generalized estimating equations. RESULTS: One thousand eight hundred twenty-five subjects were studied at baseline; 1,026 were available 10 years later. Mean age of subjects at baseline was 73.5 (range 61-95); 60.7% were women. The prevalence of functional limitations ranged from 3.1% to 29.8% at biennial Examination 18 and increased to 15.1% to 32.4% at Examination 23. The incidence of recovery ranged from 3.2% to 78.4% depending upon the task and the examination cycle. Increasing disease burden, as measured by the number of comorbidities, was associated with a decreased likelihood of recovery from functional limitations. Diabetes mellitus, stroke, depressive symptoms, hip fracture, and knee pain had the strongest adverse effect upon recovery from functional limitations. CONCLUSION: In these community-dwelling elders, recovery from prevalent functional limitations was frequent. Increasing disease burden was associated with a decreased incidence of recovery. Diabetes mellitus, stroke, depressive symptoms, hip fracture, and knee pain had the strongest adverse effect on recovery from functional limitations.

Activities of Daily Living↗
PubMed2004

Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y.

BACKGROUND: Vitamin D may improve muscle strength through a highly specific nuclear receptor in muscle tissue. OBJECTIVES: We investigated whether there is an association between 25-hydroxyvitamin D [25(OH)D] concentrations and lower-extremity function in ambulatory older persons, whether that association differs by activity level, and, if so, whether there is an identifiable threshold in the association. DESIGN: The study was a population-based survey of the ambulatory US population aged 60 to > or =90 y (n = 4100). Lower-extremity function according to serum 25(OH)D concentrations was assessed by linear regression analyses and regression plots after control for activity level (inactive or active) and several other potential confounders. Separate analyses were performed for the timed 8-foot (ie, 2.4 m) walk test and a repeated sit-to-stand test. RESULTS: The 8-foot walk test compared subjects in the lowest and highest quintiles of 25(OH)D; the latter group had an average decrease of 0.27 s [95% CI: -0.44, -0.09 s (or 5.6%); P for trend < 0.001]. The sit-to-stand test compared subjects in the lowest and highest quintiles of 25(OH)D; the latter group had an average decrease of 0.67 s [95% CI: -1.11, -0.23 s (or 3.9%); P for trend = 0.017]. In the 25(OH)D reference range of 22.5-94 nmol/L, most of the improvement occurred in subjects with 25(OH)D concentrations between 22.5 and approximately 40 nmol/L, and further improvement was seen in the range of 40-94 nmol/L. Stratification by activity level showed no significant effect modification. CONCLUSION: In both active and inactive ambulatory persons aged > or =60 y, 25(OH)D concentrations between 40 and 94 nmol/L are associated with better musculoskeletal function in the lower extremities than are concentrations < 40 nmol/L.

Aged↗
PubMed2003

[High prevalence of knee, but not hip or hand osteoarthritis in Beijing elders: comparison with data of Caucasian in United States].

OBJECTIVE: To investigate the prevalence of knee, hip and hand osteoarthritis (OA) in the elderly of Beijing and to compare the prevalence of OA between the Beijing elders and the US Caucasians. METHODS: Using the same standardized instruments and protocol as those in the Framingham Osteoarthritis Study, home interview, clinical examination and radiography were conducted among 1012 males and 1507 females, all aged 60 and over, on 4 central districts of Beijing with informed consent. The data of survey were compared with those of the corresponding US study. RESULTS: The prevalence of radiographic and symptomatic knee osteoarthritis was 42.8% and 15.4% respectively among the women aged 60 and over in Beijing, higher than those in Caucasian women of the same age. The prevalence of radiographic and symptomatic knee osteoarthritis were 27.6% and 7.1% respectively among the men aged 60 and over in Beijing, similar to those in the Caucasian men of the same age. The prevalence of radiographic hand osteoarthritis among the Beijing men and women aged 60 and over were 44.5% and 47.0% respectively, lower than those among the contemporary Caucasian in US. The prevalence of hip osteoarthritis among the men and women aged 60 and over were only 0.4% and 0.6%, significantly lower than those among the contemporary Caucasian in US. CONCLUSION: Compared to the Caucasian contemporaries, fewer Beijing elderly suffer from hand and hip osteoarthritis. However, knee osteoarthritis is much more prevalent, affecting millions of elderly Chinese.

Aged↗
PubMed2003

Lower prevalence of hand osteoarthritis among Chinese subjects in Beijing compared with white subjects in the United States: the Beijing Osteoarthritis Study.

OBJECTIVE: Fewer Chinese subjects in Beijing have hip osteoarthritis (OA) compared with whites in the United States, but as many or more Chinese subjects have knee OA. If these differences are due to a systemic predilection for disease, then the prevalence of hand OA, the best indicator of generalized disease, should be different in China. The goals of this study were to estimate the prevalence of hand OA among elderly Chinese in Beijing, and to compare it with that among elderly whites in the United States. METHODS: We recruited a random sample of Beijing residents ages > or =60 years. Subjects answered questions on joint symptoms and provided posteroanterior radiographs of the hand. The protocol was identical to that used in the Framingham, Massachusetts OA Study. The hand radiographs from the Beijing OA Study were read intermingled with films from the Framingham OA Study. We defined a hand joint as having radiographic OA if it had a Kellgren and Lawrence grade >/=2. Symptomatic OA was present when both radiographic OA and self-reported pain were present in the same joint. We classified a subject as having radiographic or symptomatic hand OA if at least 1 hand joint had radiographic or symptomatic OA. We estimated the prevalence of hand OA in elderly subjects in Beijing and compared it with the prevalence of hand OA in elderly subjects from Framingham, using an age-standardized prevalence ratio. RESULTS: We obtained both symptom information and hand radiographs from 2,525 subjects. Despite the older age of the group, only 44.5% of men and 47.0% of women had radiographic hand OA. Symptomatic hand OA occurred in 3.0% of men and 5.8% of women. Compared with white men in Framingham, the Beijing Chinese men had a much lower prevalence of radiographic hand OA (age-adjusted prevalence ratio 0.64, 95% confidence interval [95% CI] 0.58-0.70) and symptomatic hand OA (age-adjusted prevalence ratio 0.25, 95% CI 0.16-0.34). The proportion of multiple hand joints affected by OA in Chinese men was also significantly lower than in white men. A similar magnitude of difference was also observed in the women. However, prevalence of symptomatic OA at the metacarpophalangeal (MCP) joints in Chinese men and prevalence of radiographic OA at the MCP joints in Chinese women were similar to those in their white counterparts in Framingham. CONCLUSION: Elderly Chinese subjects in Beijing had a much lower prevalence of hand OA than did elderly whites in Framingham, Massachusetts. Coupled with the exceedingly low prevalence of hip OA in China, these results may suggest that the overall predilection for OA is less among subjects in China than among whites in the United States.

Aged↗
PubMed2003

Relationship between polymorphism of the angiotensin-converting enzyme gene and the response to angiotensin-converting enzyme inhibition in hypertensive patients.

The aim of this study was to investigate the relationship between polymorphism of the anglotensin-converting enzyme (ACE) gene and the blood pressure response to ACE inhibition in a hypertensive cohort. Imidapril (5-10 mg/day) or benazepril (10-20 mg/day) was administered for 6 weeks to 517 essential hypertensives. ACE gene polymorphism was examined by the polymerase chain reaction (PCR) method and the patients were classified as having the 190-bp deletion homozygous (DD) genotype, the 490-bp insertion homozygous (II) genotype, or the 490-bp insertion, 190-bp deletion heterozygous (ID) genotype. The achieved change in systolic and diastolic blood pressure (SBP and DBP) was analyzed for association with genotypes at the ACE gene locus. The DD genotype was observed in 132 patients (25.5%), the ID genotype in 255 patients (49.3%), and the II genotype in 130 patients (25.2%). The SBP reductions in the patients with the DD genotype, II genotype, and ID genotype were -14.5 +/- 12.7 mmHg, -14.3 +/- 13.1 mmHg and -14.0 +/- 12.2 mmHg, respectively (p = 0.94). The DBP reductions in the patients with the DD genotype, II genotype, and ID genotype were -8.7 +/- 7.4 mmHg, -8.7 +/- 7.7 mmHg and -8.5 +/- 6.7 mmHg, respectively (p = 0.96). There was no significant association between the ACE gene polymorphisms and the response to ACE inhibition. These results suggest that ACE genotype does not predict the blood pressure-lowering response to antihypertensive treatment with ACE inhibition.

Aged↗
PubMed2002

Alcohol consumption and risk of lung cancer: the Framingham Study.

BACKGROUND: Reports on the association between alcohol consumption and the risk of lung cancer have been inconsistent. The purpose of this study was to assess this association in a cohort study. METHODS: This study included 4265 participants in the original population-based Framingham Study cohort and 4973 subjects in the offspring cohort. Alcohol consumption data were collected periodically for both cohorts. We used the risk sets method to match control subjects to each case patient based on age, sex, smoking variables, and year of birth. We used a conditional logistic regression model to estimate the relative risk of lung cancer according to alcohol consumption. RESULTS: Alcohol consumption was generally light to moderate (i.e., <12 g/day) in both cohorts. During mean follow-ups of 32.8 years in the original and 16.2 years in the offspring cohorts, 269 cases of lung cancer occurred. In categories of total alcohol consumption of 0, 0.1-12, 12.1-24, and greater than 24 g/day, the crude incidence rates of lung cancer were 7.4, 13.6, 16.4, and 25.2 cases per 10 000 person-years, respectively, in the original cohort and 6.6, 4.3, 7.9, and 12.3 cases per 10 000 person-years, respectively, in the offspring cohort. However, after adjustment for age, sex, pack-years of smoking, smoking status, and year of birth in a multivariable conditional logistic regression model, relative risks for lung cancer from the lowest to the highest category of alcohol consumption were 1.0 (referent), 1.0 (95% confidence interval [CI] = 0.5 to 2.1), 1.0 (95% CI = 0.5 to 2.3), and 1.1 (95% CI = 0.5 to 2.3), respectively, in the original cohort and 1.0, 1.4 (95% CI = 0.5 to 3.6), 1.1 (95% CI = 0.3 to 3.6), and 2.0 (95% CI = 0.7 to 5.7), respectively, in the offspring cohort. CONCLUSION: Alcohol consumption among subjects in the Framingham Study, most of whom were light to moderate drinkers, was not statistically significantly associated with the risk of lung cancer.

Adenocarcinoma↗
PubMed2002

Bone mass and the risk of prostate cancer: the Framingham Study.

PURPOSE: To examine the relation of bone mass-a potential biologic marker for cumulative exposure to androgens, insulin-like growth factors, and calcium intake-to subsequent development of prostate cancer. METHODS: We used radiogrammetry to measure the second metacarpal cortical area of 1012 white men with no history of prostate cancer who had undergone posteroanterior hand radiography between 1967 and 1970. Participants were followed until the end of 1999. All incident cases of prostate cancer were confirmed histologically. We examined bone mass in relation to the risk of prostate cancer using a Cox proportional hazards model. RESULTS: During follow-up, 100 men developed prostate cancer. Incidence rates per 1000 person-years were 3.8 among men in the lowest quartile of bone mass, 4.8 in the second quartile, 7.4 in the third quartile, and 6.5 in the highest quartile. Compared with men in the lowest quartile of bone mass, the multivariate-adjusted rate ratio was 1.3 (95% confidence interval [CI]: 0.7 to 2.5) for those in the second quartile, 1.9 (95% CI: 1.0 to 3.4) in the third quartile, and 1.6 (95% CI: 0.9 to 3.0) in the highest quartile (P for trend = 0.06). CONCLUSION: Men with high bone mass may be at an increased risk of prostate cancer. Although the biological mechanisms underlying this relation are not understood, cumulative exposure to high levels of androgen, insulin-like growth factor 1, or calcium intake may be involved.

Bone and Bones↗
PubMed2002

Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: The Framingham Study.

Osteoarthritis is one of the most common joint disorders in the elderly, yet few studies have targeted symptomatic osteoarthritis, especially symptomatic hand osteoarthritis. The authors conducted a survey in 1992-1993 among an elderly population to estimate the prevalence of symptomatic hand osteoarthritis and to assess its impact on grip strength and functional activities. Framingham Study subjects received hand radiographs and answered queries on joint symptoms. Functional activities were assessed using an interviewer-administered questionnaire. Grip strength and observed functional performance were evaluated using standard procedures. A hand joint was defined as having symptomatic osteoarthritis if both symptoms and radiographic evidence of osteoarthritis were present. Of 1,041 subjects aged 71-100 years (36% men), the prevalence of symptomatic hand osteoarthritis was higher in women (26.2%) than in men (13.4%). Compared with those without symptomatic hand osteoarthritis, subjects with the disease had 10% reduced maximal grip strength, reported more difficulty writing, handling, or fingering small objects (odds ratio = 3.4), and showed more self-reported and observed difficulty carrying a 10-pound (4.5-kg) bundle (odds ratio = 1.7 and 1.6, respectively). In conclusion, in the context of a remarkable paucity of data on the epidemiology of symptomatic hand osteoarthritis, this study suggests that symptomatic hand osteoarthritis is a common disease among elders and frequently impairs hand function.

Activities of Daily Living↗
PubMed2002

[Quantitative assessment of Parkinsonian rigidity by vessel Doppler ultrasonography].

OBJECTIVE: To investigate the value of quantitative assessment of parkinsonian rigidity by vessel Doppler ultrasonography. METHODS: The diameter of the rigid limbs, including radial artery and vein, ulnar artery and vein, brachial veins, popliteal vein, anterior tibial vein, and posterior tibial vein in twelve individuals with PD and twelve age matched controls were measured by ultrasonography in both "on" and "off" states. Meanwhile the UPDRS unified Parkinson's disease rating scale for rigidity were also recorded both in "on" and "off " states by experienced neurologists. RESULTS: The mean diameter of radial vein, ulnar vein, brachial vein, popliteal vein, anterior tibial vein and posterior tibial vein, were 1.14, 1.13, 2.47, 3.85, 1.89, and 1.33 mm respectively in "off " state (group "A"), and were 1.58, 1.54, 2.88, 4.65, 2.27, and 1.69 mm respectively in "on" states (group "B") among the PD patients. The diameters of corresponding vessels in the controls (group "C") were 2.07, 1.69, 4.15, 5.07, 2.63, and 1.99 mm respectively. The data increased from group "A" to "C" gradually. Paired samples t tested showed a significant difference between the data of group A and group B (P = 0.00 approximately 0.03) and between group A and group C (P = 0.00 approximately 0.02) and no significant difference between group B and group C (P > 0.05, except for brachial vein with P = 0.02). The data of vein diameters in rigid limbs were correspondent to the UPDRS scores for rigidity with the correlation coefficient of 0.71, 0.82, 0.91, 0.73 (all P < 0.01), 0.60 P < 0.05 , and 0.77 P < 0.01) for the above mentioned vessels respectively. CONCLUSION: The diameter of distant veins in limbs can be adopted as objective and quantitative indicators for parkinsonian rigidity and contribute to the evaluation of therapeutical effects.

Aged↗
PubMed2002

Evidence for a gene influencing heart rate on chromosome 4 among hypertensives.

While mechanisms are poorly understood, resting heart rate has been shown to be a strong predictor of the risk of cardiovascular disease, cancer, and all-cause mortality. We performed a genome scan for quantitative trait loci influencing the resting heart rate among 962 Caucasians and 1,124 African-Americans in the Hypertension Genetic Epidemiology Network (HyperGEN), a multi-center study of genetic and environmental factors related to hypertension. The NHLBI Mammalian Genotyping Service typed a total of 391 anonymous microsatellite markers, spaced roughly equally throughout the genome. Within each race and sex, heart rate was adjusted for covariates, including age, age(2), study center, body mass index, beta-blocker use, alcohol consumption, smoking, number of city blocks walked per day, and number of hours watching television. Genome scans were performed using variance component linkage analysis as implemented by GENEHUNTER (version 2) for each race, using race-specific marker allele frequencies derived from random samples. The highest lod score detected in Caucasians was 2.14 on chromosome 4 (at 195.06 cM); a lod score of 1.14 was found at the same locus among the African-Americans, and a lod score of 3.18 resulted when the two racial groups were combined. Evidence was also found on chromosome 10 to support a recent report of an association between heart rate and the beta1 adrenergic receptor. The suggestive evidence for linkage found on chromosome 4 in both Caucasian and African-American hypertensive sib pairs indicates that further investigation on that region may be warranted to locate a gene influencing variability in resting heart rate.

Black People↗
PubMed2002

High prevalence of lateral knee osteoarthritis in Beijing Chinese compared with Framingham Caucasian subjects.

OBJECTIVE: We recently reported that, despite their thinness, elderly subjects in Beijing, China had an equal prevalence (in men) or higher prevalence (in women) of both radiographic and symptomatic knee osteoarthritis (OA) compared with that in the Framingham, Massachusetts cohort of elderly subjects. Our objective was to evaluate whether Chinese subjects might have more medial disease than do Caucasians, given a report of varus alignment in the knee joints of Chinese elderly. METHODS: We compared the prevalence of medial and lateral radiographic knee OA and measured anatomic alignment in the knees of elderly subjects from the Beijing and Framingham cohorts. Both studies recruited a random sample of the population. The Beijing OA Study used the Framingham OA Study protocol for radiographs. Anteroposterior weight-bearing films were read for Kellgren and Lawrence (K/L) grade and joint space narrowing (JSN; 0-3 scale) in each compartment. Medial disease was defined when radiographs showed a K/L grade >or=2 and medial JSN >or=1, and lateral disease was assessed in a comparable manner. Using knee-specific analyses, we compared the prevalence of medial and lateral knee OA after adjusting for age, body mass index, and the correlation between the 2 knees. Restricting the analyses to knees with JSN >or=2 and comparing the proportion of OA knees with medial disease and lateral disease yielded similar results. We assessed alignment in knees from 100 persons without OA, measuring the angle subtended by the femoral and tibial anatomic axes. RESULTS: We studied 1,781 Chinese subjects ages 60-88 years, and 1,084 Framingham subjects ages 63-93 years. Whereas medial OA was less prevalent among the Beijing men, lateral OA was more than twice as prevalent among the Beijing men and women, compared with that in the Framingham elderly. For example, of all knees with radiographic OA, 28.5% of Beijing women's knees had lateral OA versus 11% of Framingham women's knees (P < 0.001), and among men, 32.3% of Beijing men's knees versus 8.8% of Framingham men's knees (P < 0.001) had lateral OA. Alignment was more valgus in the Beijing men than in the Framingham men (mean 4.5 degrees versus 2.7 degrees valgus, respectively; P < 0.001), but no differences in alignment were evident in the women. CONCLUSION: In this first attempt to compare the characteristics of OA in different racial groups, we conclude that, opposite to expectations, Chinese subjects have much more lateral OA than do Caucasian subjects in the Framingham cohort, a predilection possibly explained in the men by differences in anatomic alignment.

Aged↗
PubMed2002

Very low prevalence of hip osteoarthritis among Chinese elderly in Beijing, China, compared with whites in the United States: the Beijing osteoarthritis study.

OBJECTIVE: To compare the prevalence of osteoarthritis (OA) of the hip among elderly persons in China and the US. METHODS: We recruited a population-based sample of 1,506 persons (82% of those enumerated) ages > or = 60 years living in Beijing, China. Subjects answered questions about joint symptoms and underwent radiography of the pelvis. Radiographs of the Beijing subjects were intermingled with hip radiographs of white women ages > or = 65 years from the Study of Osteoporotic Fractures (SOF) and white men and women ages 60-74 years from the First National Health and Nutrition Examination Survey (NHANES-I) and were then interpreted. Radiographic hip OA was defined as the presence of 1 of the following 3 findings in either hip: minimum joint space of < or = 1.5 mm, definite osteophytes and joint space narrowing, or > or = 3 radiographic features of OA. Symptomatic hip OA was defined as both radiographic OA and hip pain. RESULTS: The crude prevalence of radiographic hip OA in Chinese ages 60-89 years was 0.9% in women and 1.1% in men; it did not increase with age. Chinese women had a lower age-standardized prevalence of radiographic hip OA compared with white women in the SOF (age-standardized prevalence ratio 0.07) and the NHANES-I (prevalence ratio 0.22). Chinese men had a lower prevalence of radiographic hip OA compared with white men of the same age in the NHANES-I (prevalence ratio 0.19). There were no cases of symptomatic hip OA in the Chinese men and only 1 case in the Chinese women; 35 cases were expected in both sexes. CONCLUSION: This is the first population-based study of hip OA in China to use standardized radiographic methods and definitions. We found that hip OA was 80-90% less frequent than in white persons in the US. Identification of the genetic and environmental factors that underlie these differences may help elucidate the etiology and prevention of hip OA.

Aged↗
PubMed2002

Effect of birth cohort on risk of hip fracture: age-specific incidence rates in the Framingham Study.

OBJECTIVES: This study examined the effect of birth cohort on incidence rates of hip fracture among women and men in the Framingham Study. METHODS: Age-specific incidence rates of first hip fracture were presented according to tertile of year of birth for 5209 participants of the Framingham Study, a population-based cohort followed since 1948. Sex-specific incidence rate ratios were calculated by Cox regression to assess the relation between birth cohort and hip fracture incidence. RESULTS: An increasing trend in hip fracture incidence rates was observed with year of birth for women (trend, P =.05) and men (trend, P =.03). Relative to those born from 1887 to 1900 (incidence rate ratio [IRR] = 1.0), age-specific incidence rates were greatest in the most recent birth cohort, born from 1911 to 1921 (IRR = 1.4 for women, IRR = 2.0 for men), and intermediate in those born from 1901 to 1910 (IRR = 1.2 for women, IRR = 1.5 for men). CONCLUSIONS: Results suggest risk of hip fracture is increasing for successive birth cohorts. Projections that fail to account for the increase in rates associated with birth cohort underestimate the future public health impact of hip fracture in the United States.

Adult↗