基于广义线性混合模型的骨关节炎家庭聚集性研究

Familial aggregation and risk factors of osteoarthritis based on generalized linear mixed model

目的探讨OA患病是否存在家庭聚集性,分析山西省乡村人群OA患病的危险因素,为OA的早期预防及治疗策略研究提供新的思路。方法采用随机整群抽样的方法,在山西乡村社区抽取常住居民家庭为研究对象。应用SAS 9.2软件行t检验或χ^2检验进行单因素分析,应用广义线性混合模型探讨OA患病的家庭聚集性。结果最终调查有效家庭数1664户,共计4891名居民,剔除各入选家庭40岁以下成员,家庭成员2名及以上者再次纳入模型,共计642户家庭,2351名。经单因素分析、广义线性混合模型分析得出:年龄、BMI、教育水平以及居住环境的取暖、通风情况均为OA的影响因素。家庭作为随机效应在总人群以及40岁以上人群中均有统计学意义,在患病结局中分别有10.97%和18.42%的变异是由家庭不同而引起的,表明OA存在家庭聚集性。结论影响山西乡村人群OA患病的因素较多,且OA患病存在家庭聚集性,但造成家庭聚集性的原因是由于遗传因素引起的,还是由于居住环境、生活习惯等导致的,尚需进一步的研究证实,有关OA家庭聚集性的研究为OA早期预防和防控策略研究提供了新的思路与视角。

Objective To investigate whether there is familial aggregation in the prevalence of osteoarthritis,and to determine the risk factors of osteoarthritis in rural population of Shanxi Province,thereby providing new ideas for early prevention and treatment of osteoarthritis.Methods The resident households in rural communities of Shanxi Province were included as the subjects in the study by random cluster sampling method.Sasinformat(SAS)9.2 software was used for univariate analysis by t-test or chi-square test.The generalized linear mixed model was used to determine the familial aggregation of osteoarthritis.Results The valid final number of households was 1664 with a total of 4891 subjects.Excluding those under 40 years old,and re-including the households with 2 or more family members into the model,there were 642 households and 2351 subjects in total.According to univariate analysis and generalized linear mixed model analysis,age,body mass index(BMI),education level,as well as the heating and ventilation in residential environment were the influence factors of osteoarthritis.Family as a random effect was shown to be statistically significant in the total population and in the population over 40 years old.A total of 10.97%and 18.42%variation in the disease outcome were caused by families,indicating that there was a familial aggregation in osteoarthritis.Conclusion Many factors can affect the prevalence of osteoarthritis in rural population of Shanxi Province,and familial aggregation exists in osteoarthritis.However,familial aggregation may be caused by genetic factors,or living environment and habits,which needs validation in further studies.Nonetheless,the study on familial aggregation of osteoarthritis provides new ideas and perspectives for early prevention and treatment of osteoarthritis.