基于倾向评分匹配法探讨吸烟人群骨关节炎发生风险

Exploring the Risk of Osteoarthritis in Active and Passive Smoking Population Based on Propensity Score Matching

目的探讨主被动吸烟与骨关节炎疾病患病间的相关性,进而为骨关节炎的早期防治提供科学依据。方法采取分层整群抽样的方法,抽取山西省2个县区16岁以上常住居民进行流行病学调查,根据吸烟情况分为主动吸烟组与被动吸烟组。利用倾向评分匹配法均衡2组间的协变量,减少组间混杂因素对结果的影响,评估匹配前后主动吸烟组与被动吸烟组发生骨关节炎的危险性。结果主动吸烟组与被动吸烟组各有827例匹配成功,倾向评分匹配前2组骨关节炎患病率比较差异有统计学意义(P<0.001);经倾向评分匹配后,组间协变量年龄、性别、BMI、通风情况、饮酒情况等均达到均衡可比,被动吸烟组骨关节炎患病率仍高于主动吸烟组,且差异有统计学意义(P<0.001)。结论被动吸烟对OA发展的影响并不亚于主动吸烟,但尚不能确定被动吸烟人群的OA患病风险一定高于主动吸烟人群,其具体机制有待进一步研究证实。应重视吸烟的危害,加强对主动吸烟的干预,保护被动吸烟人群。

Objective To explore the correlation between active and passive smoking and osteoarthritis disease,and to provide a scientific basis for early prevention and treatment of osteoarthritis.Methods A stratified cluster sampling method was used to select local residents aged 16 and over in 2 counties of Shanxi Province for epidemiological investigation.According to the smoking situation,they were divided into active smoking group and passive smoking group.Using propensity score matching method to balance the covariates between the two groups,reduce the influence of intermixing factors on the results,and evaluate the risk of osteoarthritis in active smoking group and passive smoking group before and after matching.Results There were 827 cases in the active smoking group and the passive smoking group seperately.The prevalence of the first two groups of osteoarthritis was statistically significant(P<0.001).After the propensity scores were matched,age,gender,BMI,ventilation,and drinking status of the covariates between the groups were balanced and comparable.The prevalence of osteoarthritis in the passive smoking group was still higher than that in the active smoking group,and the difference in the two groups was still statistically significant(P<0.001).Conclusion The effect of passive smoking on the development of OA is no less than that of active smoking,but it is not certain that the risk of OA in passive smokers is higher than that in active smokers,and the specific mechanism needs to be further studied and confirmed.We should pay attention to the dangers of smoking,strengthen the intervention of people to smoke,and protect passive smokers.