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Abstract：
Background and objective It has been suggested that knee osteoarthritis (KOA) is associated with the development of calcification and an increased risk of cardiovascular (CV) disease, while the contribution of KOA grade is not clearly known enough. This study aimed to investigate the relationship between the grade of KOA, the echocardiographic calcification score (echo-CCS), and CV risk assessment. Methods This cross-sectional study involved 204 patients diagnosed with KOA and classified according to the Kellgren-Lawrence staging criteria. Echo-CCS was obtained according to the presence of calcification in the aortic valve, aortic root, mitral ring, papillary muscle and ventricular septum. Framingham risk score (FRS) was used for CV risk assessment. Results Calcification was detected in 79.4% of patients. The median FRS, echo-CCS, and high-sensitivity C-reactive protein (hs-CRP) levels increased as the KOA grade increased (p<0.05). A one-grade increase in KOA increased the odds of echo-CCS 1-2 group by 5.15 fold (vs. no calcification group) (OR=5.15, p=0.003), while it increased the odds of echo-CCS ≥3 group by 4.61 fold (vs. echo-CCS 1-2 group) (OR=4.61, p=0.003). Median echo-CSS and hs-CRP were higher in the high CV risk group than in the moderate and low CV risk groups. Conclusion The majority of patients with KOA had intracardiac calcification. An increased KOA grade was associated with higher echo-CSS and FRS. These findings indicate that patients with higher grades of KOA may be predisposed to developing subclinical atherosclerosis.
摘要：
背景与目的膝关节骨性关节炎(KOA)与钙化的发生和心血管疾病(CV)风险的增加有关。而KOA等级的贡献还不够清楚。本研究旨在探讨KOA分级与KOA、超声心动图钙化评分（回声-CCS），和CV风险评估。方法本横断面研究纳入204例KOA患者，并根据Kellgren-Lawrence分期标准进行分类。Echo-CCS是根据主动脉瓣钙化的存在而获得的，主动脉根部,二尖瓣环,乳头状肌和室间隔。使用Framingham风险评分（FRS）进行CV风险评估。结果79.4%的患者出现钙化。FRS中位数，echo-CCS,高敏C反应蛋白（hs-CRP）水平随着KOA分级的升高而升高（p<0.05）。KOA的一级增加使回声CCS1-2组的几率增加了5.15倍（与无钙化组）（OR=5.15，p=0.003），而回声-CCS≥3组的几率增加了4.61倍(vs.回声-CCS1-2组)(OR=4.61，p=0.003)。高CV风险组的中位回声-CSS和hs-CRP高于中、低CV风险组。结论大多数KOA患者存在心内钙化。KOA等级增加与较高的回声-CSS和FRS相关。这些发现表明，KOA等级较高的患者可能易患亚临床动脉粥样硬化。
