| アブストラクト | OBJECTIVE: Thiazide diuretic use is associated with higher bone mineral density (BMD) and possibly lower serum magnesium levels than loop diuretic use, and both high BMD and low serum magnesium have been linked to high prevalent knee osteoarthritis. This study aimed to compare the risk of a clinically relevant endpoint, knee replacement (KR) surgery, among initiators of thiazide and loop diuretics. DESIGN: Among patients aged >/=50 years with a diagnosis of knee osteoarthritis in The Health Improvement Network (THIN) in United Kingdom, we conducted a propensity score-matched cohort study to examine the relation of thiazide diuretic initiation vs loop diuretic initiation to the risk of KR over 5 years. RESULTS: Among thiazide and loop diuretic initiators (n = 3,488 for each group; mean age: 73 years; female ratio: 59%), 359 (28.6/1,000 person-years) and 283 (24.1/1,000 person-years) KRs occurred during the follow-up period, respectively. The hazard ratio (HR) of KR for thiazide diuretic initiation vs loop diuretic initiation was 1.26 (95% confidence interval [CI]: 1.08-1.47). The adherence-adjusted HR of KR for continuous use of thiazide diuretics was 1.44 (95% CI: 1.21-1.72). CONCLUSIONS: In this population-based cohort of patients with knee osteoarthritis, thiazide diuretic use was associated with a higher risk of KR than loop diuretic use. This association may potentially be due to thiazide diuretics' effect on BMD and serum magnesium. |
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| 組織名 | Health Management Center, Xiangya Hospital, Central South University, Changsha,;Hunan, China; Division of Rheumatology, Allergy, and Immunology, Department of;Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA,;USA. Electronic address: JWEI6@mgh.harvard.edu.;Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA.;Electronic address: tneogi@bu.edu.;Department of Medicine, University of California at San Diego, San Diego, CA,;USA; VA San Diego Medical Center, San Diego, CA, USA. Electronic address:;rterkeltaub@ucsd.edu.;Division of Nephrology, Department of Medicine, Massachusetts General Hospital,;Harvard Medical School, Boston, MA, USA. Electronic address:;AFENVES@mgh.harvard.edu.;Division of Rheumatology, Allergy, and Immunology, Department of Medicine,;Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;;Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha,;Hunan, China. Electronic address: CZENG6@mgh.harvard.edu.;Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA;;Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical;School, Boston, MA, USA. Electronic address: demisra@bu.edu.;Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.;Electronic address: hchoi@partners.org.;Hunan, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha,;Hunan, China; National Clinical Research Center of Geriatric Disorders, Xiangya;Hospital, Central South University, Changsha, Hunan, China. Electronic address:;lei_guanghua@csu.edu.cn.;Electronic address: yzhang108@mgh.harvard.edu. |
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