Furuya Takefumi, Kotake Shigeru, Inoue Eisuke, Nanke Yuki, Yago Toru, Hara Masako, Tomatsu Taisuke, Kamatani Naoyuki, Yamanaka Hisashi
Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, Japan.
J Bone Miner Metab. 2008;26(5):499-505. doi: 10.1007/s00774-007-0836-y. Epub 2008 Aug 30.
There are limited data in the literature concerning risk factors for incident fractures in men with rheumatoid arthritis (RA). We evaluated the association between potential risk factors and incident clinical fractures in male Japanese patients with RA. A total of 1050 male patients with RA were enrolled in a prospective, observational cohort study from 2000 to 2005. Participants were followed from 6 to 66 months (median follow-up, 48.7 months) and classified into three groups according to their incident fracture status from baseline: no new fracture, any new nonvertebral fracture, and new clinical vertebral fracture. The associations of potential risk factors were analyzed by Cox proportional hazards models. During follow-up, 30 patients (2.9%) developed a new nonvertebral fracture or a vertebral fracture. The baseline age, history of total knee replacement (TKR), and serum C-reactive protein (CRP) levels were associated with any nonvertebral fracture [baseline age: hazard ratio (HR), 1.08, 95% confidence interval (CI), 1.03-1.14; history of TKR: HR 6.02, 95% CI 1.19-30.42; and CRP: HR 0.60, 95% CI 0.38-0.95]. The baseline Japanese health assessment questionnaire (HAQ) score and daily dose of prednisolone were also associated with the incidence of clinical vertebral fractures (HR 7.74, 95% CI 2.10-28.48, and HR 1.28, 95% CI 1.14-1.45, respectively). Older age, history of TKR, and low serum CRP levels appear to be associated with any incident nonvertebral fracture in Japanese men with RA. High HAQ disability score and baseline doses of daily prednisolone may correlate with incident clinical vertebral fracture in Japanese men with RA.
关于类风湿关节炎（RA）男性患者发生骨折的危险因素，文献中的数据有限。我们评估了日本男性RA患者潜在危险因素与临床骨折发生之间的关联。2000年至2005年，共有1050名男性RA患者纳入一项前瞻性观察队列研究。对参与者随访6至66个月（中位随访时间为48.7个月），并根据其从基线开始的骨折发生情况分为三组：无新发骨折、任何新发非椎体骨折和新发临床椎体骨折。通过Cox比例风险模型分析潜在危险因素的关联。随访期间，30例患者（2.9%）发生了新发非椎体骨折或椎体骨折。基线年龄、全膝关节置换术（TKR）史和血清C反应蛋白（CRP）水平与任何非椎体骨折相关[基线年龄：风险比（HR）为1.08，95%置信区间（CI）为1.03 - 1.14；TKR史：HR为6.02，95%CI为1.19 - 30.42；CRP：HR为0.60，95%CI为0.38 - 0.95]。基线日本健康评估问卷（HAQ）评分和泼尼松龙每日剂量也与临床椎体骨折的发生率相关（分别为HR 7.74，95%CI 2.10 - 28.48，以及HR 1.28，95%CI 1.14 - 1.45）。年龄较大、TKR史以及血清CRP水平较低似乎与日本男性RA患者发生的任何非椎体骨折相关。高HAQ残疾评分和泼尼松龙每日基线剂量可能与日本男性RA患者发生的临床椎体骨折相关。
