女性骨质疏松症与类风湿关节炎之间的关联：一项横断面研究。
Association between osteoporosis and rheumatoid arthritis in women: a cross-sectional study.
作者信息
Sarkis Karin Sedó, Salvador Mariana Barbieri, Pinheiro Marcelo Medeiros, Silva Raissa Gomes, Zerbini Cristiano Augusto, Martini Lígia Araújo
机构信息
Nutrition Department, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
出版信息
Sao Paulo Med J. 2009 Jul;127(4):216-22. doi: 10.1590/s1516-31802009000400007.
CONTEXT AND OBJECTIVES
Osteoporosis has frequently been observed in patients with rheumatoid arthritis. The present study was undertaken in order to evaluate factors associated with osteoporosis among women with rheumatoid arthritis.
DESIGN AND SETTING
Cross-sectional study, carried out in a public hospital in São Paulo.
METHODS
The participants were 83 women with rheumatoid arthritis (53.7 +/- 10.0 years old). Bone mineral density (BMD) and body composition were measured by dual energy X-ray absorptiometry. The patients were divided into three groups according to BMD: group 1, normal BMD (n = 24); group 2, osteopenia (n = 38); and group 3, osteoporosis (n = 21). Tests were performed to compare differences in means and correlations, with adjustments for age, duration of disease and cumulative corticosteroid. The relationships between clinical factors, physical activity score, dietary intake, body composition and biochemical parameters were analyzed using linear regression models.
RESULTS
Mean calcium, vitamin D and omega-6 intakes were lower than the recommendations. Associations were found between BMD and age, disease duration, parathyroid hormone concentration and fat intake. The linear regression model showed that being older, with more years of disease and lower weight were negatively correlated with BMD [Total femur = 0.552 + 0.06 (weight) + 0.019 (total physical activity) - 0.05 (age) - 0.003 (disease duration); R(2) = 48.1; P < 0.001].
CONCLUSION
The present study indicates that nutritional factors and body composition are associated with bone mass in women with rheumatoid arthritis.
背景与目的
类风湿关节炎患者中经常观察到骨质疏松症。本研究旨在评估类风湿关节炎女性患者中与骨质疏松症相关的因素。
设计与地点
在圣保罗的一家公立医院进行的横断面研究。
方法
研究对象为83名类风湿关节炎女性患者（年龄53.7±10.0岁）。采用双能X线吸收法测量骨密度（BMD）和身体成分。根据BMD将患者分为三组：第1组，BMD正常（n = 24）；第2组，骨量减少（n = 38）；第3组，骨质疏松症（n = 21）。进行测试以比较均值差异和相关性，并对年龄、病程和累积皮质类固醇进行调整。使用线性回归模型分析临床因素、体力活动评分、饮食摄入量、身体成分和生化参数之间的关系。
结果
钙、维生素D和ω-6的平均摄入量低于推荐值。发现BMD与年龄、病程、甲状旁腺激素浓度和脂肪摄入量之间存在关联。线性回归模型显示，年龄较大、病程较长和体重较低与BMD呈负相关[全股骨 = 0.552 + 0.06（体重）+ 0.019（总体力活动）- 0.05（年龄）- 0.003（病程）；R(2)=48.1；P<0.001]。
结论
本研究表明，营养因素和身体成分与类风湿关节炎女性患者的骨量有关。
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