Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
J Clin Densitom. 2012 Jan-Mar;15(1):39-48. doi: 10.1016/j.jocd.2011.06.003. Epub 2011 Aug 17.
The overall goal of this study was to assess the longitudinal changes in bone strength in women reporting rheumatoid arthritis (RA; n=78) compared with nonarthritic control participants (n=4779) of the Women's Health Initiative bone mineral density (WHI-BMD) subcohort. Hip structural analysis program was applied to archived dual-energy X-ray absorptiometry scans (baseline, years 3, 6, and 9) to estimate bone mineral density (BMD) and hip structural geometry parameters in 3 femoral regions: narrow neck (NN), intertrochanteric (IT), and shaft (S). The association between RA and hip structural geometry was tested using linear regression and random coefficient models. Compared with the nonarthritic control, the RA group had a lower BMD (p=0.061) and significantly lower outer diameter (p=0.017), cross-sectional area (p=0.004), and section modulus (p=0.035) at the NN region in the longitudinal models. No significant associations were seen at the IT regions or S regions, and the association was not modified by age, ethnicity, glucocorticoid use, or time. Within the WHI-BMD, women with RA group had reduced BMD and structural geometry at baseline, and this reduction was seen at a fixed rate throughout the 9 yr of study.
本研究的总体目标是评估报告患有类风湿关节炎 (RA) 的女性 (n=78) 与妇女健康倡议骨密度 (WHI-BMD) 子队列中的非关节炎对照参与者 (n=4779) 相比，骨强度的纵向变化。应用髋关节结构分析程序对存档的双能 X 射线吸收仪扫描 (基线、第 3 年、第 6 年和第 9 年) 进行分析，以估计 3 个股骨区域的骨密度 (BMD) 和髋关节结构几何参数：窄颈 (NN)、转子间 (IT) 和骨干 (S)。使用线性回归和随机系数模型测试 RA 与髋关节结构几何之间的关联。与非关节炎对照组相比，在纵向模型中，RA 组的 BMD 较低 (p=0.061)，NN 区域的外径 (p=0.017)、横截面积 (p=0.004) 和截面模量 (p=0.035) 明显较低。在 IT 区域或 S 区域未观察到显著相关性，并且年龄、种族、糖皮质激素使用或时间并未改变这种相关性。在 WHI-BMD 中，患有 RA 的女性在基线时的 BMD 和结构几何降低，并且在整个 9 年的研究中以固定速率降低。
