Macintyre Norma J, Muller Monique E, Webber Colin E, Adachi Jonathan D
School of Rehabilitation Science.
Physiother Can. 2012 Summer;64(3):284-91. doi: 10.3138/ptc.2011-22BH.
People with rheumatoid arthritis (RA) are at increased risk for osteoporosis. This study explored the relationships between compartment-specific (cortical and trabecular) bone properties in the distal radius, a common site for osteoporotic fracture, and RA-related pain, upper-limb disease activity, and hand function in adults diagnosed within the previous 8 years.
Cortical and trabecular bone properties (mass, density, and apparent trabecular structure) were assessed at the 4% site of the radius in 21 adults with RA using peripheral quantitative computed tomography (pQCT). Clinical measures included upper-limb active joint count; self-reported pain (AIMS-2 Arthritis Pain scale) and physical function (AIMS-2 Hand and Finger Function scale); and grip strength (modified sphygmomanometer). Associations were characterized using correlations (Pearson correlation coefficients or Spearman's rho).
Cortical and trabecular bone mass and trabecular bone density were negatively associated with the number of active joints (r=-0.47, -0.54, and -0.47, respectively). Cortical bone density and mass were associated with grip strength (r=0.61 and 0.51, respectively). Cortical and trabecular bone density and cortical bone mass were negatively associated with scores on the Hand and Finger Function scale (r=-0.49, -0.45 and -0.56, respectively).
Although the patterns differed slightly for cortical and trabecular bone, better bone health in both compartments was associated with fewer active joints and lower self-reported hand disability in adults with RA.
类风湿关节炎(RA)患者患骨质疏松症的风险增加。本研究探讨了桡骨远端(骨质疏松性骨折的常见部位)特定区域(皮质骨和小梁骨)的骨特性与RA相关疼痛、上肢疾病活动度及手功能之间的关系,研究对象为在过去8年内确诊的成年患者。
使用外周定量计算机断层扫描(pQCT)对21例RA成年患者桡骨4%部位的皮质骨和小梁骨特性(质量、密度和表观小梁结构)进行评估。临床指标包括上肢活动关节计数;自我报告的疼痛(AIMS-2关节炎疼痛量表)和身体功能(AIMS-2手和手指功能量表);以及握力(改良血压计)。采用相关性分析(Pearson相关系数或Spearman秩相关系数)来描述关联情况。
皮质骨和小梁骨质量以及小梁骨密度与活动关节数量呈负相关(相关系数分别为-0.47、-0.54和-0.47)。皮质骨密度和质量与握力相关(相关系数分别为0.61和0.51)。皮质骨和小梁骨密度以及皮质骨质量与手和手指功能量表评分呈负相关(相关系数分别为-0.49、-0.45和-0.56)。
尽管皮质骨和小梁骨的模式略有不同,但在患有RA的成年人中,两个区域更好的骨骼健康与更少的活动关节以及更低的自我报告的手部残疾相关。