Ma Can-Chen, Xu Sheng-Qian, Gong Xun, Wu Ying, Qi Shan, Liu Wen, Xu Jian-Hua
Department of Rheumatology & Immunology, The First Affiliated Hospital of Anhui Medical University, No. 218, Ji-xi Road, Hefei, Anhui, 230022, China.
Arch Osteoporos. 2017 Dec;12(1):33. doi: 10.1007/s11657-017-0329-0. Epub 2017 Apr 3.
Usage of glucocorticoid (GC) is a strong risk factor of osteoporosis (OP) and osteoporotic fracture (OPF) in Chinese patients with rheumatoid arthritis (RA). Controlling GC daily dosage and shortening GC course are helpful in preventing glucocorticoid-induced osteoporosis (GIOP) and OPF for Chinese patients with RA.
This study aims to investigate the prevalence and risk factors of GIOP, and also identify influences of GC daily dosage and GC treatment course for GIOP in Chinese patients with RA.
Seven hundred and ninety patients with RA and 158 normal subjects were enrolled in the study. Clinical and laboratory features and medications of GC were recorded in detail. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry in all subjects.
BMD at all measured sites in RA was significantly lower than that in control group. Prevalence of OP was obviously higher in RA with GC group (41.6%), compared with RA without GC group (29.4%). Prevalence of OPF in group of RA with GC (21.0%) was higher than that in group of RA without GC (13.3%). Usage of GC, female, and age were risk factors for the occurrence of OP and OPF in RA, while body mass index (BMI) was the protective factor of OP. Prevalence of GIOP and OPF had statistical significance among groups of different treatment courses with GC, whereas no statistical difference was found among groups with different daily dosages of GC.
GIOP exists generally in Chinese patients with RA, which relates to treatment course not daily dosage of GC. Usage of GC is also the risk factor for the happening of OPF in Chinese patients with RA.
在中国类风湿关节炎(RA)患者中,使用糖皮质激素(GC)是骨质疏松症(OP)和骨质疏松性骨折(OPF)的一个重要危险因素。控制GC每日剂量并缩短GC疗程有助于预防中国RA患者发生糖皮质激素性骨质疏松症(GIOP)和OPF。
本研究旨在调查GIOP的患病率及危险因素,并确定GC每日剂量和GC治疗疗程对中国RA患者GIOP的影响。
本研究纳入了790例RA患者和158例正常受试者。详细记录了GC的临床和实验室特征及用药情况。所有受试者均采用双能X线吸收法测量骨密度(BMD)。
RA患者所有测量部位的BMD均显著低于对照组。使用GC的RA组OP患病率(41.6%)明显高于未使用GC的RA组(29.4%)。使用GC的RA组OPF患病率(21.0%)高于未使用GC的RA组(13.3%)。GC的使用、女性和年龄是RA患者发生OP和OPF的危险因素,而体重指数(BMI)是OP的保护因素。不同GC治疗疗程组之间GIOP和OPF的患病率有统计学意义,而不同GC每日剂量组之间未发现统计学差异。
中国RA患者普遍存在GIOP,这与GC的治疗疗程而非每日剂量有关。GC的使用也是中国RA患者发生OPF的危险因素。