Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, 311200, Zhejiang, China.
Clinical Research Center, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, 311200, Zhejiang, China.
J Orthop Surg Res. 2021 Mar 15;16(1):190. doi: 10.1186/s13018-021-02338-0.
It is reported that osteoporosis commonly occurs among patients with rheumatoid arthritis (RA), whereas the association between osteoporosis and osteoarthritis (OA) remains controversial. Our aim in this study was to investigate the association between BMD, as a marker of osteoporosis, and OA and RA among adults 20-59 years of age, using a population-based sample from the National Health and Nutrition Examination Survey (NHANES).
Our analysis was based on the NHANES data collected between 2011 and 2018. Data regarding arthritis status and the type of arthritis (OA or RA) were obtained from questionnaires. Lumbar BMD was measured by dual-energy X-ray absorptiometry. The association between OA, RA, and lumbar BMD was evaluated using logistic regression models. Subgroup analyses, stratified by gender and race, were performed. The association between duration of arthritis and lumbar BMD was also investigated.
A total of 11,094 adults were included in our study. Compared to the non-arthritis group, participants with OA had a higher lumbar BMD (β = 0.023, 95% CI 0.011-0.035), with no significant association between lumbar BMD and RA (β = 0.014, 95% CI - 0.003 to 0.031). On subgroup analyses stratified by gender, males with OA had a higher lumbar BMD compared to those without OA (β = 0.047, 95% CI 0.028-0.066). In females, OA was not associated with lumbar BMD (β = 0.007, 95% CI - 0.008 to 0.021). There was no association between lumbar BMD and RA in both males (β = 0.023, 95% CI - 0.003 to 0.048) and females (β = 0.008, 95% CI - 0.015 to 0.031). Duration of arthritis was not associated with lumbar BMD for both OA (β = - 0.0001, 95% CI - 0.0017 to 0.0015) and RA (β = 0.0006, 95% CI - 0.0012 to 0.0025).
Lumbar BMD was associated with OA but not with RA. While a higher lumbar BMD was associated with OA in males, but not in females. Our findings may improve our understanding between OA, RA, and bone health.
据报道，骨质疏松症在类风湿关节炎（RA）患者中较为常见，而骨质疏松症与骨关节炎（OA）之间的关联仍存在争议。本研究旨在使用来自全国健康和营养检查调查（NHANES）的基于人群的样本，调查 20-59 岁成年人中 BMD（骨质疏松症的标志物）与 OA 和 RA 之间的关系。
我们的分析基于 2011 年至 2018 年收集的 NHANES 数据。关节炎状况和关节炎类型（OA 或 RA）的数据来自问卷调查。腰椎 BMD 通过双能 X 射线吸收法测量。使用 logistic 回归模型评估 OA、RA 和腰椎 BMD 之间的关联。进行了性别和种族分层的亚组分析。还研究了关节炎持续时间与腰椎 BMD 之间的关系。
本研究共纳入 11094 名成年人。与非关节炎组相比，OA 组的腰椎 BMD 较高（β=0.023，95%CI0.011-0.035），而 RA 与腰椎 BMD 之间无显著关联（β=0.014，95%CI-0.003 至 0.031）。在按性别分层的亚组分析中，OA 男性的腰椎 BMD 高于无 OA 男性（β=0.047，95%CI0.028-0.066）。在女性中，OA 与腰椎 BMD 无关（β=0.007，95%CI0.008-0.021）。在男性（β=0.023，95%CI0.003-0.048）和女性（β=0.008，95%CI0.015-0.031）中，RA 与腰椎 BMD 均无关。OA 持续时间与腰椎 BMD 无关（β=-0.0001，95%CI-0.0017 至 0.0015），RA 持续时间与腰椎 BMD 无关（β=0.0006，95%CI-0.0012 至 0.0025）。
腰椎 BMD 与 OA 相关，但与 RA 无关。虽然在男性中，较高的腰椎 BMD 与 OA 相关，但在女性中则不然。我们的发现可能会增进我们对 OA、RA 和骨骼健康之间关系的理解。
