Azzouzi Hamida, Ichchou Linda
Department of Rheumatology, Mohammed VI University Hospital, Faculty of Medicine, Mohammed I University, Oujda, Morocco.
J Bone Metab. 2021 May;28(2):151-159. doi: 10.11005/jbm.2021.28.2.151. Epub 2021 May 31.
Rheumatoid arthritis (RA) is a known cause of joint destruction and systemic bone loss. In this study, we aimed to evaluate the bone damage and bone loss profiles of established RA patients.
We designed a cross-sectional study on a cohort of established RA patients. The bone evaluation was performed by obtaining standard X-ray images of hands and feet combined with bone mineral density (BMD) measurements. Radiographic joint damage was calculated by the modified total Sharp /van der Heijde score (mTSS). BMD was obtained by performing dual energy X-ray absorptiometry of the lumbar spine and femoral neck. Data on age, smoking, alcoholism, steroid prescription, body mass index (BMI), disease duration, disease activity, and functional disability were collected.
A total of 93 RA patients were recruited. Their mean age was 51.59±12.38 years, with a mean disease duration of 12.07±9.19 years. A total of 36.6% of patients had osteoporosis, and the mean mTSS was 70.33±48.93. Both hip (P=0.0005) and lumbar BMD (P=0.0005) were correlated with mTSS. Backward regression analyses determined that bone damage was associated with high titers of rheumatoid factor, low lumbar BMD, and low BMI. General bone loss was associated with gender, steroid dose, steroid duration, menopause, and BMI.
Bone damage was associated with low BMI and axial bone loss in our RA population.
类风湿性关节炎(RA)是已知的关节破坏和全身性骨质流失的病因。在本研究中,我们旨在评估确诊RA患者的骨损伤和骨质流失情况。
我们针对一组确诊的RA患者设计了一项横断面研究。通过获取手和脚的标准X线图像并结合骨密度(BMD)测量来进行骨评估。采用改良的总Sharp/van der Heijde评分(mTSS)计算影像学关节损伤。通过对腰椎和股骨颈进行双能X线吸收测定法获取BMD。收集了年龄、吸烟、酗酒、类固醇处方、体重指数(BMI)、病程、疾病活动度和功能残疾等数据。
共招募了93例RA患者。他们的平均年龄为51.59±12.38岁,平均病程为12.07±9.19年。共有36.6%的患者患有骨质疏松症,平均mTSS为70.33±48.93。髋关节(P = 0.0005)和腰椎BMD(P = 0.0005)均与mTSS相关。向后回归分析确定骨损伤与高滴度类风湿因子、低腰椎BMD和低BMI有关。全身性骨质流失与性别、类固醇剂量、类固醇使用时长、绝经和BMI有关。
在我们的RA患者群体中,骨损伤与低BMI和轴向骨质流失有关。