Ketabforoush Arsh Haj Mohamad Ebrahim, Aleahmad Mehdi, Qorbani Mostafa, Mehrpoor Golbarg, Afrashteh Sima, Mardi Shayan, Dolatshahi Elahe
Karaj, Iran Student Research Committee, Alborz University of Medical Sciences.
Tehran, Iran Present Address: Cellular and Molecular Research Center, Iran University of Medical Sciences.
J Diabetes Metab Disord. 2023 Mar 17;22(1):775-785. doi: 10.1007/s40200-023-01200-w. eCollection 2023 Jun.
Osteoporosis is a sizable comorbidity complication in Rheumatoid Arthritis (RA) sufferers. In the current study, the prevalence of osteopenia and osteoporosis in active RA sufferers and the association of disease-related factors of osteoporosis and reduced bone mineral density (BMD) have been examined.
In this cross-sectional study, 300 new-onset symptoms (less than one year) RA patients without a history of glucocorticoids or DMARDs were selected. Biochemical blood measurements and BMD status were performed with dual-energy X-ray absorptiometry. According to the T-scores of the patients, they were divided into three groups: osteoporosis<-2.5, -2.5 < osteopenia <-1, and - 1 < normal. Also, the MDHAQ questionnaire, DAS-28, and FRAX criteria were calculated for all patients. Multivariate logistic regression was used to determine the associated factors of osteoporosis and osteopenia.
The Prevalence of osteoporosis and osteopenia was 27% (95%CI:22-32) and 45% (95%CI:39-51), respectively. The multivariate regression analysis showed that age could play a role as an associated factor for spine/hip Osteoporosis and Osteopenia. The female gender is also a predictor of Spine osteopenia Patients with Total hip Osteoporosis were more likely to have higher DAS-28 (OR 1.86, CI 1.16-3.14) and positive CRP (OR 11.42, CI 2.65-63.26).
recent-onset RA patients are at risk for osteoporosis and its complications, regardless of using glucocorticoids or DMARDs. Demographic factors (e.g. age and female gender), patients' MDHAQ scores, and disease-related factors(e.g., DAS-28, positive CRP were associated with reduced BMD levels. Therefore, it is recommended that clinicians investigate early BMD measurements to have a reasonable judgment for further interventions.
The online version contains supplementary material available at 10.1007/s40200-023-01200-w.
骨质疏松是类风湿关节炎（RA）患者中一种相当常见的合并症并发症。在本研究中，已对活动期RA患者中骨质减少和骨质疏松的患病率以及骨质疏松和骨密度（BMD）降低的疾病相关因素之间的关联进行了研究。
在这项横断面研究中，选取了300例无糖皮质激素或改善病情抗风湿药（DMARDs）使用史的新发病症状（少于1年）的RA患者。采用双能X线吸收法进行血液生化检测和BMD测定。根据患者的T值，将他们分为三组：骨质疏松组（T值＜-2.5）、骨质减少组（-2.5＜T值＜-1）和正常组（-1＜T值）。此外，还对所有患者计算了MDHAQ问卷、DAS-28和FRAX标准。采用多因素逻辑回归分析来确定骨质疏松和骨质减少的相关因素。
骨质疏松和骨质减少的患病率分别为27%（95%CI：22-32）和45%（95%CI：39-51）。多因素回归分析表明，年龄可能是脊柱/髋部骨质疏松和骨质减少的相关因素。女性也是脊柱骨质减少的一个预测因素。全髋部骨质疏松患者更有可能具有更高的DAS-28（OR 1.86，CI 1.16-3.14）和C反应蛋白阳性（OR 11.42，CI 2.65-63.26）。
近期发病的RA患者有发生骨质疏松及其并发症的风险，无论是否使用糖皮质激素或DMARDs。人口统计学因素（如年龄和女性性别）、患者的MDHAQ评分以及疾病相关因素（如DAS-28、C反应蛋白阳性）与BMD水平降低有关。因此，建议临床医生尽早进行BMD检测，以便为进一步干预做出合理判断。
在线版本包含可在10.1007/s40200-023-01200-w获取的补充材料。
