Department of Musculoskeletal Medicine, Yoshii Hospital, Kochi, Japan.
Department of Rheumatology, Dohgo Onsen Hospital Rheumatology Center, Ehime, Japan.
Mod Rheumatol. 2024 Mar 28;34(3):493-499. doi: 10.1093/mr/road058.
The validity of prognostic nutritional index (PNI) as an index of incident bone fragility fracture (inc-BFF) in rheumatoid arthritis (RA) patients was investigated.
RA patients whom continuously followed up for >3 years were picked up. Patients were classified in accordance with inc-BFF positivity (BFF+ and BFF-). Their clinical background including PNI was statistically examined for inc-BFF. The background factors were compared between the two groups. Patients were narrowed into subgroups according to the factor that showed a significant difference between the two groups, and they were statistically examined according to the PNI for the inc-BFF. The two groups were narrowed with propensity score matching and compared to the PNI.
A total of 278 patients with 44 BFF+ and 234 BFF- were recruited. In the background factors, the presence of prevalent BFF and the simplified disease activity index remission rate had a significantly higher risk ratio. In a subgroup who comorbid lifestyle-related diseases, PNI had a significantly higher risk ratio for the inc-BFF. After the propensity score matching, the PNI showed no significant difference between the two groups.
PNI is available when patients with RA comorbid lifestyle-related diseases. PNI is not an independent key for the inc-BFF in RA patients.
探讨预后营养指数（PNI）作为类风湿关节炎（RA）患者脆性骨折事件（inc-BFF）指标的有效性。
选取连续随访>3 年的 RA 患者。根据 inc-BFF 阳性（BFF+和 BFF-）将患者进行分类。对 inc-BFF 的临床背景包括 PNI 进行统计学检查。比较两组之间的背景因素。根据两组之间存在显著差异的因素将患者分为亚组，并根据 PNI 对 inc-BFF 进行统计学检查。通过倾向评分匹配缩小两组，并比较 PNI。
共纳入 278 例患者，其中 44 例为 BFF+，234 例为 BFF-。在背景因素中，既往 BFF 存在和简化疾病活动指数缓解率的风险比更高。在合并生活方式相关疾病的亚组中，PNI 对 inc-BFF 的风险比更高。在倾向评分匹配后，两组之间的 PNI 无显著差异。
当 RA 患者合并生活方式相关疾病时，PNI 可用。PNI 不是 RA 患者 inc-BFF 的独立关键因素。
