中国类风湿关节炎患者糖皮质激素性骨质疏松症与肌肉减少症和维生素 D 缺乏的关系。
Association of sarcopenia and vitamin D deficiency with glucocorticoid-induced osteoporosis in Chinese patients with rheumatoid arthritis.
机构信息
Department of Endocrine Laboratory, The First Affiliated Hospital of Anhui Medical University, No. 218, Ji-xi Road, Hefei, 230022, China.
Department of Rheumatology & Immunology, The First Affiliated Hospital of Anhui Medical University, No. 218, Ji-xi Road, Hefei, 230022, China.
出版信息
Clin Rheumatol. 2024 Jan;43(1):15-22. doi: 10.1007/s10067-023-06784-5. Epub 2023 Oct 13.
OBJECTIVES
The study aimed to explore the association of sarcopenia and vitamin D deficiency with glucocorticoid-induced osteoporosis (GIOP) in Chinese patients with rheumatoid arthritis (RA).
METHOD
Skeletal muscle mass, serum 25(OH)D levels, and bone mineral density (BMD) were assessed.
RESULTS
The prevalence of OP, sarcopenia, and vitamin D deficiency in RA patients was significantly higher than in controls (all P < 0.001). The percentage of GC use was 56.9%, and the prevalence of GIOP was 38.1% in 480 RA patients. The prevalence of OP in RA patients without sarcopenia was lower than that in RA patients with sarcopenia (P < 0.05). In RA patients with and without GC, the prevalence of OP in patients without sarcopenia was significantly lower than that in patients with sarcopenia (P < 0.001 and P < 0.05). Female sex (OR = 54.737; 95% CI: 7.103-421.809; P < 0.0001), age (OR = 1.078; 95% CI: 1.048-1.110; P < 0.0001), sarcopenia, and vitamin D deficiency (OR = 2.250; 95% CI: 1.246-64.065; P = 0.007) were risk factors for GIOP in RA patients.
CONCLUSIONS
GIOP is associated with sarcopenia and vitamin D deficiency and is widespread among Chinese patients with RA. Key points ·Percentage of using GC and the prevalence of OP were all high in Chinese patients with RA. ·GIOP was widely existed in Chinese RA patients, which was associated with sarcoprnia and vitamin D deficiency.
目的
本研究旨在探讨中国类风湿关节炎（RA）患者中肌少症和维生素 D 缺乏与糖皮质激素诱导的骨质疏松症（GIOP）的关系。
方法
评估骨骼肌质量、血清 25（OH）D 水平和骨密度（BMD）。
结果
RA 患者的 OP、肌少症和维生素 D 缺乏的患病率明显高于对照组（均 P < 0.001）。480 例 RA 患者中 GC 使用率为 56.9%，GIOP 患病率为 38.1%。无肌少症的 RA 患者的 OP 患病率低于有肌少症的 RA 患者（P < 0.05）。在有和无 GC 的 RA 患者中，无肌少症的患者的 OP 患病率明显低于有肌少症的患者（P < 0.001 和 P < 0.05）。女性（OR = 54.737；95%CI：7.103-421.809；P < 0.0001）、年龄（OR = 1.078；95%CI：1.048-1.110；P < 0.0001）、肌少症和维生素 D 缺乏（OR = 2.250；95%CI：1.246-64.065；P = 0.007）是 RA 患者发生 GIOP 的危险因素。
结论
GIOP 与肌少症和维生素 D 缺乏有关，并且在中国 RA 患者中普遍存在。关键点·中国 RA 患者使用 GC 的比例和 OP 的患病率均较高。·GIOP 在中国 RA 患者中广泛存在，与肌少症和维生素 D 缺乏有关。
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