Jadhav Praveen Pratap, Patwardhan Vivek Gajanan
Omkar Rheumatology Clinic, Gaikwad Mala, Nashik, India.
Hirabai Cowasji Jehangir, Medical Research Institute, Jehangir Hospital, Pune, India.
Mediterr J Rheumatol. 2023 Sep 12;34(4):479-485. doi: 10.31138/mjr.120923.eoh. eCollection 2023 Dec.
Patients with rheumatoid arthritis (RA) are associated with low bone mineral density (BMD). Chronic comorbidities such as type II diabetes mellitus have shown to affect BMD parameters in patients with RA. Hypertension (HT) is a chronic disease and its coexistence with RA can alter bone health. The aim of this study was to investigate if HT affected BMD parameters in RA patients diagnosed for the first time.
Patients with the diagnosis of RA who underwent BMD studies formed the study population. Patients with HT were sorted from this population and formed a separate group. Healthy controls were drawn from subjects who came for a check-up. BMD was done with the GE Lunar DPX machine. Mean T Scores at spine, femur neck and total femur were recorded. Data from the three groups were analysed and compared. Linear regression analyses were performed.
Analysis suggested that the age had inverse and BMI had direct correlation with BMD T scores in all groups. The additional diagnosis of HT in RA patients was associated with higher BMD as compared to patients with RA, but lower than controls. R values were 0.341, 0.402 and 0.436 for mean T scores at spine, femur neck and femur total respectively. Figures from multiple regression analysis suggest that BMI alone did not explain the higher T score values in HT patients.
Additional morbidity of HT in RA patients negates the porotic effect of RA as judged by bone densitometry. Hence, BMD reports should be read with caution in these patients.
类风湿关节炎（RA）患者存在骨矿物质密度（BMD）较低的情况。诸如2型糖尿病等慢性合并症已显示会影响RA患者的BMD参数。高血压（HT）是一种慢性病，它与RA共存会改变骨骼健康。本研究的目的是调查HT是否会影响首次诊断的RA患者的BMD参数。
接受BMD研究的RA诊断患者构成研究人群。从该人群中筛选出HT患者并组成一个单独的组。健康对照从前来体检的受试者中选取。使用GE Lunar DPX机器进行BMD检测。记录脊柱、股骨颈和全股骨的平均T值。对三组数据进行分析和比较。进行线性回归分析。
分析表明，在所有组中年龄与BMD T值呈负相关，体重指数（BMI）与BMD T值呈正相关。与RA患者相比，RA患者中额外诊断出HT与更高的BMD相关，但低于对照组。脊柱、股骨颈和全股骨平均T值的R值分别为0.341、0.402和0.436。多元回归分析的数据表明，仅BMI并不能解释HT患者较高的T值。
根据骨密度测定结果判断，RA患者中HT这一额外病症抵消了RA的骨质疏松效应。因此，对于这些患者的BMD报告应谨慎解读。
