Omichi Yasuyuki, Shinomiya Fumio, Mima Noriaki, Hirose Jun, Enomoto Tsutomu, Goto Tomohiro, Nakano Shunji, Enishi Tetsuya, Morimoto Masatoshi, Sairyo Koichi
Orthopedics, Tokushima Municipal Hospital, Tokushima, JPN.
Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JPN.
Cureus. 2024 Jul 21;16(7):e65056. doi: 10.7759/cureus.65056. eCollection 2024 Jul.
Introduction There has been no study on bone structural properties in postmenopausal women with rheumatoid arthritis (RA) in Japan. This study investigated bone mineral density (BMD) and bone structural properties in Japanese postmenopausal women with RA. Methods The study had a cross-sectional design and included 119 postmenopausal women aged 50-80 years with RA symptoms for more than five years. BMD, trabecular bone score (TBS), and results of hip structure analysis (HSA) were measured on dual-energy X-ray absorptiometry scans. The control group consisted of 288 women aged 50-80 years without RA. The RA group and control group using bisphosphonates were compared after propensity score matching for age, body mass index, and fracture history. Women in the RA group were also compared according to the use of glucocorticoids (GCs). Results After the propensity matching score, there were no other significant differences in BMD, TBS, and HSA parameters between the RA group and the control group. In the RA group, the TBS was lower in patients on GCs than those not on GCs (1.272 vs 1.313, p=0.008). There were no other significant differences in BMD and HSA parameters between patients in the RA group according to the use of GCs. Conclusion Although there were no differences in BMD, the TBS was lower in patients on GCs than those not on GCs in the RA group. It is thus important for physicians who administer GCs to treat patients with RA to be aware of not only BMD but also TBS.
引言 在日本,尚未有关于绝经后类风湿关节炎(RA)女性骨骼结构特性的研究。本研究调查了日本绝经后RA女性的骨密度(BMD)和骨骼结构特性。方法 本研究采用横断面设计,纳入了119名年龄在50 - 80岁、有超过五年RA症状的绝经后女性。在双能X线吸收测定扫描中测量BMD、小梁骨评分(TBS)和髋部结构分析(HSA)结果。对照组由288名年龄在50 - 80岁且无RA的女性组成。在对年龄、体重指数和骨折史进行倾向得分匹配后,比较RA组和使用双膦酸盐的对照组。RA组中的女性也根据糖皮质激素(GCs)的使用情况进行比较。结果 在倾向得分匹配后,RA组和对照组在BMD、TBS和HSA参数方面没有其他显著差异。在RA组中,使用GCs的患者的TBS低于未使用GCs的患者(1.272对1.313,p = 0.008)。根据GCs的使用情况,RA组患者在BMD和HSA参数方面没有其他显著差异。结论 尽管在BMD方面没有差异,但RA组中使用GCs的患者的TBS低于未使用GCs的患者。因此,治疗RA患者的医生不仅要了解BMD,还要了解TBS,这一点很重要。