Reid D M, Kennedy N S, Smith M A, Tothill P, Nuki G
Br Med J (Clin Res Ed). 1982 Jul 31;285(6338):330-2. doi: 10.1136/bmj.285.6338.330.
Rheumatoid arthritis may be associated with generalised as well as periarticular osteoporosis. To assess the extent of bone loss and the influence of corticosteroid treatment total body calcium was measured by in-vivo neutron activation analysis in 63 patients with rheumatoid arthritis treated with non-steroidal anti-inflammatory drugs alone and 31 treated with additional low-dose corticosteroids. The results were compared with those in 40 normal controls matched for age, sex, and menopausal state. There were significant reductions in mean total body calcium in the group treated with non-steroidal anti-inflammatory drugs (5.3% in men; 6.8% in women) and greater reductions in the corticosteroid-treated patients (11.5% in men, 15.5% in women). The reduction was correlated with disease duration and activity in the patients treated with non-steroid anti-inflammatory drugs alone. Measured total body calcium was significantly less than the values predicted when this relation was used in the corticosteroid-treated patients. The data suggest that increased bone loss in patients with rheumatoid arthritis treated with corticosteroids is attributable to drug treatment rather than disease activity. Many patients with rheumatoid arthritis treated with low-dosage corticosteroids and some postmenopausal women with the disease are likely to be at risk from the complications of osteoporosis.
类风湿性关节炎可能与全身性以及关节周围骨质疏松有关。为了评估骨质流失的程度以及皮质类固醇治疗的影响，通过体内中子活化分析测量了63例仅接受非甾体抗炎药治疗的类风湿性关节炎患者和31例接受额外低剂量皮质类固醇治疗的患者的全身钙含量。将结果与40名年龄、性别和绝经状态相匹配的正常对照者的结果进行比较。仅接受非甾体抗炎药治疗的组中，平均全身钙含量显著降低（男性降低5.3%；女性降低6.8%），而接受皮质类固醇治疗的患者降低幅度更大（男性降低11.5%，女性降低15.5%）。在仅接受非甾体抗炎药治疗的患者中，钙含量的降低与疾病持续时间和活动度相关。在接受皮质类固醇治疗的患者中，当使用这种关系时，测得的全身钙含量显著低于预测值。数据表明，接受皮质类固醇治疗的类风湿性关节炎患者骨质流失增加归因于药物治疗而非疾病活动。许多接受低剂量皮质类固醇治疗的类风湿性关节炎患者以及一些患有该病的绝经后女性可能面临骨质疏松并发症的风险。
