Madsen O R, Egsmose C, Hansen B, Sørensen O H
Osteoporosis Research Centre, Copenhagen Municipal Hospital, University of Copenhagen, Denmark.
Clin Exp Rheumatol. 1998 Jan-Feb;16(1):27-32.
To examine differences in soft tissue composition, bone quality, bone mass and quadriceps strength between women with rheumatoid arthritis (RA) and healthy controls.
79 women with RA (median disease duration 10 yrs) were studied. Most were or had been on steroids. 67 healthy age-matched women served as controls. The lean tissue mass (LTM) and fat mass (FM) of the total body and of the major body subregions, as well as the bone mineral density (BMD, g/cm2) of the femoral neck, spine (L2-L4) and distal forearm were measured by dual energy x-ray absorptiometry (DXA). Bone quality expressed as the speed of sound (SOS m/sec), broadband ultrasound attenuation (BUA, dB/MHz) and stiffness was assessed by an Achilles ultrasound device, and isometric quadriceps strength by an isokinetic dynamometer.
No between-group differences were found for the body mass index (BMI, weight/height2), total or regional percentage fat, LTM and FM. However, women with RA had 20% lower quadriceps strength than controls. BMD at the femoral neck and distal forearm, and SOS, BUA and stiffness were significantly lower in patients than in controls. No difference was found for spine BMD. In the RA group, z-scores for SOS and stiffness were significantly more reduced than those for BMD. Multiple regression analyses indicated negative associations between ultrasound parameters and the cumulative steroid dose.
Reductions in BMD and muscle strength in RA were not accompanied by changes in soft tissue composition, Bone quality assessed by ultrasonography was compromised in RA and may be modified by steroids.
研究类风湿关节炎（RA）女性患者与健康对照者在软组织成分、骨质、骨量和股四头肌力量方面的差异。
对79名RA女性患者（疾病中位病程10年）进行研究。大多数患者正在或曾经使用过类固醇药物。67名年龄匹配的健康女性作为对照。采用双能X线吸收法（DXA）测量全身及主要身体分区的瘦组织质量（LTM）和脂肪质量（FM），以及股骨颈、脊柱（L2-L4）和前臂远端的骨密度（BMD，g/cm²）。通过跟腱超声设备评估以声速（SOS，m/sec）、宽带超声衰减（BUA，dB/MHz）和硬度表示的骨质，通过等速测力计评估等长股四头肌力量。
两组在体重指数（BMI，体重/身高²）、全身或局部脂肪百分比、LTM和FM方面未发现差异。然而，RA女性患者的股四头肌力量比对照组低20%。患者的股骨颈和前臂远端骨密度以及SOS、BUA和硬度均显著低于对照组。脊柱骨密度未发现差异。在RA组中，SOS和硬度的z评分比骨密度的降低更显著。多元回归分析表明超声参数与累积类固醇剂量之间呈负相关。
RA患者的骨密度和肌肉力量降低并未伴有软组织成分的改变，超声评估的骨质在RA中受损，且可能受类固醇药物影响。
