Risk factors associated with bone loss and occurrence of fragility fractures in rheumatoid arthritis patients

Risk factors associated with bone loss and occurrence of fragility fractures in rheumatoid arthritis patients

To investigate the bone mineral density (BMD) in rheumatoid arthritis (RA) Tunisian patients, to identify the risk factors associated with its decrease and to assess the fracture risk. The study included 173 patients and 173 matched healthy controls. BMD was assessed by the dual-energy X-ray absorpt...

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Bibliographic Details
Published in:Egyptian rheumatologist Vol. 41; no. 1; pp. 1 - 5
Main Authors: Wafa, Hamdi, Raja, Alaya, Dhia, Kaffel, Nada, Boughanmi, Imene, Zouche, Montacer, Kchir Mohamed
Format: Journal Article
Language:English
Published: Elsevier B.V 01-01-2019
Subjects:
Bone mineral density
Fracture
FRAX
Osteoporosis
Rheumatoid arthritis
Osteoporosis
FRAX
Fracture
Bone mineral density
Rheumatoid arthritis
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Summary:To investigate the bone mineral density (BMD) in rheumatoid arthritis (RA) Tunisian patients, to identify the risk factors associated with its decrease and to assess the fracture risk. The study included 173 patients and 173 matched healthy controls. BMD was assessed by the dual-energy X-ray absorptiometry. The risk of hip fracture (HF) and major osteoporotic fracture (MOF) were assessed using the fracture risk assessment tool (FRAX). The disease activity, radiological severity and functional status were investigated. The mean age of patients was 54.1 ± 11.04 years and 141 were females; 71.6% menopausal. Disease duration was 8.2 ± 8 years and disease activity score was 5.54 ± 1.26. Sharp van-der-Heijde (SvdH) score was 113.9 ± 106.8, health assessment questionairre (HAQ) score 1.03 ± 0.9. The BMD was significantly reduced in 138 (79.8%) patients and FRAX was higher compared to control (p < .001). The frequency of osteoporosis (48% vs. 18.5%), the risk of MOF (1.8 ± 2.6 vs. 0.6 ± 0.3) and HF (0.7 ± 1.7 vs. 0.08 ± 0.1) were significantly higher in RA patients than in controls. Bone loss in RA was significantly associated with age, low body mass index (BMI), longer disease duration, rheumatoid factor, SvdH, atlantoaxial subluxation and corticosteroids use. Menopause, low calcium intake, erythrocyte sedimentation rate and HAQ were risk factors for reduced BMD. The risk of MOF and HF was associated with age, menopause, calcium intake, BMI, disease duration, HAQ, SvdH, cumulative dose and duration of corticosteroids. bone loss and fragility fracture are frequent in RA and related to disease severity, function impairment and corticosteroids use.
ISSN:1110-1164
2090-2433
DOI:10.1016/j.ejr.2018.01.004