Risk of vertebral fracture and relationship to bone mineral density in steroid treated rheumatoid arthritis.

N F Peel, D J Moore, N A Barrington, D E Bax, R Eastell

Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, United Kingdom.

OBJECTIVES--To determine the prevalence of vertebral fracture in postmenopausal women with steroid treated rheumatoid arthritis (RA), and whether the risk of vertebral fracture could be predicted from measurements of bone mineral density (BMD). METHODS--Vertebral deformities were defined from spine radiographs in 76 postmenopausal women with steroid treated RA (aged 50-79 years) and 347 age matched women from a population based group, using a morphometric technique. Lumbar spine (LS) BMD was measured by dual energy x ray absorptiometry. RESULTS--The odds ratio for vertebral fracture in the women with RA was 6.2 (95% confidence interval 3.2 to 12.3). The decrease in LS-BMD was less than expected for the observed prevalence of vertebral fracture and, among the women with RA, LS-BMD was not lower in those with vertebral fractures. CONCLUSIONS--We conclude that patients with steroid treated RA may have abnormal bone quality, and that LS-BMD cannot be used to predict the risk of vertebral fracture in these patients.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Ursum, J, Britsemmer, K, van Schaardenburg, D, Lips, P T A, Dijkmans, B A C, Lems, W (2009). High prevalence of vertebral deformities in elderly patients with early rheumatoid arthritis. Ann Rheum Dis 68: 1512-1513 [Full Text]  
• Tatsuno, I., Sugiyama, T., Suzuki, S., Yoshida, T., Tanaka, T., Sueishi, M., Saito, Y. (2009). Age Dependence of Early Symptomatic Vertebral Fracture with High-Dose Glucocorticoid Treatment for Collagen Vascular Diseases. J. Clin. Endocrinol. Metab. 94: 1671-1677 [Abstract] [Full Text]  
• Guler-Yuksel, M, Bijsterbosch, J, Goekoop-Ruiterman, Y P M, de Vries-Bouwstra, J K, Hulsmans, H M J, de Beus, W M, Han, K H, Breedveld, F C, Dijkmans, B A C, Allaart, C F, Lems, W F (2008). Changes in bone mineral density in patients with recent onset, active rheumatoid arthritis. Ann Rheum Dis 67: 823-828 [Abstract] [Full Text]  
• Guler-Yuksel, M, Bijsterbosch, J, Goekoop-Ruiterman, Y P M, Breedveld, F C, Allaart, C F, de Vries-Bouwstra, J K, Dijkmans, B A C, Lems, W F, Ronday, H K, Peeters, A J, de Jonge-Bok, J M (2007). Bone mineral density in patients with recently diagnosed, active rheumatoid arthritis. Ann Rheum Dis 66: 1508-1512 [Abstract] [Full Text]  
• Saviola, G., Abdi. Ali, L., Shams. Eddin, S., Coppini, A., Cavalieri, F., Campostrini, L., Sacco, S., Bucci, M., Cirino, G., Rossini, M. (2007). Compared clinical efficacy and bone metabolic effects of low-dose deflazacort and methyl prednisolone in male inflammatory arthropathies: a 12-month open randomized pilot study. Rheumatology (Oxford) 46: 994-998 [Abstract] [Full Text]  
• Chavassieux, P., Seeman, E., Delmas, P. D. (2007). Insights into Material and Structural Basis of Bone Fragility from Diseases Associated with Fractures: How Determinants of the Biomechanical Properties of Bone Are Compromised by Disease. Endocr. Rev. 28: 151-164 [Abstract] [Full Text]  
• Prather, H., Van Dillen, L., Metzler, J. P., Riew, K. D., Gilula, L. A. (2006). Prospective Measurement of Function and Pain in Patients with Non-Neoplastic Compression Fractures Treated with Vertebroplasty. JBJS 88: 334-341 [Abstract] [Full Text]  
• Orstavik, R E, Haugeberg, G, Uhlig, T, Mowinckel, P, Kvien, T K, Falch, J A, Halse, J I (2004). Quantitative ultrasound and bone mineral density: discriminatory ability in patients with rheumatoid arthritis and controls with and without vertebral deformities. Ann Rheum Dis 63: 945-951 [Abstract] [Full Text]  
• O'Brien, C. A., Jia, D., Plotkin, L. I., Bellido, T., Powers, C. C., Stewart, S. A., Manolagas, S. C., Weinstein, R. S. (2004). Glucocorticoids Act Directly on Osteoblasts and Osteocytes to Induce Their Apoptosis and Reduce Bone Formation and Strength. Endocrinology 145: 1835-1841 [Abstract] [Full Text]  
• Orstavik, R. E., Haugeberg, G., Mowinckel, P., Hoiseth, A., Uhlig, T., Falch, J. A., Halse, J. I., McCloskey, E., Kvien, T. K. (2004). Vertebral Deformities in Rheumatoid Arthritis: A Comparison With Population-Based Controls. Arch Intern Med 164: 420-425 [Abstract] [Full Text]  
• Orstavik, R E, Haugeberg, G, Uhlig, T, Mowinckel, P, Falch, J A, Halse, J I, Kvien, T K (2004). Self reported non-vertebral fractures in rheumatoid arthritis and population based controls: incidence and relationship with bone mineral density and clinical variables. Ann Rheum Dis 63: 177-182 [Abstract] [Full Text]  
• Porter, N., Beynon, H.L., Randeva, H.S. (2003). Endocrine and reproductive manifestations of sarcoidosis. QJM 96: 553-561 [Full Text]  
• Yeap, S. S., Hosking, D. J. (2002). Management of corticosteroid-induced osteoporosis. Rheumatology (Oxford) 41: 1088-1094 [Abstract] [Full Text]  
• Walsh, L. J., Lewis, S. A., Wong, C. A., Cooper, S., Oborne, J., Cawte, S. A., Harrison, T., Green, D. J., Pringle, M., Hubbard, R., Tattersfield, A. E. (2002). The Impact of Oral Corticosteroid Use on Bone Mineral Density and Vertebral Fracture. Am. J. Respir. Crit. Care Med. 166: 691-695 [Abstract] [Full Text]  
• Madsen, O R, Sorensen, O H, Egsmose, C (2002). Bone quality and bone mass as assessed by quantitative ultrasound and dual energy x ray absorptiometry in women with rheumatoid arthritis: relationship with quadriceps strength. Ann Rheum Dis 61: 325-329 [Abstract] [Full Text]  
• Gudbjornsson, B, Juliusson, U I, Gudjonsson, F V (2002). Prevalence of long term steroid treatment and the frequency of decision making to prevent steroid induced osteoporosis in daily clinical practice. Ann Rheum Dis 61: 32-36 [Abstract] [Full Text]  
• Walsh, L J, Wong, C A, Oborne, J, Cooper, S, Lewis, S A, Pringle, M, Hubbard, R, Tattersfield, A E (2001). Adverse effects of oral corticosteroids in relation to dose in patients with lung disease. Thorax 56: 279-284 [Abstract] [Full Text]  
• Naganathan, V., Jones, G., Nash, P., Nicholson, G., Eisman, J., Sambrook, P. N. (2000). Vertebral Fracture Risk With Long-term Corticosteroid Therapy: Prevalence and Relation to Age, Bone Density, and Corticosteroid Use. Arch Intern Med 160: 2917-2922 [Abstract] [Full Text]  
• Kvien, T. K, Haugeberg, G., Uhlig, T., Falch, J. A, Halse, J. I, Lems, W. F, Dijkmans, B. A C, Woolf, A. D (2000). Data driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis. Ann Rheum Dis 59: 805-811 [Abstract] [Full Text]  
• Conron, M., Young, C., Beynon, H. L. C. (2000). Calcium metabolism in sarcoidosis and its clinical implications. Rheumatology (Oxford) 39: 707-713 [Abstract] [Full Text]  
• LLOYD, M E, SPECTOR, T D, HOWARD, R (2000). Osteoporosis in neurological disorders. J. Neurol. Neurosurg. Psychiatry 68: 543-547 [Full Text]  
• Jardinet, D., Lefebvre, C., Depresseux, G., Lambert, M., Devogelaer, J.-P., Houssiau, F. A. (2000). Longitudinal analysis of bone mineral density in pre-menopausal female systemic lupus erythematosus patients: deleterious role of glucocorticoid therapy at the lumbar spine. Rheumatology (Oxford) 39: 389-392 [Abstract] [Full Text]  
• Gilboe, I.-M., Kvien, T. K, Haugeberg, G., Husby, G. (2000). Bone mineral density in systemic lupus erythematosus: comparison with rheumatoid arthritis and healthy controls. Ann Rheum Dis 59: 110-115 [Abstract] [Full Text]  
• LEMS, W F, DIJKMANS, B A C (1998). Should we look for osteoporosis in patients with rheumatoid arthritis?. Ann Rheum Dis 57: 325-327 [Full Text]