Background Hand osteoarthritis (OA) and its more severe subset erosive hand OA are common causes of pain and morbidity. Some metabolic factors were suggested to be implicated in erosive disease. Furthermore, few studies investigated differences in systemic bone loss between erosive and non-erosive hand OA.
Objectives To compare bone mineral density (BMD) and major cardiovascular risk factors between patients with erosive and non-erosive hand OA in a cross-sectional study.
Methods Patients with symptomatic disease fulfilling the American College of Rheumatology (ACR) criteria for hand OA were included in this study. Erosive hand OA was defined by at least one erosive interphalangeal joint. All patients underwent clinical assessments of joint swelling and radiographs of both hands. DEXA examination of lumbar spine, total femur and femur neck was performed. Metabolic risk factors (body mass index, hypertension, diabetes, dyslipidaemia) and smoking habits were collected.
Results Altogether, 134 patients (13 male) with symptomatic nodal hand OA were included in this study between April 2012 and January 2015. Mean (SD) age of all patients was 65.98 (8.16) years and disease duration was 8.54 (7.14) years. Out of these patients, 72 had erosive hand OA. Baseline population characteristics did not differ between both groups. Osteoporosis (T-score <-2.5 SD) was diagnosed in 12.5% (9/72) of patients with erosive hand OA and in 8.06% (5/62) of patients with non-erosive hand OA. Although bone mineral density did not significantly differ between the groups, T-scores of lumbar spine (-0.46 vs. -1.04 SD, p<0.001), total femur (-0.36 vs. -1.20 SD, p<0.001) and femur neck (-0.92 vs. -1.20 SD, p<0.01) were significantly lower in patients with erosive compared with non-erosive disease. Furthermore, there were more patients with dyslipidaemia (p<0.05) and arterial hypertension (p<0.05) among patients with erosive compared with non-erosive hand OA. On the other side, there were less patients with diabetes mellitus (p<0.05) among patients with erosive compared with non-erosive hand OA.
Conclusions These results suggest that patients with erosive hand OA are at risk for development of general bone loss and cardiovascular diseases.
Acknowledgements This work was supported by the project MHCR No. 023728.
Disclosure of Interest None declared