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Bone mineral density in patients with recently diagnosed, active rheumatoid arthritis
  1. M Güler-Yüksel (m.yuksel{at}lumc.nl)
  1. Leiden University Medical Center, Netherlands
    1. J Bijsterbosch (j.bijsterbosch{at}umail.leidenuniv.nl)
    1. Leiden University Medical Center, Netherlands
      1. Y PM Goekoop-Ruiterman (y.p.m.goekoop{at}lumc.nl)
      1. Leiden University Medical Center, Netherlands
        1. J K de Vries-Bouwstra (j.k.de_vries-bouwstra{at}lumc.nl)
        1. VU Medical Center, Netherlands
          1. H K Ronday (k.ronday{at}hagaziekenhuis.nl)
          1. Haga hospital, Netherlands
            1. A J Peeters (peeters{at}rdgg.nl)
            1. Reinier de Graaf Gasthuis, Netherlands
              1. J M de Jonge-Bok (kayserilimelek{at}hotmail.com)
              1. Groene Hart hospital, Netherlands
                1. F C Breedveld (f.c.breedveld{at}lumc.nl)
                1. Leiden University Medical Center, Netherlands
                  1. B AC Dijkmans (bac.dijkmans{at}vumc.nl)
                  1. VU Medical Center, Netherlands
                    1. C F Allaart (c.f.allaart{at}lumc.nl)
                    1. Leiden University Medical Center, Netherlands
                      1. W F Lems (wf.lems{at}vumc.nl)
                      1. VU Medical Center, Netherlands

                        Abstract

                        Objectives: Osteoporosis is a well known extra-articular phenomenon in patients with uncontrolled, longstanding rheumatoid arthritis (RA). In the present study, the extent of osteoporosis and reduced bone mineral density (BMD) and the disease-related and demographic factors that are associated with osteoporosis and reduced BMD are examined in patients with recently diagnosed, active RA.

                        Methods: BMD of the total hip and the lumbar spine was measured in 381 DMARD and corticosteroid-naïve patients with recently diagnosed, active RA using dual energy x-ray absorptiometry. Osteoporosis was defined as T-score ≤-2.5 SD and reduced BMD as Z-score ≤-1 SD. Multivariate logistic regression analyses were performed to detect associations of osteoporosis and reduced BMD with disease activity, functional disability and joint damage (Sharp/vanderHeijde Score), as well as with demographic factors.

                        Results: Osteoporosis and reduced BMD were found in 11% and 25%, respectively, of the patients in the spine and/or the hip. Longer symptom duration and presence of rheumatoid factor (RF) were the only RA-specific markers for osteoporosis and reduced BMD. Further, postmenopausal status in females, a low BMI and familial osteoporosis and, remarkably, male gender were independently associated with osteoporosis and reduced BMD.

                        Conclusion: In DMARD and corticosteroid-naïve patients with recently diagnosed active RA, BMD seems to be well preserved and predominantly related to demographic factors. Longer symptom duration and a positive RF, but not higher disease activity or more joint damage, were related to osteoporosis and reduced BMD.

                        • bone mineral density
                        • early rheumatoid arthritis
                        • osteoporosis

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