Background Rheumatoid arthritis (RA) has a significant influence on bone loss in both peripheral (juxtaarticular osteoporosis) and axial skeleton. Glucocorticoids (GC) are often used in the therapy of RA and contribute significantly to favourable disease outcome but have been accused to cause a bone loss in these patients.
Objectives To assess the influence of GC on the occurrence of osteoporosis in RA patients.
Methods Hundred and seven women with RA were evaluated. They were divided in two age-groups: 40–49 and 50–59. The assessment of bone mineral density was performed by dual energy x-ray absorptiometry (DEXA), using Lunar DPX densitometer. Anterior-posterior spine scan of lumbar vertebrae L1-L4 was performed.
Results The following average values of bone mineral density (BMD) were found: 1.116 g/cm2 for age-group of 40–49 and 0.942 g/cm2 for 50–59 years old patients. In comparison with control group (300 healthy women of the same age-groups) we found significantly lower BMD in RA patients (p < 0.05 for the age group of 40–49 and p < 0.001 for age-group of 50–59).
Annual rate of bone loss in both control and group of RA patients was also evaluated. In the control group annual loss was 0.57%, and in group of RA patients 1.45% (p < 0.001).
In RA patients treated with GC significantly lower BMD in comparison with RA patients not taking these drug was found.
Conclusion Osteopenia defined as BMD below one standard deviation from the corresponding young adult normal value was found in 26% of RA patients aged 40–49 and in 45% RA patients aged 50–59.
In conclusion this study has confirmed that the disease itself, therapy with glucocorticoids and oestrogen deficiency during menopause influence bone loss in RA patients.
- rheumatoid arthritis
- bone mineral density
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