Background Rheumatoid arthritis (RA) is a systemic and chronic inflammatory disease that has been associated with disability and several extra-articular complications such us generalised osteoporosis.
Objectives To quantify the bone mineral density (BMD) and to evaluate frequency of osteoporosis in non-menopausal women. To examine variables associated with low BMD in patients with RA.
Methods Transversal study based on a group of 130 non-menopausal women with RA. All the patients fulfilled the 1987 criteria of the American College of Rheumatology for RA diagnosis. The dual-energy X ray absorptiometry (DXA) method (Hologic QDR 2000) was used to measure BMD in the anteroposterior lumbar spine (L1-L4) and left hip, and clinical data were collected. The results are compared with those of the control group made of 116 non-menopausal healthy women.
Results The mean age of the patients was 38.4±8.2 years and the body mass index (BMI) was 25.2±5.8 kg/m2. The median disease duration was 8.2±6.3 years. The mean disease activity score (DAS28) was 4.42±1.3, and mean Health Assessment Questionnaire score (HAQ) was 0.989±0.79. 91.2% of our patients take an average of 6.2±4 mg/day of corticosteroids whereas 82% of our patients take DMARDs. The mean values of the spine and hip BMD are respectively of 0.927±0.13 g/cm2 and 0.845±0.13 g/cm2, they’re inferior to those of the control group which mean values are respectively of 0.983±0.11 g/cm2 and 0.916±0.11 g/cm2 (p<0.0002, p<9.10-6).The prevalence of osteoporosis at lumbar spine and hip are respectively 6.9% and 12%. Osteopenia occurred in 33.8% at lumbar spine and 27% at total hip. Bivariate analysis demonstrated that several factors such as BMI, disease duration, HAQ score, joint damage (modified Sharp score), and cumulative corticosteroid dose were correlated with low BMD at both measurement sites. However, multivariate analysis reveal that the low BMI were associated with low BMD at both hip and spine. In addition, disease activity and level of disability were an important determinant of hip BMD.
Conclusions This study suggests the magnitude of the osteoporosis problem in female RA population and confirms the BMD reduction in RA, independently of the menopause and current use of corticosteroids.
Disclosure of Interest None Declared
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