Association of general osteoporosis and local bone erosion in patients with rheumatoid arthritis
10.3760/cma.j.issn.1007-7480.2012.10.007
- VernacularTitle:类风湿关节炎患者全身骨质疏松和局部骨侵蚀的关系研究
- Author:
Juan DENG
;
Biwei PEI
;
Shengqian XU
;
Tong LIU
;
Chen CHEN
;
Jianhua XU
- Publication Type:Journal Article
- Keywords:
Arthritis,rheumatoid;
Osteoporosis;
Sharp score
- From:
Chinese Journal of Rheumatology
2012;16(10):674-678
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between the general osteoporosis and local bone erosion in patients with rheumatoid arthritis (RA).Methods Bone mineral density (BMD) of femur (femur neck,Ward area,greater trochanter) and lumbar spine 2-4 (L2-4) by dual energy X-ray absorptiometry was measured in 120 patients with RA and 120 normal controls.All the clinical and laboratory factors of RA were recorded in details,and the radiographic changes in both hands of 76 RA patients were assessed by Sharp'method.Statistical anylysis was carried out by using t test and x2 test.Results ① Compared with normal controls,the BMD of total femur,L2,L3,L4 and L2-4 decreased significantly (P＜0.01),while there was no significant differences in the BMD of femur neck,Ward area and greater trochanter between the two groups (P＞0.05).② The incidence of osteoporosis in RA (34.2％) was higher than that in normal controls (15.0％)(x2=11.889,P=0.001).③ Patients with osteoporosis had elder age,higher scores of HAQ,higher scores of space narrowing and bone erosion of joint by X-ray' Sharp method than those of patients without osteoporosis.There were no significant differences in the changes of other clinical and laboratory parameters between the two groups(P＞0.05).④ BMD of total femur,femur neck,Ward area,greater trochanter,L2,L3,L4 correlated with Sharp scores in RA and had shown a negative correlations(P＜0.05).Logistic regression analysis showed that age(OR=1.069,P=0.012,95％CI:1.015-1.125) and Sharp scores(OR=1.022,P=0.003,95％CI:1.007-1.037) were risk factors for osteoporosis in RA patients,but treating with DMARD (OR=0.172,P=0.041,95％CI:0.032-0.930) was a protective factor for osteoporosis in patients with RA.Conclusion The BMD decreases significantly and correlates with age and local bone erosion in patients with RA,while the incidence of osteoporsis increases remarkably.
