Generalized Osteoporosis in Korean Rheumatoid Arthritis Patients.
- Author:
Yeong Shil JOO
1
;
Shin Seok LEE
;
Wan Uk KIM
;
Jun Ki MIN
;
Sung Hwan PARK
;
Yeon Sik HONG
;
Sang Heon LEE
;
Chul Soo CHO
;
Ho Youn KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Catholic University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Generalized osteoporosis;
Bone mineral density;
Rheumatoid arthritis;
Bone metabolism
- MeSH:
Absorptiometry, Photon;
Alkaline Phosphatase;
Arthritis, Rheumatoid*;
Body Mass Index;
Bone Density;
Bone Diseases, Metabolic;
Female;
Femur;
Femur Neck;
Humans;
Menopause;
Metabolism;
Osteocalcin;
Osteoporosis*;
Osteoporotic Fractures;
Postmenopause;
Rheumatoid Factor
- From:The Journal of the Korean Rheumatism Association
2000;7(1):32-42
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: To assess the extent of generalized osteoporosis in Korean rheumatoid arthritis patients and evaluate the importance of disease activity, duration of disease, menopausal status, corticosteroid use and markers of bone metabolism. METHODS: Bone mineral density was measured by dual energy x-ray absorptiometry (DEXA) at 3 locations in 134 rheumatoid arthritis patients, aged 21~80 (57 premenopausal and 66 postmenopausal patients). Markers of bone metabolism were measured and assessed in relation to the disease activity and corticosteroid use. RESULTS: The mean age of the study population was 49 years and mean age of the menopause was 48.1+/-3.6 years. Decreased bone mineral density was observed at all 3 locations measured in the study population (Z-score -0.36, -0.14 and -0.66 for BMD of L-spine, femoral neck and femur Ward? triangle respectively). Fifty nine percent of the patients showed osteopenia (T-score <-1) and 13.4% showed T-score lower than -2.5. The best independent predictors of bone mass (stepweise multiple regression analysis) was body mass index, cortocosteroid use, and CRP in premenopausal patients and years post menopause, age, alkaline phosphatase and rheumatoid factor in postmenopausal patients. Urinary excretion of deoxypyridinoline was increased in both pre- and postmonopausal RA patients while serum osteocalcin level was normal in both groups. Deoxypyridinoline level was significantly correlated with CRP in premenopausal RA patients. CONCLUSION: Generalized osteoporosis is also prevalent in Korean rheumatoid arthritis patients. Bone metabolism appears to be uncoupled. Deoxypyridinoline correlated best with CRP and thus can provide a rational approach for selecting and treating patients with RA to reduce the risk of osteoporotic fracture.
