Periarticular osteoporosis of the forearm correlated with joint destruction and functional impairment in patients with rheumatoid arthritis
Periarticular osteoporosis of the forearm correlated with joint destruction and functional impairment in patients with rheumatoid arthritis
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DOI：
10.1007/s00198-015-3256-1
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发表时间：
2016-02-01
影响因子：
4
通讯作者：
Matsuda, S.
中科院分区：
文献类型：
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作者：
Iwata, T.;Ito, H.;Matsuda, S.
类风湿关节炎（RA）患者前臂远端关节周围骨质疏松症与关节破坏或功能损害之间的关系尚不清楚。从一项单一的机构队列研究中，我们发现前臂关节周围骨密度（BMD）与关节破坏或功能损害之间存在很强的相关性。本研究旨在探讨(1)前臂不同关节周围感兴趣区域（ROIs）骨密度的差异，(2)前臂关节周围骨密度与关节破坏和身体功能的相关性，(3)预测前臂骨密度的自变量，(4)RA早期不同ROIs的前臂骨密度。方法在RA队列中进行横断面研究。测量包括前臂远端骨密度，用改良夏普总分（mTSS）评估手部关节破坏，用健康评估问卷（HAQ）评估功能障碍，以及其他临床数据。采用相关分析和逐步回归分析分析影响前臂骨密度值的变量。结果在本研究纳入的405例患者中，370例（平均年龄62.9岁）被确定为具有完整数据集的明确RA。前臂远端骨密度（BMDud）与前臂远端三分之一骨密度（BMD1/3）相比显著降低。在逐步回归分析中，bmd /3患者的mTSS是独立预测变量，而年龄和与上肢相关的部分HAQ评分是BMDud和bmd /3患者的常见自变量。即使在病程较短的患者中，BMDud也明显小于BMD1/3。病程短的患者，非缓解组bmd /3明显低于缓解组。结论前臂远端关节周骨密度与RA的关节破坏和功能损害密切相关。在该病的临床表现时，前臂远端关节周围骨密度可能已经降低。
The relationship between periarticular osteoporosis in the distal forearm and joint destruction or functional impairment in patients with rheumatoid arthritis (RA) is not sufficiently elucidated. From a single institutional cohort study, we found a strong correlation between periarticular forearm bone mineral density (BMD) and joint destruction or functional impairment.Introduction This study was conducted to investigate (1) the difference between various periarticular regions of interest (ROIs) of BMD of the forearm, (2) the correlation between periarticular forearm BMD and joint destruction and physical function, (3) the independent variables for predicting BMD of the forearm, and (4) the forearm BMD of different ROIs in the early stage of RA.Methods We conducted a cross-sectional study in an RA cohort. Measurements included BMD of the distal forearm, joint destruction of the hands assessed by modified total Sharp score (mTSS), functional impairment assessed by a health assessment questionnaire (HAQ), and other clinical data. Variables affecting the forearm BMD values were analyzed by correlation and stepwise regression analyses.Results Of the 405 patients enrolled in the present study, 370 (average age; 62.9 years) were identified as having definite RA with a complete set of data. BMD in the distal end of the forearm (BMDud) was significantly reduced compared with that in the distal third of the forearm (BMD1/3). In a stepwise regression analysis, the mTSS in BMD1/3 was an independent predicting variable, while age and partial HAQ scores associated with the upper extremity were common independent variables in BMDud and BMD1/3. BMDud was significantly less than BMD1/3, even in patients with a short duration of the disease. BMD1/3 was significantly less in non-remission group compared with that in remission group in patients with a short duration of the disease.Conclusion Periarticular BMD in the distal forearm is closely correlated with joint destruction and functional impairment in RA. Periarticular BMD in the distal forearm may be already reduced at the clinical manifestation of the disease.