The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis.
The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis.
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DOI：
10.1186/s12891-016-0952-8
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发表时间：
2016-02-24
影响因子：
2.3
通讯作者：
Bae SC
中科院分区：
文献类型：
--
作者：
Lee JH;Sung YK;Choi CB;Cho SK;Bang SY;Choe JY;Hong SJ;Jun JB;Kim TH;Lee J;Lee HS;Yoo DH;Yoon BY;Bae SC
本研究的目的是调查类风湿关节炎（RA）患者骨质疏松症的患病率，并使用韩国关节炎观察研究网络（KORONA）数据库分析这些患者的危险因素。在2009年7月至2011年12月期间招募的KORONA RA患者中，本研究纳入了自KORONA入组后1年内具有骨矿物质密度（BMD）结果的绝经后女性。比较三组患者的基线特征，由BMD结果定义。根据年龄和性别亚组计算研究患者的BMD测量率和骨质疏松症患病率。采用多因素Logistic回归分析探讨骨质疏松症与人口统计学和疾病相关危险因素的关系。在1322例绝经后女性RA患者中，619例（46.8%）患者在研究入组前1年内测量了BMD，属于骨质疏松组（T评分≤-2.5 SD）。RA合并骨质疏松患者的既往骨折发生率高于其他组，尤其是股骨骨折（p = 0.004）和腕关节骨折（p = 0.042）。高龄（≥70岁; OR = 2.28，95%CI：1.40-3.58），较低的体重指数（<25; OR = 2.14，95%CI：1.52-3.02），病程较长（≥10年; OR = 1.46，95% CI：1.07-2.00），糖皮质激素累积剂量较高（OR = 1.03，95%CI：1.01-1.05）、健康评估问卷评分高（OR = 1.37，95%CI：1.11-1.69）是骨质疏松的独立危险因素。入组KORONA队列的RA患者中有很大比例（90.8%）患有骨质疏松症和骨质减少症。然而，尽管骨折的高危人群，该人群的BMD测量率仍然很低。
The aim of this study was to investigate the prevalence of osteoporosis in rheumatoid arthritis (RA) patients and to analyze the risk factors in these patients using the KORean Observational study Network for Arthritis (KORONA) database. Among the RA patients in the KORONA who were recruited between July 2009 and December 2011, postmenopausal women with bone mineral density (BMD) results within one year from the time of KORONA enrollment were included in this study. The baseline characteristics of patients in three groups, defined by BMD results, were compared. The BMD measurement rates and prevalence of osteoporosis in the study patients were calculated in accordance with age and gender subgroups. Multivariable logistic regression analysis was used to explore the association between osteoporosis and demographics and disease-related risk factors. Of 1322 postmenopausal woman patients with RA in whom BMD was measured within one year of study enrollment, 619 patients (46.8 %) were in the osteoporosis group (T-score ≤ −2.5 SD). RA patients with osteoporosis had a higher frequency of previous fractures than those in other groups, especially fractures of the femur (p = 0.004) and wrist (p = 0.042). Advanced age (≥70 years; OR = 2.28, 95 % CI: 1.40–3.58), lower body mass index (<25; OR = 2.14, 95 % CI:1.52–3.02), longer disease duration (≥10 years; OR = 1.46, 95 % CI: 1.07–2.00), higher cumulative glucocorticoid dose (OR = 1.03, 95 % CI: 1.01–1.05), and higher Health Assessment Questionnaire score (OR = 1.37, 95 % CI:1.11–1.69) were independent risk factors for osteoporosis. A large percentage (90.8 %) of RA patients enrolled in the KORONA cohort had osteoporosis and osteopenia. Nevertheless, BMD measurement rates in this population remained low, despite high risk groups of fractures.